A holistic preventive pediatric dentistry approach providing treatment of primary and young permanent teeth, fissure sealants and topical fluoride applications.
Indication
- Treatment of dental caries (cariogenic lesion) in primary and permanent teeth
- Early childhood caries
- Prevention of occlusion and space loss problems
- Trauma-related primary or permanent tooth injuries
- Fissure sealant application in children at high caries risk
- Strengthening enamel with topical fluoride
- Primary tooth pulp treatment (pulpotomy, pulpectomy) and protective crown when needed
Preparation
- Behavioral assessment of the child and dentist adaptation (tell-show-do approach)
- Clinical examination and, when needed, periapical/panoramic radiography
- Caries risk assessment and a nutrition/oral hygiene questionnaire
- Pre-procedure information and consent for the family
- Evaluation of sedation or general anesthesia options in children with high anxiety
How it's performed
- The treatment principle in primary teeth is to preserve the tooth so that the permanent tooth can erupt with adequate space
- Local anesthesia (initiated with topical anesthesia when needed)
- Carious tissue is cleaned and restored with an appropriate material such as glass ionomer or composite
- In pulpal involvement, pulpotomy or pulpectomy is performed; in advanced cases, a stainless steel crown is placed
- Fissure sealant: a thin protective resin is applied to the chewing surfaces of the back teeth
- Topical fluoride: applied to the enamel as gel, varnish or foam to increase caries resistance
- A space maintainer is placed when needed to prevent space loss
Post-procedure
- Warning not to eat or bite the lip until the anesthesia wears off in the first 1-2 hours
- Care with chewing for 24 hours after restoration
- Brushing twice daily with age-appropriate fluoride toothpaste
- Reducing the consumption of sugary snacks and beverages
- Routine dental check-up every 6 months and fluoride application as needed
- Regular evaluation of sealants and renewal when needed
Risks
- Temporary tooth sensitivity after restoration
- Possibility of failure of primary tooth pulp treatments and early tooth loss
- Prolonged treatment due to lack of cooperation from the child
- Lip/cheek biting due to local anesthesia
- Development of new caries with insufficient hygiene after treatment
FAQ
Why is treating primary teeth important?
Primary teeth have roles in speech, chewing and preparing space for permanent teeth. Early loss may cause problems with the eruption of permanent teeth.
What is a fissure sealant and to whom is it applied?
A sealant is the application of a thin resin coating to the deep grooves on the chewing surfaces of the back teeth. It is generally used to prevent caries in children aged 6-14.
Is topical fluoride application safe?
It is safe when performed at appropriate doses under physician supervision. It can be repeated at intervals of 3-12 months depending on caries risk.
My child is afraid of the dentist; what can be done?
In pedodontics, behavior management techniques (tell-show-do), nitrous oxide sedation or, in necessary cases, general anesthesia options can be considered.
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