Pediatric Dentistry is the area of ​​dentistry that promotes oral health in babies, children, adolescents and patients with special needs. The pediatric dentist’s mission is to provide both preventive and therapeutic care. This way we stimulate the development of children with beautiful and healthy smiles.


When does tooth development begin?

The milk or temporary teeth begin to form during the first trimester of pregnancy and the adult or permanent teeth during the second trimester. In this way, any disorder that occurs in terms of the health of a pregnant woman can cause disturbances in terms of both dentitions. Some medications are included, such as tetracyclines, which may cause color or formation changes.


When should the first visit to the pediatric dentist be made?

The first visit should be carried out when the first temporary tooth erupts, around 6 months of age. In this first consultation, an examination of the oral cavity should be carried out and guidelines provided to parents/guardians on measures for the prevention and promotion of oral health and nutritional advice.

The second visit should take place around 2 ½ – 3 years of age, when it is verified that all the baby teeth have erupted. The purpose of this consultation will be to observe the development of all orofacial structures and to verify the existence of pathologies, such as dental caries. As noted, adjustments will be made to the guidelines and implementation of preventive care, both at home and in the dental office. From this consultation, the pediatric dentist will decide the frequency of subsequent consultations, depending on the risk assessment and dental caries activity.


When does the first milk tooth appear in the oral cavity?

The first milk tooth appears between 6 and 8 months of age and around 3 years of age, the eruption of the 20 teeth that complete the temporary dentition should take place. It should be noted that there are small individual variations in terms of eruptive timing, which are often attributed to genetic influences. However, if, around 12 months of age, the child does not have any erupted teeth, he should consult a pediatric dentist.


What symptoms can be associated with erupting baby teeth and how can I alleviate them?

Symptoms that arise with the eruption of the first teeth are: gingival inflammation (swelling and reddish gums), hypersalivation (increased amount of saliva), anxiety and restlessness, changing nutritional habits, lack of appetite and difficulty sleeping. The intensity of these symptoms is usually moderate. If fever, vomiting or diarrhea develops, consult your pediatrician.

In order to alleviate the symptoms, you should clean the gums with wet gauze 2 to 3 times a day, put a specific gel on the gums, prescribed by the pediatrician or pediatric dentist, and provide cooled teethers.


When do permanent teeth come in?

The eruption of the permanent dentition undergoes greater variability as a result of the influence of hormonal factors and sex differences. It is generally assumed that the first permanent tooth to erupt is the first permanent molar. It appears around 6 years of age and behind the second temporary molar. As no milk tooth “falls out”, the parents/guardians and even the child may not realize it. The permanent dentition is complete in the oral cavity by the age of 14, with the exception of the permanent third molar or wisdom tooth.


Should the child use a pacifier?

The pacifier satisfies the child’s sucking need in the first years of life. Its use prevents the habit of digital or lingual suction or even other objects. Therefore, the pacifier is preferable as its use can be stopped more easily and generally causes less disturbance in the development of orofacial structures.


When should pacifier use be stopped?

If alterations in the development of the jaws are observed, these will be self-corrected, if the use of a pacifier or the habit of digital sucking is abandoned before 4 years of age. However, if these habits are maintained, it is possible that these changes become permanent and difficult to correct. Therefore, you should consult a pediatric dentist who will advise you on the treatment and cessation of these habits.


What precautions should I take regarding my son/daughter’s nutrition?

Healthy nutritional habits must be acquired during the first years of life. Therefore, the choice of foods and the acquisition of healthy habits in children are very important. Foods that have large amounts of sugar should be avoided and you should not put sugar in food or drinks that are ingested.

If the child needs to eat food/snacks between meals, sugary foods such as chewing gum, sweets, biscuits, soft drinks and fruit juices that contain sugar should be avoided. It is therefore recommended to eat vegetables, fruit, unsweetened fruit juices and cheese.

Bad nutritional habits lead to the appearance of lesions due to dental caries, as is the case of nightly ingestion of milk through a bottle and the consequent appearance of early childhood caries.


What is early childhood caries?

Early childhood caries is defined as any stage of caries lesion on any surface of temporary teeth, in a child up to 71 months of age.

Nocturnal ingestion of milk from a bottle is one of the most common causes of early childhood caries. During sleep, the amount of saliva decreases and milk, or any other food ingested before falling asleep, remains on the dental surfaces, causing the appearance of caries lesions. Therefore, only milk or water should be placed in the bottle and its intake should be during the day and not during sleep. Juice or other liquids should not be put in the bottle, a spoon should be used for this, until the child is able to drink from a glass.

Never give the child a pacifier dipped in sugar or honey.


How should oral hygiene be done in children?

Prior to tooth eruption, hygiene of the oral cavity should be carried out with a compress moistened with water or saline, to promote cleaning of the gums, after each meal.

After the appearance of the first teeth, maintain the hygiene of the gums with the compress and use a brush with a suitable size and toothpaste to clean the teeth after each meal.


Why are baby teeth important?

Baby teeth perform important functions such as aesthetics, chewing, swallowing, speech and maintenance of spaces for the correct eruption of permanent teeth.

A lesion caused by caries in a baby tooth and consequent abscess, when not treated, can influence the child’s health and cause pain and sometimes fever.

Premature loss of baby teeth can cause:

– Changes in phonetics and speech difficulties

– Occlusal and functional problems, consequent lack of space for the eruption of permanent teeth and incorrect development of the jaws

– Aesthetic changes that compromise the child’s social behavior


What is fluorine?

Fluoride is a compound that makes teeth more resistant to tooth decay. It should be administered in adequate amounts according to age, geographic area and diet. For this reason, you should consult a pediatric dentist to be informed about the correct dosage and method of fluoride application, according to the child’s needs.


How should I act in case of dental trauma?

in milk teeth

During the first years of life, when the child begins to explore the world around him, there is a greater propensity for falls and consequent dental trauma. When an injury occurs to the baby tooth, the permanent tooth may be compromised aesthetically (“stain” or deformation of the crown of the tooth). In case of avulsion of the milk tooth, it should not be reimplanted.

After the trauma, you should always consult a pediatric dentist so that a clinical and radiographic examination can be carried out, treatment if necessary and advice on the care to be taken.


In the permanent dentition

Whatever the type of trauma that occurred, you should always consult the pediatric dentist for a physical and radiographic examination and to know what precautions to take.

If a partial fracture or avulsion of the tooth has occurred, you should:

  1. Look for the fragment or complete tooth and hold it by the crown (white part) and not by the root (yellow part);
  2. Reimplant the fragment or tooth immediately, if possible;
  3. In case of contamination of the tooth, rinse the fragment or tooth under tap water and reimplant it;
  4. Keep the fragment or tooth in position with the aid of a pocket handkerchief and immediately go to a dental office;
  5. If it is not possible to reimplant the fragment or tooth, transport it in milk or serum. If milk or serum is not available, carry the fragment or tooth in the child’s oral cavity (between the cheek and the gum);
  6. Look for an odontopediatrician or dentist urgently.


In both dentitions

If the child performs contact sports such as rugby, hockey, karate, cycling, skateboarding or any other activity where there is a likelihood of trauma to the face, additional protection with a helmet and/or mouth guard should be used.