Pediatric Dentistry

• Fluoride Treatment
• Pit and Fissure Sealants
• Filling for Baby and Permanent Teeth
• Scaling (Teeth Cleaning)
• Root Canal Treatment for Baby Teeth
• Extraction of Baby and Permanent Teeth
• Pediatric Crowns

Fluoride helps prevent cavities in three ways:
1.1 Strengthening the enamel before and after teeth emerge.
1.2 Encouraging remineralization of enamel and preventing mineral loss.
1.3 Inhibiting bacterial activity that causes cavities.อไรด์ยังช่วยยับยั้งการย่อยสลายอาหารของเชื้อจุลินทรีย์ที่ทำให้ฟันผุ

Types of Fluoride Treatment
1.Fluoride Gel

• Recommended for children 6 years and older
• Reduces cavities in permanent teeth by 28% and in baby teeth by 20%
• Applied using a fluoride tray for 4 minutes under dentist supervision

2.Fluoride Varnish

• Ideal for children under 6 years old or those at high risk for cavities
• Helps stop early tooth decay (white spot lesions)
• Prevents cavities by 46% in permanent teeth and 33% in baby teeth
• Applied with a brush, focusing on high-risk areas

After Fluoride Varnish Application:

• Avoid eating or drinking for 30 minutes
• Avoid hard foods for 2 hours
• Do not brush teeth for 1 night

Sealants use a polymer-based material to cover deep grooves in molars, preventing cavities and making teeth easier to clean.

Who Needs Sealants?
Children aged 6-12 years with deep molars at risk for decay

Procedure:

• Teeth are cleaned and dried
• An etching solution is applied for better adhesion
• The sealant is placed and cured with light

Benefits:

• Prevents cavities in deep grooves
• Stops early-stage decay from progressing

Aftercare:

• Avoid biting hard foods
• Maintain good oral hygiene
• Visit the dentist every 6 months for check-ups

Dental fillings are a restorative procedure used to repair teeth that have lost structure due to cavities or other damage. Tooth decay can occur as early as six months old, when a baby’s first teeth begin to erupt. Since the enamel on baby teeth is about half as thick as that of permanent teeth, they are more prone to cavities, especially upper front teeth and molars, which are harder to clean.

Stages of Tooth Decay

• Early Stage – White spots appear on the enamel, but no symptoms are noticeable.
• Cavities in Enamel and Dentin – The decay progresses, forming holes in the tooth. At this stage, children may experience sensitivity or pain, especially when food gets stuck.

The materials used for dental fillings include:

• Amalgam Filling – A silver-colored metal filling used only for back teeth. The dentist must grind the tooth into a box-like shape to secure the material. After the filling is applied, it is generally recommended to avoid chewing on the treated side for 24 hours to allow the amalgam to fully harden.
• Tooth-colored fillings – These include:
  – Composite resin filling – A material that closely matches the natural color of teeth and can be used for both front and back teeth. It is popular among patients seeking an aesthetic option. This material hardens through exposure to a dental curing light and requires a bonding agent to adhere to the tooth structure.
  – Glass ionomer filling (GI) – A tooth-colored filling material that is less durable than composite resin. It bonds chemically to the tooth and releases fluoride, making it a popular choice for children’s fillings.
• Temporary filling – Used to cover and protect the tooth temporarily (such as IRM or Cavit) while monitoring symptoms or waiting for further treatment. Temporary fillings are not meant for long-term use and will typically wear down, crack, or break within one to two months. They are only used as a short-term solution before permanent treatment is provided.

Children who develop tartar are often those who do not brush their teeth diligently or do not clean their teeth thoroughly enough. If tartar buildup in children is not removed, it will continue to accumulate, potentially leading to periodontal disease in adulthood.

This treatment is performed on primary teeth that have decayed deeply into the dental pulp, which can cause tooth pain, gum inflammation, and abscess formation. Pediatric dentists remove the infected dental pulp or inflamed tissue to preserve the primary tooth so it can function normally until the permanent tooth erupts. The treatment typically requires only 1-2 visits and includes placing a crown on the treated tooth to prevent further pain and ensure normal function.

Types of Primary Tooth Root Canal Treatment

1. Partial Pulpotomy
   This method is suitable for cases where the infection is limited to the pulp chamber. The child experiences little to no pain unless food gets stuck. The pediatric dentist removes only the affected portion of the pulp tissue.
2. Complete Pulpectomy
   This method is used when the infection has spread to the root canals, causing persistent tooth pain, particularly at night or for extended periods, even after food debris is removed. The pediatric dentist completely removes the infected tissue and fills the root canals to prevent further infection.

Procedure for Primary Tooth Root Canal Treatment

• The pediatric dentist takes an X-ray to assess the condition of the tooth, the extent of decay, and the root structure to determine whether root canal treatment is necessary.
• Local anesthesia is administered, and a rubber dam is placed to isolate the affected tooth from the others.
• The root canal is widened and cleaned using a disinfectant solution.
• The canals are then filled with a special root canal filling material.
• Finally, the opening is sealed with a temporary filling material.

The extraction of primary teeth can be categorized into three types:

Extraction of Retained Primary Teeth to Allow Permanent Teeth to Erupt
This procedure is performed when a primary tooth obstructs the eruption of a permanent tooth or fails to fall out even after the permanent tooth has begun to emerge. Pediatric dentists will assess and extract the problematic primary tooth to ensure that the permanent tooth erupts in the correct position.

Extraction of Severely Decayed Primary Teeth That Cannot Be Restored
When a primary tooth is extensively decayed and cannot be restored, the pediatric dentist evaluates whether it can still be saved. If the tooth cannot be preserved for any reason, the dentist may decide to extract it to prevent the infection from spreading to the underlying permanent tooth bud.

Extraction of Supernumerary Teeth (Extra Teeth)
In some cases, children may develop extra teeth beyond the normal set. These additional teeth can interfere with the eruption of permanent teeth or cause misalignment. When this occurs, the pediatric dentist will extract the extra tooth to allow the permanent teeth to emerge properly.

A pediatric crown or primary tooth crown is a dental procedure used to treat severe tooth decay in children when a filling is no longer a viable option due to extensive tooth structure loss. The crown, designed to resemble a natural tooth, is placed over the damaged tooth to restore its function. There are two main types of pediatric crowns:

Stainless Steel Crown (SSC)
A silver-colored crown made from stainless steel, also known as an “angel crown.” It is highly durable and resistant to wear. However, it lacks aesthetic appeal, especially when placed on front teeth or other visible areas.

Tooth-Colored Pediatric Crowns
These crowns are designed to blend seamlessly with natural teeth, providing a more aesthetically pleasing result. Common materials for these crowns include:

• Strip Crown: A tooth-colored composite resin crown that offers a natural look but is more prone to chipping or breaking.
• Polycarbonate Crown: A durable option that provides a balance between strength and aesthetics.
• Zirconia Crown: A highly durable and natural-looking ceramic crown known for its strength and longevity.

Advantages and Disadvantages of Dental Crowns
Dental crowns for children are a treatment option for severe tooth decay where the cavity is extensive and the remaining tooth structure is insufficient for a regular filling. This procedure is necessary when other restorative methods are not viable. However, it tends to be more expensive than fillings, takes longer to complete, and requires more tooth reduction. Additionally, there is a risk of affecting the dental pulp, with a probability ranging from 1% to 15%.