A Child's Toothache

When your child complains of tooth pain , first try to get your child to show you exactly where the pain is coming from and get a little history about how long it's been hurting and possible causes.

The most common cause of dental pain is tooth decay, which is a bacteria-induced infection. Examine the tooth or teeth to see if there are any obvious brown spots or cavities (tiny holes), which will be more easily seen on the biting surfaces or between the teeth. Next, look at the gum surrounding the tooth and the nearby inner areas of the mouth to see if there are any sores or swelling. In the absence of a dental injury, a swelling could mean an abscess as a result of a nerve infection caused by tooth decay. 

Evaluate any tooth pain that keeps a child awake at night or persists into the next day, because it could indicate a dental problem that will only become worse if left untreated.

What follows are some helpful hints in the meantime until you take your child to dentist:-

1. If you don't see anything unusual, the next step is to help your child gently floss on either side of the hurting tooth. This may free a food particle or piece of candy that might be stuck, causing uncomfortable pressure. If discomfort is still evident, take steps to relieve your child's symptoms.
2. For temporary relief:-

• Give your child an over-the-counter pain reliever, such as ibuprofen or acetaminophen, to reduce the pain of the toothache for several hours.
• Apply an ice pack against the jaw, especially if there is swelling. Apply on the outside — on and off for a minute or two at a time, being careful not to burn the cheeks or soft tissues with the ice. If these two measures do not stop the pain, then you should consult your dentist immediately.

Under no circumstances should you rub aspirin (or any other painkiller) on your child's gum — it is very acidic and can cause burns, creating pain rather than relieving it. 

If there is no sign of tooth decay ask your child if there was a recent injury he or she neglected to mention. Look for obvious signs of trauma like chipped teeth or fractures. A blow or injury to a front tooth, for example, may not affect the lips or tongue, but may damage the tooth or nerve inside the tooth.

 Even if you are successful at relieving a toothache or other pain in the mouth,still make sure to visit dentist & get your check up done.

RECEDING GUMS IN CHILDREN

Children with bad brushing routines face dental problems much more serious than cavities. Periodontitis, a bacterial infection of the gums and tissues surrounding teeth, is the leading cause of tooth loss, according to the American Academy of Periodontology. The Academy states the majority of children have some level of gum disease. If left untreated, periodontitis can damage bone and loosen teeth.

Periodontal Disease

Gingivitis, which is the first stage of periodontal disease, is characterized by red, swollen gums that bleed easily during brushingChronic gingivitis commonly occurs in children. Gingivitis may progress to periodontal disease, characterized by bad breath and bleeding, swollen gums. The gums begin to recede, or pull back, from the teeth. The gums may recede so far as to expose the roots of the teeth. Aggressive periodontitis occurs in children who have no other health conditions and may affect only the molars and incisors, or it may be a general infection that involves the entire mouth. Children with generalized aggressive periodontitis tend to have heavy plaque and tartar buildup, whereas those with more local infection usually have little to no tartar on their teeth.
Causes

Poor oral hygiene resulting in an accumulation of plaque and bacteria causes periodontal disease and receding gums. Other factors contributing to gum disease include mouth breathing, which dries the gums and front teeth, a diet lacking in vitamin C, grinding teeth during sleep, a family tendency toward periodontitis and some medications. Chronic medical conditions, such as diabetes autoimmune diseases, and hormonal fluctuations also contribute to gum infections. Smoking and smokeless tobacco are risk factors for periodontal disease in teenagers.
Treatment

Treatment depends on the extent of disease and your child's age and overall health. Thorough plaque removal, usually involving deep cleaning beneath the gum line, is essential. Early, mild periodontitis responds to deep cleaning, but more extensive disease requires medication to eliminate the infection or surgery to reshape damaged tissue and bone.
Prevention

Good oral hygiene prevents receding gums and periodontal disease.. Adolescents tend to relax their oral hygiene habits because of lack of interest. Establishing regular brushing and flossing habits in young children helps to maintain healthy habits. Regular dental appointments for routine cleaning and periodontal examinations help to prevent plaque accumulation and catch gum disease in early stages. Check your child's mouth for tartar buildup, receding or bleeding gums and bad breath, which may be warning signs of gum disease.

Temper Tantrums in Children/Children Dentistry

Temper Tantrums in Children
Children Dentistry

Children Dentistry

Children, who display sudden fits of anger in public, create an embarrassing and annoying situation not just for their parents but also for others. Trying to calm a tot who is screaming on the top of her lung can make a saint run for cover but as parents you need to communicate no matter how tough your child is.

WHAT CAUSES TANTRUMS IN CHILDREN?

Children dentistry

Just like adult, children too have their good and bad days where they might be a little cranky, irritable and grumpy. This is as normal and natural to them as it may be to any other individual.Therefore,such behavious need not be put under microscope.However,if there are too many instances where the child is exhibiting negative behaviours consistently, so much so that it begins to emerge as a behaviour patterns,it needs to be explored. There could be external or internal factors that may cause the child to react in such a manner.

The home and school environment would be the two different places that need to be investigated in detail as they are the primary institutions from where maximum learning, both positive and negative,takes place.A negative home environment, where relationships between parents,grandparents and other relatives is troublesome,could contribute to the child’s stressed emotional state.His relationship with his friends,siblings and teachers would tell a lot. Very often,it is seen that temper tantrums are a means to seek attention,importance or gratification of needs. It could be his way of expressing his distress or a cry of help and so, it must be given immediate attention.

HOW TO TACKLE A TWO -YEAR OLD WITH A TEMPER TANTRUM?

Children dentistry

First of all,try to understand what is making child upset or cranky.A two year old will not be able to express his distress verbally.Therefore,you need to be very patient ant not lose your calm.Little cues could help you to figure out what he requires.Make sure he is well fed, is not sleep deprived and doesn't have a wet or a messy diaper,as these are the basic reasons that can keep the baby restless and uncomfortable.Also, a comfortable environment where the temperature is neither too hot nor too cold.Beyond these,one needs to look at the emotional signs-how much care& attention is being given to child,how much time are you giving him.These are important points that need to be looked into.Apart from this,the easiest & best way to deal with a baby's tantrums is to distract attention. A change of environment could help.Also,try and engage him with toys or any other activity that could divert his mind.

CHILDREN OFTEN HURT THEMSELVES DURING TANTRUMS.HOW CAN A PARENT HANDLE SUCH SITUATIONS?

Children dentistry

Keeping a watch on them is important. You need to be very careful that you don't pick up things that could be dangerous or knowingly or unknowingly indulge in behaviours that could be dangerous or knowingly or unknowingly indulge in behaviour’s that could be physically injurious. Remove all those sharp, risky things from your child's vicinity, if possible. Ignore his ill-behavior,but not the child!!!!!!!

WHEN SHOULD PARENTS NOT GIVE IN TO TANTRUMS?

 Children Dentistry

There is difference between pampering children and spoiling them. Children need love and affection and a certain fulfilment of their need and want to feel that emotion of love. However, when that becomes the only medium of expression & understanding and the demands & wants keep growing with your child putting increased amount of pressure to satisfy his wishes each and every time, it is a serious issue. It is at this time, that you need to realise that there is some unhealthy learning taking place which needs to be corrected immediately.

TIPS TO CONTAIN THE TANTRUMS IN CHILDREN?

Children Dentistry

• Remove him from the environment which is the source of the temper tantrums.
• Redirect his attention to another activity that is of interest to him.
• Avoid getting into arguments & debates with him at that very moment as he will most likely be unresponsive.
• Intervene before he is about to go out of control. Talk to the child right then only to prevent any further escalation of the mood.
• If you are about to enter a situation where you know that the chances of him throwing a temper tantrum are high, make sure you brief him about the rules in advance.

HOW CAN TEACHERS DEAL WITH TEMPER TANTRUMS IN SCHOOLS?

Children Dentistry

The behavioural pattern or the tendency remain the same .It is just the situation which changes, from the home to school.Therefore,the way of handling would also be the same. One difference that is seen is that children do not take their teachers as much for granted as they do their parents and therefore do not cross the extreme lines of bad behaviour. Due to this, we often hear that children who are ill-tempered at home are more civil in school. Before jumping to any conclusion, it is important that the teachers, like parents, try and talk to the child. Free and open communication could help in achieving an important breakthrough to understand the child’s pain and distress. Addressing his concerns and helping him work through his stress could almost immediately lead to a reduction in his negative behaviours. IN some cases, a negative reward could also lead to the change of behaviour from an unhealthy to a healthy one.

HOW TO DEAL WITH SEVERE TEMPER TANTRUMS IN CHILDREN?

Children Dentistry

If parents or teachers are unable to help the child, it is important that a professional’s help is sought. Children rebel at times and become more defiant to what is being communicated by parents and teachers but are more receptive to a neutral third party who could be a counsellor or a therapist.

HOW TO MANAGE A CHILD WHO THROWS A TEMPER TANTRUM IN PUBLIC?

Children Dentistry

If a child is misbehaving and goes out of control, it is important that the parents get hold of the child immediately and remove him from that place. Take the child to another room or outside where there is nobody and tell him that he will not go back or would have to go back home if he doesn’t conduct himself well. He has to calm down.

CAN OLDER SIBLINGS HELP IN DEFUSING THE YOUNGER ONE’S TANTRUM?

Children Dentistry

Sometimes, yes, if older sibling is mature and cooperative enough to understand the situation. Sometimes the older ones could add fuel to the fire too!!!!!!!

Children Dentistry

Is pacifiers useful for baby?/children dentistry

Pacifier
Children Dentistry

 Children Dentistry
A pacifier is an artificial nipple designed for infants in order to suck on for relaxation. Babies are recognized for sucking anything they get into their hands. Many suck their thumbs or fingers. Baby when Foetus commence sucking their thumb before they are born, so they have an intense desire for sucking. Requirement for sucking differs from baby to baby.
Pacifiers are known in different names in various countries.They are called  Dummy in United Kingdom, Australia and New Zealand.
Breast feeding is most effective way to calm infants after that the thumb or the finger may also be put into the mouth of the infant to get used as the pacifier.

Types of Pacifiers /Children Dentistry

Latex Pacifier
Children Dentistry

Silicone Pacifier
Children Dentistry

There are two main types of pacifier:

Latex Pacifier

• A latex pacifier is softer and more flexible than a silicone pacifier
• It wears out faster though
• It comes in different designs and colors

Silicone pacifier

• A silicone pacifier is firm and holds its shape longer
• It is easy to clean
• It is more durable than a later pacifier
• It comes in different designs and color

Good pacifier should have shield and handle as one piece and nipple must be knotted around back of the handle, it'll prevent nipple from falling. The shield should have air holes to prevent saliva from collecting behind it, that may cause irritation. Pacifiers should be simple to clean & easy to hold. Pacifiers come in several designs and sizes. Pacifier nipples come in various shapes like with long, short or flattened end. Baby may prefer a certain type.

Advantages of Pacifiers/children dentistry

• Pacifier help to calm the baby.
• Pacifiers help baby to settle to sleep
• Pacifier offer temporary distraction. If your baby is hungry, a pacifier may comfort the baby for few minutes. 
• Pacifier helps to soothe a fussy baby.

Disadvantages of Pacifiers/children Dentistry

• Long-term dummy use can bring about dental problems - dummies or thumb-sucking may result in problems as the teeth grow and develop, particularly if the child is still by using as a comfort when their permanent teeth are coming through. To correct these problems, the child may need to wear a temporary or fixed brace on their teeth for a year or two when they are older.
• Pacifier interfere with breast feeding
• Speech problems - using a dummy prevents babies from babbling, that's an essential part of learning to talk, and discourages toddlers from chatting, that they need to do to develop their language skills.
• Connection to stomach and various infections - dummy use may be associated with a greater risk of symptoms like vomiting, fever, diarrhoea, and colic, in addition to with the doctor being called to the home, and having to go into hospital.
• If lost during sleep, its absence can wake up the child and can make him cry. 
• Children who suck pacifiers may be more prone to ear infections (otitis media)
• Honey filled pacifiers  may lead to nursing bottle caries in children

Children Dentistry

Importance of brushing( teach your kids importance of brushing)/children dentistry

Children Dentistry

Teach your kids importance of brushing teeth
Children Dentistry

Mother are usually find running around their children to brush their teeth. Children are lazy and moms get tired after the daily runningaround. Till a particular age parents could make sure their children do things right. But after a certain stage it is practically unattainable and nor do young children appreciate the interference of parents. So, could possibly be the best way to enable your kids to be aware of the benefits of brushing are to set an example. Make your children aware of the significance of brushing.

Children Dentistry

If you brush well your own tooth will be whitened just like a pearl as well as fine needles to say you'll smile with full confidence. Self-confidence and personal worth are of utmost importance along with a perfect smile will simply help you enhance them. Regardless of what you are along with you share vibes that are energy waves and also the assessment of the body else also helps in order to determine your self. For those who have a proper dental hygiene you're certain to stay in the great publications from the other person. If you think teeth as well as dental care is not important or people don't bother about such particulars might be you need to reconsider. Everyone regardless of who's this always views dental hygiene once they evaluate a person like a individual.

Children Dentistry

Children Dentistry

Brushing your tooth is of utmost importance and could end up being that is the least you can do. You should clean your tooth twice daily. Dentists advise you to clean twice a day. Brushing twice is the minimum however thinking about additional factors such as rate of plaque development, incidence associated with caries and periodontal wellness your dentist can recommend you to brush more after that 2 times. The regularity of cleaning do matters but it is the proper technique which is very important. If you are cleaning twice or thrice but not using the proper method then your purpose of maintaining good oral hygiene defies. Clean as soon as in the morning after taking the breakfast every day and clean once from bedtime at night. Cleaning at night is very important simply because during the night when you rest and it has not really blown the food contaminants which are presently there within the mouth is going to be fermented through the germs in the mouth to create the actual acid and this will cause the decay of the tooth. At night when you are resting the spit movement is less. The actual personal cleaning home of spit is much less and as you aren't eating anything, the actual ingesting reflex also reduces. All of these elements add in and also the incidence of caries increases.

Children Dentistry

Eating healthy will also assist you to keep your teeth. Try to avoid carbonated beverages, for some research contain the declare that a tooth held in a carbonated consume can break down. If this sounds like the result soda pops have might be you would decide to reconsider. Brush your teeth following supper so that all the food contaminants which found refuge in the day could be abrogated. If you have the receded gum select a soft clean which means that your tooth is not set exposed to international germs. Gums contain the teeth in their place producing their own maintenance an absolute necessity. Additionally clean the actual language to remove stagnantly positioned germs. Clean teeth in sets so that the entire mouth is well cleaned. A toothbrush mind should be little in dimensions, the bristles should be inside a cross labyrinth to ensure the process ensures wholesome teeth

Children Dentistry

Clean twice a day not less than 3 to 4 minutes. Put the clean in an angel associated with 45 degrees. Make sure you clean the teeth all angels so you encounter wholesome as well as clean breath. Great toothpaste will enable you to get rid of oral plaque buildup, resist tooth decay, and take away unsightly stains brought on by coffee and tea and fresh inhale. When plaque forms at first glance of the teeth, this brings together with the sugar or even any food a person ate and then this particular powerful decaying mixture is the single reason for tooth decay. Good indications to visit your dentist is going to be bleeding gums, swollen gum area or tooth pain. When the trouble has developed well enough, it'll deform the shape of the tooth after which concentrate on the chewing gum. The actual gums deteriorate and therefore are then not capable of keeping one's teeth in position. Brush twice a day with regard to 3 minutes, consume a nutritious diet, as well as go to your dental professional whenever you have dental care issues

Children Dentistry

Children Dentistry

Bad Breath in Children

Bad Breath in children
children dentistry

Children detistry

Bad breath in children is one thing that isn't strange with regard to infants. It does happen although it happens sparingly. Generally, baby bad breath happens during the mornings when mouth usually is rested. Because the mouth is not used much, Therefore, the microorganisms that cause foul breath might invade the mouth as well as multiply with out inhibition. This occurs because there is  no saliva to defend the  mouth through harmful bacteria that is the root of foul breath.






How to treat bad breath in children/ children dentistry

Clean your child gum with wet cloth
Bad breath in children
Children Dentistry

1. If your child don't have teeth  yet,  clean his mouth with wet gauze or muslin cloth by gently rubbing the remnants of milk and other food items within the gums and mouth. By this way, he will not produce bad breath. Apart  from this, you should also try to check for any foreign objects within the baby’s mouth or throat. Any foreign object inside the baby’s mouth can cause bad breath in the infant.
2. If your child developed teeth, it is advisable to clean the teeth with a soft bristled brush , lightly scrub all the dirt away.It is important to remember to be gentle with your baby at all times so as not to irritate his gums and teeth if he has any.
3. When the bad breath continues without any no reason, you should look for his oral habits. Does he or she pull upon items that have the bad odor In the event that he is doing, make sure that the item that he fancies is always made clean. This should be done so that he'd not really imbibe the actual odor of the object.



Monitor your child when he brushes his teeth
Bad breath in children
Children dentistry

4. If you have done everything in your own capacity to eliminate the bad breath but still the baby has this, it is advisable to possess the doctor look at your child. Some inner situation may be at the office resulting in the bad breath for the child.

The doctor will need to check for sinus and tonsil problems that may be the probable cause of child bad breath. If you already did every thing and still the baby has a issue, it is best for the doctors to evaluate him simply to be sure that he is in good health.
Bad breath in children/children dentistry

What is Children dentistry/pediatric dentistry

Children dentistry

Proper Brushing Technique

Brushing Technique

Brushing technique

• Brush your teeth twice daily or after every meal.
• Change your brush in every three month
• Use soft toothy brush
• Proper tooth brushing for two mins is sufficient.Brushing technique

Proper brushing technique

kids dental care: Establish Good Brushing Habits From A Young Age/pediatric dentistry

Pediatric dentistry/children dentistry

Kid's Dental Care
pediatric dentistry/children dentistry

Guardian need to acquire entire details relating to safeguarding kid’s teeth to help make certain that their wards hold properly maintained teeth, and also make certain that no probabilities are taken when it comes to their kid’s dental care.  The very first factor that parents require to teach their children is to establish good brushing habits which is so essential to their getting forever healthy nice teeth.

Be aware that Candy Is Harmful For the Child’s Teeth 
Guardian need to to know and discover the most effective techniques known for protecting the child from baby bottle tooth decay and for suitable kid’s dental care realize the truth about candy and know why it could be harmful for their kid's dental health, much more as compared to some other food. You will discover many house hold  truths also as secrets that have to be known by parents that can support in keeping the kid’s mouth cavity totally free and these secrets requirements to get investigated and observed.

Cavities inside the kid’s mouth are every single parent’s nightmare. But, with appropriate information as well as well-timed kid’s dental care, a great deal of kids might be able to stay cavity cost-free, nearly. The biggest enemy "cavities "are bacteria that will make a habit of living, operating too as playing in the kid’s mouth. Very good kid’s dental care calls for the child getting taught also as taking oral hygiene seriously as it is going to prevent cavities from occurring given that, if bacteria is removed and there's no left  food for it to feed on, the battle will have been won.

Gurgians need to have the child to brush his or her own teeth, but for kid’s under 7, it might be the responsibility of the parents to brush their child’s teeth till the child has not learned to brushed his or her own teeth. kid’s dental care also demands that the parent ensures that the child has sufficient fluoride since that is the single most important factor for the  decrease in kid’s cavities as it helps in incorporating it into tooth enamel and thus efficiently resists acid attack.


Guardian should also be prepared for any kind of emergency. they should have through knowledge -" what need to be done in case of a child’s dental emergency such as when the child loses a tooth in an accident".

kid’s dental care as well as knowing how to stop dental injuries to the kid in addition to exactly what needs to be completed in situation associated with mishaps may possibly assist in saving the particular child’s tooth.

Realizing just about all there is to know regarding kid’s dental treatments need to assist educate mother and father that the whole child’s teeth, which includes its baby teeth, are very important. Numerous mothers and fathers might be unaware or even misinformed that infant the teeth are not as essential given that they is going to be replaced in time. This can be cannot be entirely true because infant teeth assist several essential capabilities, causing them to be just as important as the other teeth.

Overall, teaching the kid from a young age group every  basics associated with dental hygiene in addition to being knowledgeable about different risks and troubles associated with their teeth, and behaving in a manner that is preventive of these situations will assure that the kid’s dental care  provides effectively recently been addressed.

Child Dental Care Might Be Difficult but Important!!!!!/pediatric dentistry

Child Dental Care !!!
pediatric dentistry/children dentistry

Pediatric dentistry/children dentistry

Young kids almost never wish to brush their teeth as they do not understand the value of brushing .They will tend not to take some time from more pleasing activities. They usually avoid  till the parents help them to begin a habit which will continue the remainder of their existence. Generally there are lots of benefits for encouraging with child dental care. Several companies offer products for child dental care are making product packaging on toothpaste full of drawings , attractive images & cartoons which will capture the attention of kids. The tooth brushes designed for child dental care usually have exciting figures on the brush that remind them of their favourite movie, cartoon character &toys.

Child dental care depends upon building the correct routine. This suggests that your children must brush their teeth with a toothbrush and toothpaste. The children have to make sure that they do not just go through the motions. They should brush thoroughly and carefully to brush each tooth properly. Parents should keep an eye on the progress for a while or regularly to ensure good care. Children must brush their teeth each and every morning after breakfast, plus  they need to brush again after their dinner .

Correct Child Dental Care Demands Nutritious diet and visits to the Dentists

A healthy diet will save money and help avoid pain for the children in the family. A good diet will certainly promote healthy gums and teeth. The children in the family should avoid sweets which may cause cavities and also other problems. The children should brush their teeth or rinse out their mouths whenever they have some sweets. The diet with lots of vegetables and fruit will provide the minerals and vitamins essential for good dental and overall health. The family must ensure their children follow the nutritional information given by health care professionals.

Good child dental care ought to include regular visits to your dentist. Several dentists highly recommend visits every 6 months for cleaning and evaluation by dental care experts. The dentist will probably study the teeth and will also be able to judge the quality of the daily routine of each one . The dentist would suggest modifications if required. The dental hygienist will perform a cleaningof the bareas of teeth which the patient may have missed during the daily routine. The dentist may take some x-rays to check on for just about any issues that aren't noticeable in the regular evaluation.  

Endodontic treatment in children/pediatric dentistry

Pediatric dentistry/children dentistry
No aspect of treatment in pediatric dentistry has been as controversial as endodontic treatment in children.

Endodontic treatment in children  involves the pulp of a teeth. The pulp contains the tooth nerve. It also contains blood vessels that provide the tooth o2 as well as nutrition. When the pulp is injured or infected, endodontic treatment is often done to make an effort to save the tooth

Endodontic treatment in children:-Pediatric dentistry/children dentistry

Endodontics in children is more challenging & difficult than adult due to the following reasons:-

1. Behaviour management problems in children
2. Limited mouth opening
3. Complexities of the root canal system such as presence of fine & tortuous canals,accessory canals,lateral canals,anastomoses etc in primary molars.
4. danger of injuring the permanent tooth bud.

How ever ,these can be overcome with patience, skill & considerable clinical acumen

Objectives of Endodontic Treatment in children:-Pediatric dentistry/children dentistry

1. Successful treatment of cariously involved pulp
2. Maintaining the tooth in the oral cavity in non-pathogenic & healthy condition
3. Endodontically treated teeth should help in mastication & serve as natural space maintainers.
4. Their retention in the mouth helps in speech
5. Guidance of developing dentition provided by the primary teeth.

Need of endodontic treatment in children:

1. Very important teeth such as primary second molar,when first permanent molar has not reupted or there is absence of the succedaneous tooth.
2. Tooth with is very sensitive to temperature chance
3. Has a broken tooth with exposed pulp

Contraindications For Endodontic treatment in children:-Pediatric dentistry/children dentistry

1. Furcation involvement due to caries
2. Severe mobility due to infection
3. Mobility due to physiologic root resorption

Other factors to be Considered:-Pediatric dentistry/children dentistry

1. The tooth has a good chance to remain in the oral cavity.
2. Endodontic Preservation should have more advantageous than extraction.
3. Level of patients cooperation
4. Parental desire
5. Level of caries activity of the child & over all prognosis.

Pulp therapy in Children's teeth can be classified as:-

Vital pulp therapy

Indirect pulp capping
Direct pulp capping
Pulpotomy
Apexogenesis

Non-vital pulp therapy

Partial pulpectomy
apexification

Vital pulp Therapy


Indirect pulp capping
In indirect pulp capping infected dentin is removed with out creating any pulp exposure then a medicament is placed in pulp chamber in an effort to remineralize the underlying demineralised dentin.

Endodontic treatment in children
pediatric dentistry/children dentistry

Indication

1. Teeth with deep caries, which are free from pulpitis
2. No history of spontaneous toothache.
3. No tenderness to percussion
4. No abnormal mobility
5. No internal or external root resorption detected radiographically.

Contraindication

1. Teeth with caries involving pulp.
2. tenderness to percussion.
3. abnormal mobility
4. Radiographic evidence of interradicular bone loss

Procedure

1. Removal of gross caries lesion.
2. placement of calcium hydroxide paste .
3. evaluation after 6-8 weeks
4. Permanent restoration

Direct pulp capping

This procedure involves the placement of a layer of protective material directly over the exposed pulp.

Endodontic treatment in children
Pediatric dentistry/children dentistry

Indication

1. Small pulp exposure during cavity preparation.
2. When the tooth is not painful.
3. Minimal or no bleeding from the exposure site.

Contraindication

1. Large pulp exposure
2. Presence of caries surrounding the exposure site
3. History of spontaneous pain
4. Excessive bleeding

Procedure

1. Complete caries excavation is done
2. Calcium hydroxide is placed( dycal is the material of choice)
3. The tooth is restored with intrim restoration
4. It teeth is asymtomatic for 6-8 weeks permanent restoration is done

Note:-Direct pulp capping is never done in primary teeth.

Pulpotomy

This procedure  is used when coronal part of  pulp is affected by decay or injury, but the root part is unaffected.The coronal part of the pulp is removed & medicament is placed over it to enable the radicular pulp to maintain its vitality.

Indication

1. Acute pulpitis
2. Caries which has resulted in invasion of microorganism into coronal pulp after exposure.
3. Permanent teeth with pulp exposed, when the root formation is incomplete.

Endodontic treatment in children
Pediatric dentistry/children dentistry

Non-vital pulp therapy

Partial pulpectomy

This procedure is done in primary teeth when both coronal & radicular pulp tissue show clinical evidence of infection.The term partial pulpectomy is preferred over root canal therapy as complete negotiation of accessory canal is not possible in primary teeth.

Indication

1. History of spontaneous pain, generally at nite
2. Presence of intraoral swelling & sinus
3. Clinically evident caries exposure.
4. Pathologic root resoption not involving more than 1/3rd of the root

Pediatric dentistry/children dentistry

Oral Health Problems in Children/pediatric dentistry

Oral health problem in children/pediatric dentistry

There are a number of problems that affect the oral health of children which includes tooth decay, thumb sucking, tongue thrusting, lip sucking, and early tooth loss. Even though milk teeth or baby’s  teeth are replaced with permanent teeth then also keeping baby teeth healthy is important for child's overall health and well-being.Pediatric dentistry/children dentistry

Baby bottle tooth decay
Children Dentistry

Baby bottle tooth decay

Baby bottle tooth decay also called early childhood caries, nursing caries  and nursing bottle syndrome occurs when a baby's is between 18 months and 3 years of age and baby’s teeth are in frequent contact with sugars from liquid carbohydrates, such as fruit juices, milk, formula, fruit juice diluted with water, sugar water or any other sweet drink. Human breast milk can cause tooth decay as well. As these liquids break down in the mouth into simple sugars and are allowed to sit in the mouth, bacteria start feeding on the sugars, causing tooth decay. If this left untreated decayed teeth can cause pain and make it difficult for child to  chew and eat. Baby’s teeth also serve as "space maintainers or saver" for adult teeth. If baby teeth are damaged or destroyed, they can't help guide permanent teeth into their proper position, possibly resulting in crowded or crooked permanent teeth. Badly decayed baby teeth could lead to an abscessed tooth, with the possibility of infection spreading elsewhere. The upper front teeth are most vulnerable to damage from nursing bottle mouth.Pediatric dentistry/children dentistry

Prevention & treatment  of baby bottle tooth decay

Baby left with bottle in mouth during sleep
children dentistry

• At any time, don't dip your baby's pacifier in sugar, honey, or any sugary liquid.
.
•  At bedtime, don't put your baby to bed with a bottle filled with sugary liquids watered-down fruit juice or milk. Give plain water.
•   Don't allow your baby to nurse continuously throughout the night while sleeping, since human breast milk can cause decay. Use a pacifier or give a bottle filled with plain water instead.
• Don't add sugar to your child's food
•    Use a wet cloth or gauze to wipe your child's teeth and gums after each feeding. This helps remove any bacteria-forming plaque and excess sugar that have built up on the teeth and gums.
• Teach your baby to drink from a cup by his or her first birthday. Moving to a "sippy cup" reduces the teeth's exposure to sugars

How to clean baby's mouth

Thumb sucking/Pediatric dentistry/children dentistry

Thumb sucking is the placement of thumb or one or more fingers in varying depths in the mouth. Generally, it's normal and healthy for infants to suck their thumbs, fingers, pacifiers or toys. Object sucking gives children a sense of emotional security and comfort. However, if thumb sucking continues beyond the age of 5 ,when the permanent teeth begin to erupt, dental problems may occur. Depending on the frequency, intensity, and duration of the sucking, the teeth can be pushed out of alignment, causing them to protrude and create an overbite. The child may also have difficulty with the correct pronunciation of words. In addition, the upper and lower jaws can become misaligned and the roof of the mouth might become malformed.

Thumb sucking
children dentistry

How to stop child thumb sucking

• First of all you should keep in mind that thumb sucking is normal and should not be a concern of parents unless the habit continues as the permanent teeth begin to emerge. It is usually said that children lacking parental care, love and affection resort to this habit. Thus the parents should be counselled to provide the child with adequate love and affection.
• The child must make the decision on their own to stop sucking their thumb or fingers before the habit will cease. To help toward this goal, parents and family members can offer encouragement and positive reinforcement. Thumb sucking is a security mechanism act such as scolding, nagging, or punishments are generally ineffective. This makes children defensive and driving them back to the habit. Instead, give praise or rewards for time successfully avoiding the habit. Gradually increase the time needed without sucking to achieve the reward. The younger the child, the more frequent the rewards will need to be given.
•  For children who want to stop, cover the finger or thumb with a band-aid as a reminder. Take the thumb or finger out of the mouth after the child falls asleep.some bitter chemicals can also be used such as pepper ,quinine and asafoetida.
• Dunlop put forward a theory called beta hypothesis that states that the best way to break a habit is by its conscious, purposeful repetition. Dunlop suggested that the child should be asked to sit in front of a large mirror and asked to suck his thumb observing himself as he indulges in the habit. The procedure is very effective if the child is asked to do the same at a time when he is involved in an enjoyable activity
• To help older children break the habit, parents should try to determine why their child is doing it -- find out what stresses your child faces and try to correct the situation. Once the problem is gone, the child often finds it is easier to give up sucking. If this doesn't work, you should contact pediatric dentist(children dentist) who will give dental appliances to the child to wear in the mouth to prevent sucking. These appliances can be removable as well as fixed and  are cemented to the upper teeth, sit on the roof of the mouth and make thumb sucking harder and therefore less pleasurable.

Tongue thrusting-pediatric dentistry/children dentistry

Tongue thrust is a condition in which the tongue makes contact with any teeth anterior to the molars during swallowing. Just like thumb sucking, tongue thrusting exerts pressure against the front teeth, pushing them out of alignment, which causes them to protrude, creating an overbite and possibly interfering with proper speech development.

Causes

• Retained infantile swallow.
• Upper respiratory tract infection.
•  Neurological disturbance
•   Macroglossia
•   Retrogonatic mandible
•   As associated with thumb sucking
•   Improper feeding habits

Treatment

• Various muscle exercise of the tongue. Ask the patient to count 60-69
• Yawing
•  Whistling
• Lip exercise
• Trainers-the child is taught correct method of swallowing
•  Habit breakers given by dentist(pediatric dentist,children dentist) such as removable cribs or rakes, oral screen

Mouth Breathing

Mouth breathing can be because of complete or partial obstruction of nasal passage

•  Deviated nasal septum.
• Nasal polyp.
• Obstructive adenoids.
• chronic inflammation of nasal mucosa. 
• Allergic reaction of nasal mucosa
•  Localised benign tumors
• Mouth breathing can also be habitual
• Mouth breating is also common in child whose lip morphology does not permit complete closure of the mouth.

Treatment

•   Removal of nasal obstruction-consult ENT
• Deep breathing exercise
•   Oral screen

Lip sucking/pediatric dentistry/children dentistry

Lip sucking involves repeatedly holding the lower lip beneath the upper front teeth. Sucking of the lower lip may occur by itself or in combination with thumb sucking. This practice results in an overbite and the same kinds of problems as discussed with thumb sucking and tongue thrusting. Stopping the habit involves the same steps as described for stopping thumb sucking.

Early tooth loss/pediatric dentistry/children dentistry

Premature loss of a child's primary teeth typically occurs due to tooth decay, injury, or lack of jaw space.If teeth are lost before the permanent teeth emerge, the nearby teeth can tip or shift into the space now unoccupied. When a permanent tooth tries to emerge into its space, there may not be enough room. The new tooth may emerge tilted. Crooked or misaligned teeth can cause a range of problems from interfering with proper chewing to causing temporomandibular joint problems.If your child loses a tooth prematurely, your dentist(pediatric dentist, children dentist) may recommend a space maintainer. A space maintainer is a plastic or metal device that holds open the space left by the missing tooth. Your dentist(pediatric dentist,children dentist) will remove the device once the permanent teeth begin to erupt.Pediatric dentistry/children dentistry

                                                                                       

Care for a Child's Teeth/pediatric dentistry

children dentistry

When to Start Caring for Your Baby's Teeth               

It's a good idea to get in the habit of cleaning your baby's gums even before teeth emerge.

To clean your baby's mouth:Lay your baby in your lap with his head close to your chest.Gently, but firmly, rub a clean and damp piece of gauze or soft cloth along both the upper and lower gum pads.Clean the gums at least two times a day.Even better clean  baby's gums after every feeding.

What Is Teething?

Teething refers to the time when baby teeth appear. Generally, teething first occurs between 6 months to 24 months of age. While this process is uneventful in some children; for others, it causes quite a bit of discomfort and irritability.

teething ring
/children dentistry

Symptoms of Teething

• Placing objects or fingers in the mouth and biting down on them
• Increased irritability
• Increased saliva or drooling
• Loss of appetite or becoming choosy about foods
• Tender and swollen gums
• Rash on cheeks or redness in the area of the cheeks near the affected gums
• Restlessness
• Ear pulling, which may be a sign of teething or possibly an ear infection (make an appointment to have your child seen by your doctor or pediatrician)
• Teething does not result in fever, vomiting, or diarrhea. If your child experiences these problems, contact your doctor.

Teething Pain:Massage your child's gums with a clean finger or the back of a small cold spoon.Allow your child to bite down teething ring.Try an over-the-counter teething ointment to numb the gums. Ask your dentist or doctor for some product recommendations.

When to  start brushing baby's teeth?

It's a good idea to start cleaning y baby's teeth twice a day as soon as you see a tooth emerging. If you start early, your baby will get used to having his teeth cleaned, and hopefully you'll avoid problems later on.It's best to carry on brushing your child's teeth for him until he's at least seven. By that age, he should be able to do it properly for himself.

cleaning baby's gum with wet muslin or gauze
/children dentistry

Tooth brush for baby:At first, you may find it easier to clean your baby's teeth using a piece of clean gauze or muslin. Wrap it around your finger, put a tiny smear of toothpaste on it, and rub around your baby's teeth.later on   when the baby is 1 1/2 to 2 years old, purchase a child-size toothbrush.pick soft, round-ended bristles of differing lengths, and a small, angled head tooth brush. This will allow you to reach all parts of baby's mouth easily and comfortably. Look at the packaging to see what age range the brush is designed for.At least once a day  preferably before bedtime you should brush your child's teeth. Several other times during the day preferably after meals -let your child try to brush her own teeth; this will consist mainly of her chewing on the toothbrush. At this age, make no attempt to try to teach your child toothbrushing techniques. It is more important to establish a pattern of dental care, and even chewing on a toothbrush helps clean the teeth.Replace your baby's toothbrush after three months, or sooner if the bristles have started to spread out

 Tooth paste for a baby:Fluroride is the active ingredient in toothpaste which helps prevent tooth decay. Too much of it, though, can be harmful. When choosing a toothpaste, check the packaging for fluoride levels:

Under-threes should use a lower-fluoride toothpaste. This is one containing about 1000ppm (parts per million) of fluoride.

Brushinh
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Over-threes can use an ordinary toothpaste, provided it contains no more than between 1350ppm and 1500ppm of fluoride.

Use a pea-sized dab of an ADA-accepted fluoride toothpaste. Take care your child don’t swallow it.

Use the recommended small amounts and encourage spitting out as your baby grows. If you follow these guidelines, lower fluoride and ordinary toothpastes are safe to use even in areas where fluoride has been added to the water.

 Brushing Techniques for Child:

You may want to supervise your children until they get the hang of these simple steps:

• Use a pea-sized dab of an ADA-accepted fluoride toothpaste. Take care that your child does not swallow the toothpaste.
• Using a soft-bristled toothbrush, brush the inside surface of each tooth first, where plaque may accumulate most. Brush gently back and forth.
• Clean the outer surfaces of each tooth. Angle the brush along the outer gumline. Gently brush back and forth.
• Brush the chewing surface of each tooth. Gently brush back and forth.
• Use the tip of the brush to clean behind each front tooth, both top and bottom.
• you should also clean the tounge.

How to protect baby's teeth

Never give your baby a bottle of milk, juice, or a sweetened beverage when you put her to bed, and never put honey, syrup, or another sweetening agent on your baby's pacifier. These practices can cause severe destruction of your baby's teeth. Tooth decay, or nursing decay syndrome, can result from such practices. When your baby sucks on a bottle when she is awake, the liquid is rapidly diluted with saliva and swallowed. However, if your baby falls asleep while nursing and swallows less often, the bacteria normally present in her mouth have time to turn the sugars in these liquids into acids that attack the tooth enamel. Sweetening agents on a pacifier also permit the sugars to remain in the mouth too long. The teeth most severely damaged are the upper incisors, and it has been necessary to remove teeth destroyed by this type of decay in children as young as 18 months old.

children dentistry

Taking a Child to a Dentist

Your child may be initially afraid of the dentist, just as children usually fear strangers.You should begin taking your child to the dentist no later than by the age of two years.Usually all the primary teeth have erupted by the time your child is between two and three years of age. Most children three years of age or younger have no or few dental problems, and the first visit to the dentist can consist primarily of an examination and probably a cleaning.