1. How can I allay the fear of my child about the visit to the dentist’s surgery?

2. Why is the treatment of milk teeth so important?

3. When do first milk teeth appear, and when do the permanent ones?

4. What does tooth sealing, varnishing and silver nitrate penetration consist of?

5. What is early dental caries?

6. How frequently should check-up visits take place?

7. When should the first visit to the dentist take place?

8. When should the first hygiene procedures be applied to the child?

9. What oral hygiene agents should be used in a child?

10. Should I allow my child to go to sleep with a bottle of sweet drink?

1. How can I allay the fear of my child about the visit to the dentist’s surgery?

The first contact with a dentist is an important experience for your child, which shapes the subsequent attitude of the child to further visits to the dental surgery. There are two main reasons for such fear of the dentist: the child’s painful experiences from previous visits, and the general picture given by its parents, which strengthens the belief that dental treatment is associated with pain. At this point adaptation visits and instructing the parents play an important role; parents should explain to their child the course and aim of the visit to the dentist before the first visit.

2. Why is the treatment of milk teeth so important?

As with the permanent teeth, the milk teeth may suffer from dental caries, which may lead to painful pulp inflammation and, in consequence, premature tooth loss if untreated. In turn, tooth loss results in the inhibition of bone growth and bite abnormalities (crowding or abnormal position of the teeth, impaction of a permanent tooth in the bone). Purulent inflammation is a source of infection for the whole body of the young patient, and may lead to inflammation of the kidneys, heart or joints, as well as damage to the germs (buds) of permanent teeth that are close to the roots of the milk teeth.

3. When do first milk teeth appear, and when do the permanent ones?

The first milk teeth appear around the 6th month of life (normal range is 5th to 10th month full-term babies, and from 6th to 11th month in premature babies); usually the lower medial incisors appear first; however, upper medial incisors may also appear first.

The first permanent teeth appear at approximately the 6th year of life, and they are the first molar teeth (next to the 2nd premolar milk teeth). However, more and more frequently, lower medial incisors appear as the first permanent teeth.

4. What does tooth sealing, varnishing and silver nitrate penetration consist of?

Tooth sealing is a procedure of sealing spaces (pits and fissures) particularly susceptible to dental caries with special resins. The procedure is performed after the appearance (eruption) of the first permanent teeth (molars), which do not suffer from caries; however, milk teeth are also sealed more and more frequently.

Varnishing with a small brush is done to cover tooth surfaces with a fluorine varnish to strengthen the dental enamel and reduce its susceptibility to caries.

Silver nitrate penetration is a procedure applied in the case where most of the surface of a milk tooth is damaged by caries to such an extent that filling cannot be applied. The procedure consists of saturating such a tooth with a bactericidal substance that stops the carious process.

5. What is early dental caries?

Early dental caries poses a significant problem in the dentistry of early childhood. It starts just after the eruption of the first milk teeth, being a significantly acute form of caries, which may lead in a few months to such extensive damage to tooth tissues that the only solution is tooth extraction (removal). Parents should monitor the teeth of their children closely, and note that any suspicious changes (discoloration or spotting) are indication for a possibly urgent consultation with a paediatric dentist.

6. How frequently should check-up visits take place?

The carious process develops faster in milk teeth than in permanent ones due to their poor mineralisation (thin enamel layer). Parents should take care that their children have check-up visits every three moths, unless the dentist recommends otherwise.

7. When should the first visit to the dentist take place?

When the first teeth appear, parents should take their child to the dentist (at around 6-12 months). The dentist will assess whether the development of the teeth and facial part of the skull is regular and will schedule a check-up visit.

8. When should the first hygiene procedures be applied to the child?

The answer is as early as possible. Even before the eruption of the milk teeth, the baby’s mouth should be regularly washed with a cotton roll soaked in a chamomile infusion or boiled, cold water and the gums should be gently massaged. In this way the baby becomes accustomed to toothbrushing in the future and oral hygiene is maintained. In the same manner, the milk teeth should be cleaned after each meal; note that the teeth should be cleaned from both lips and tongue side.

At approximately one year of age you should start to clean the child’s teeth with an appropriate toothbrush. Up to five years, the teeth should be brushed by a parent or by the child itself under parental supervision.

9. What oral hygiene agents should be used in a child?

The toothbrush should be selected according to the child’s mouth (a toothbrush with a small head and soft bristle). Until your baby learns how to spit out the saliva, clean the teeth with toothbrush alone, without toothpaste, and after a time introduce any toothpaste designed for children (with an appropriate fluorine content and pleasant flavour).

10. Should I allow my child to go to sleep with a bottle of sweet drink?

It is absolutely contra-indicated, as it leads to the development of so-called Baby Bottle Tooth Decay (BBTD, bottle caries). Sweet sticky meals (ready-to-use meals, juices, sweetened milk) that adhere to the tooth surface promote this type of dental carries. Cariogenic bacteria transform sugar contained in such meals into acids, and prolonged (overnight) contact of the teeth with an acidic environment causes their demineralisation. Moreover, the night-time decrease in the production of saliva, which has neutralising properties, additionally increases the risk of caries development. The bottle caries is a particularly aggressive form of caries, which leads to complete damage of extensive tooth surfaces over a short period.