Children’s dental treatment – useful tips

Question: a three-year-old has holes in his teeth. We’ve been to the children’s dentists, but always unsuccessfully, either do nothing or go home with a measured gum, never repairing anything, because the little one is hysterically preventing repair. Now we were at the Institute of Stomatology for the last time, signing up for the general drug, but when we said the amount we had to pay, our hands hung again because there was no such money – €300 for the milk teeth of a three-year-old. What to do? What else are the options? I’ll wait for the answer. Thank you!

Says dentist Rūta Rastiņa:

Good afternoon.
Reading the question, I expected it to be longer. Probably concerned parents have thought about it, just haven’t asked: what to do to keep the little one’s teeth from spoiling in the future – neither milk nor permanent ones?

What if a child is scared of a dentist?

A three-year-old is not quite convinced to attend an event beyond his comprehension, which is fearful or just different from daily events. That’s what he feels like visiting a dentist.

If a child has never been taken to a dentist’s office (for example, when older children or parents go to a hygienist or doctor), then a little person HAS REASON TO express at least dislike. Especially if he gets “hurt” a little bit too.

The best thing would have been for the three-year-old to be taken to the dentist for the first time only as a visitor. Little would get to know the conditions, the facility, see the procedures, as well as that other people are not afraid. Then the little one would have a sense of security too. If the little one was excited with a chair, allowed to push a button, his fear would turn into curiosity, and it’s already a step closer TO a possible CONVERSATION with the child.

Doctors use different methods to collaborate with the small patient – looking into the baby’s mouth, seeing the teeth and assessing the damage.
EU here I talked about SITTING IN A CHAIR voluntarily, OPENING MY MOUTH VOLUNTARILY AND showing my teeth to a doctor. It can happen on both the first visit and the third, but it can never happen EITHER. Crucially, without rushing to achieve or undermine a child’s trust. Then, too, the therapeutic procedures slowly become acceptable to the little one.

If such an opportunity is missed, and the child doesn’t let up, doesn’t enter into any relationship with the medics, if the teeth are already hurting, you have to think about how to help him. Above all, so that the little heart does not tremble with fear and that the experience does not leave a huge trace of his psyche and memory.

First chance

If the child is healthy, doctors are taking PREMEDICATION with sedative medicines given to the child as a pill or candle usually 30 minutes before the procedure is performed. The child can then undergo procedures, is not asleep, but is sleepy and “docile.” Even if you cry, it doesn’t stick in his memory. The baby sits on the lap of an adult (mum, dad) who helps lock the baby’s hands and legs. A soft rubber “brick” is placed between the baby’s teeth, allowing him to keep his mouth open and access the sick tooth. The dentist and assistant have to work very quickly, sometimes even assistants are called in.

Always painful procedures are performed with anaesthesia (except if parents refuse). All doses of the drug are pre-determined according to the child’s weight, age and, if necessary, in coordination with the child’s physician (therapist) and anaesthetist.

Parents themselves, when preparing to take a child to a dentist, should under no circumstances give medication to a child unless they have been prescribed and prescribed by a doctor!

Second chance

It is and remains the general narcosis. This is usually meant for children whose physical or mental health condition does not permit normal manipulation, whose dental condition is critical, which on many occasions could not be persuaded and calmed to allow the dentist to work. You also need narcosis if your parents want it for reasons they know.

This, like every drug, is a serious measure. The child is examined and counselled by a paediatrician, an anaesthetist. Only with their conclusion is a drug performed by an anaesthetist.

The more teeth to repair, the longer the child is under narcosis. To reduce this time, more radical treatments are chosen many times compared to conventional treatment without narcosis (for example, the tooth is pulled out rather than sealed).

If a child has health indications for doing narcosis, it is likely that the expenses are paid.

If they are “just through teeth,” it must be said, it is and remains the fault of family traditions (eating, drinking, hygiene), beliefs, habits and ignorance.

I deliberately say “families” because a three-year-old is under no circumstances responsible for causing caries in the teeth. And by the word “family,” I mean all the adults close to the family who participate in raising and babysitting a child.

And here we’ve come to the unasked question:

• why holes have occurred in the teeth of a three-year-old child, and
• what do I do to avoid having more of them?

But before that, I’ll mention the third option, which the doctor will never recommend and which is even a shame to write, i.e. do nothing and make the baby go through all the tooth pain and welcome the new – permanent teeth that will only start to hatch around the age of 6. That’s what happens, unfortunately.

What is a carriage?

Caries is a local disease in the teeth caused by bacteria. Their existence requires carbohydrates (sugar, sweets, farinaceous foods, products rich in starch, fruits, berries, juices), which are nutrients for bacteria. They turn bacteria right there into acids in the mouth. Acids dissolve dental minerals and develop caries over time.

This is a simplified explanation of the mechanism of caries, which everyone knows from the age of kindergarten.

The longer and more frequent the acid exposure to tooth enamel (minerals soluble – this is called DEMINERALISATION), the faster the onset of caries can be expected. Especially when the demineralisation process takes precedence over the so-called REMINERALISATION process – the introduction of minerals back into the teeth from saliva. Saliva is as important to teeth as blood to tissues and organs. In order to maximise the saliva inflow for dental tissue, teeth must be unadulterated – clean!

How does milk tooth caries develop?

At first, the carriage is like a milky-white patch that quickly turns into chalky white. Then there are defects in the teeth tissue (parents say bits of the tooth fall out) a brown-pigmented, soft dentine (tissue that sits beneath the enamel) appears. Caries develop particularly rapidly in milk teeth, parents may not even notice the white spots. They usually only notice “blacks” on their teeth. Teeth start to crumble, break until only black and brown tooth roots remain visible. Anything described can go even within months.

Of course, at each of these stages of tooth decay, the teeth are in varying ways sensitive and painful. If there are many such lesions, they not only hurt, but also disrupt the child’s eating, thus developing. If teeth are pulled out, there are problems with sound making, permanent dental health, positioning and gritting. And ultimately it’s unaesthetic. No child deserves such teeth!

WHAT TO DO and WHAT NOT TO DO:

1. BRUSHING A CHILD’s TEETH and TEACHING THEM TO BRUSH THEIR TEETH for the child himself.

From infancy, start brushing your first teeth – initially with a “tipple”-like cleanser that Mum puts on her finger. Then, with a thimble that already has small fringes, then with a small brush and water, then add baby toothpaste (the size of a small pea) from the age of three – use ONLY baby PASTE containing FLUORINE!)

DO NOT USE ADULT TOOTHPASTES THAT CONTAIN TOO MUCH FLUORINE AND ARE NOT FOR CHILDREN!

From the age of three, a child should be taken to a hygienist and dentist for first control. Typically, by this age, teeth are controlled by parents and a hygienist. A visit by a hygienist is THEN MANDATORY at least every 6 months. Milk teeth too!

Children should be taught to use a toothbrush, have to clean their own teeth, but parents should CLEAN THEM AT least until the child’s school age. I believe that for longer, particularly good hygiene is all the more important during tooth changes.

The cleaner the teeth, the better the saliva will mineralise them and the stronger they will become against acid “attacks” in the future.

Visiting a dentist with a dental check and X-ray should become a constant tradition at least once a year.

2. RESTRICT THE USE OF SWEETS

Good is the Scandinavian-initiated “Sweet Sunday” method. Then the kid knows full well that there will be one day of sweets. BUT he also understands he’ll eat a healthy diet on other days of the week and won’t mess with sweets.

This method can be applied even to very young children, which by the way helps children’s parents maintain good teeth and beautiful bodies too!

3. DON’T GIVE YOUR CHILD SWEETS and NIBBLES BETWEEN MEALS

ABOUT JUICES

Yes, juices are not water!!! THEY ARE SWEET and should be considered a drink just like a wedge and lemonade! As well as the vitamins and minerals your child needs, they contain fruit sugars, sugar and acids! It damages your teeth!

“Is that why I won’t give my child apple juice from my garden?” – I hear my mothers and grandmothers say. Oh, yes, fathers too.

• I’ll give it, but with the mayor and at the meal! As a “food” (dessert), knowing all the benefits and downsides it can bring.
• I won’t give the juices between meals, the bastard in a small lightweight bottle and give it to the child as a drink of choice all day long (and, don’t God, all night long!!!).
• And I’ll also include all sweetened drinks in the juice queue, like teas, “sapphire,” lemonades, etc.

NIGHT FEEDING and DRINKING

1. … and now for feeding the night. For breastfed children, caries only arrive on the teeth from the mother’s milk the child gets how much and when they want through nights + days. Milk contains milk sugar and is also capable of causing caries.
2. Night drinks – they must not be sweetened! Neither juices nor tea with sugar ARE TO BE GIVEN AT NIGHT AS A DRINK FOR A CHILD.
   If you start giving them until your teeth have hatched, the child has disagreed with a less sweet drink when your teeth are already in your mouth.
3. Sweetness on the Nanny! This is now the great-grandmother method, which hopefully no mum uses anymore. I’ll tell you, for safety’s sake, that

• SWEETENING the BABY (e.g. with honey) IS A VERY GREAT SIN in relation to the baby’s teeth.
  It is the sweets at night and sweet drinks in bottles around the clock that produce the very rapidly developing caries (most often the front ones) in the milk teeth and quickly only the roots remain in place of the teeth.
• BISCUITS, CANDY
  If they are in the mouth between meals (meals are no more than 4-5 x a day), they damage the teeth because they contain carbohydrates, settle on the teeth as an application and serve even longer as soil for bacteria.

WHAT TO DO NOW

NOW your little baby has to suffer because something hasn’t quite gone right because of his feeding, drinking, brushing his teeth so far. You’ll see for yourself why it’s your little one that has damaged teeth.

Often it’s not just parents and grandparents, it’s nannies who find it easier to be a friend with a child, giving him a pleasantly delicious nibble. Look for who has been at the “fault” and change everything for the better!

NOW your baby needs to find and get to know HIS DENTIST, which will help him deal with the existing holes and look after the next baby’s dental health with his parents.

The milk teeth are secured by the doctor with fluorine-containing agents, coated with special “liquid seals” that prevent further damage to the teeth.

EVEN cardiac tooth roots can and should be strengthened and preserved to ensure the correct hatching and position of the child’s permanent teeth in the tooth row. Place crowns on very damaged milk teeth that maintain tooth function until tooth changes. A three-year-old baby still has to wait a long time for a milk tooth change to begin, so treating or not treating each existing tooth should be highly considered.

Prevention is always cheaper than treatment. If you start doing everything right now, you have quite a chance to wait (albeit statistically less than those who have had their milk teeth healthy) and keep healthy permanent teeth for your child.
What do I wish you and your child sincerely, too!

Respectfully,
Dr. Rūta Rastiņa.