- First check-up: when the first tooth appears, at the latest at age 1
- Protection with fissure sealants and fluoride varnish
- Treatment of cavities in primary teeth, space maintainers
- A reassuring first visit through gradual introduction
In short: Paediatric dentistry covers preventive procedures, treatment of cavities, space maintainers and trauma follow-up during the primary and mixed dentition. Procedures are planned after an examination, taking the child's age and cooperation into account.
What does the first visit look like?
The first appointment is often an introduction: the child sits in the chair, their teeth are looked at with a mirror, and the instruments are introduced through play. If no treatment is needed, brushing is demonstrated. The aim is for the child to get to know the clinic as a safe place. The parent's calm attitude is decisive; instead of sentences such as "no needle, it won't hurt", neutral phrases such as "we are going to count your teeth" are recommended.
Preventive procedures
Fluoride varnish: A procedure in which a varnish is applied to the tooth surface, strengthening the enamel and able to arrest early cavities; it is generally repeated every 6 months.
Fissure sealant: The deep grooves on the chewing surface of molars are areas the brush cannot reach. These grooves are sealed with a flowable material; the procedure requires no drilling. Around ages 6 and 12, when the permanent molars erupt, are the suitable periods.
Space maintainer: If a primary tooth is lost early, a fixed or removable space maintainer is planned to preserve the place of the permanent tooth.
Cavities in primary teeth
The enamel of primary teeth is thinner; decay progresses quickly. Small cavities are treated with a filling, and cavities that reach the nerve with a pulpotomy (partial root canal treatment); extraction is the last option. Waiting with the thought "it will fall out anyway" carries the risk of pain, abscess and damage to the permanent tooth underneath.
Baby bottle caries
In babies who take milk or a sugary liquid from a bottle at night, the front teeth can decay rapidly. Stopping the night bottle after age 1, and wiping the teeth with a damp cloth or a finger brush from the first tooth onwards, is recommended.
Dental trauma
After a fall or a blow, a primary or permanent tooth may be fractured, displaced or completely knocked out. If a permanent tooth has been knocked out, time is critical: the tooth must be brought to the clinic in milk or saline, without touching the root. The approach is different for primary teeth; in both cases you should come in without delay.
Home care
- Brushing from the first tooth; a rice-grain amount of fluoride toothpaste up to age 3, then a pea-sized amount
- The parent brushes or finishes the brushing until age 7–8
- Limiting the number of snacks; giving sugary and acidic drinks with main meals
- A check-up every 6 months
Approach with anxious children
The "tell-show-do" method is used: each step is first explained, shown with the instrument, and then carried out. Sessions are kept short; in the first session an introduction alone may be enough. It is recommended that parents do not recount their own dental experiences in front of the child.
Points to consider
- If cavities in primary teeth are left untreated, pain, abscess and damage to the permanent tooth bud can occur.
- A night bottle and frequent sugary snacking are the most common causes of rapid decay in the front teeth.
- The amount of fluoride toothpaste must be adjusted to age (a rice-grain amount up to age 3).
- Thumb-sucking and dummy use that continue after age 4 can affect the position of the teeth and jaws.
- In dental trauma the first hours are decisive; if a permanent tooth has been knocked out, you should come in immediately without letting it dry.
Frequently asked questions
Should a cavity in a primary tooth be treated?
Yes. Primary teeth hold space for the permanent teeth and allow chewing and speech. A cavity that is not treated can lead to pain, abscess and a developmental problem in the permanent tooth underneath.
Is fluoride toothpaste safe?
The joint recommendation of dental and paediatric bodies is fluoride toothpaste from the first tooth: a rice-grain amount up to age 3, then a pea-sized amount. This amount is considered safe even if it is swallowed.
My child does not want to sit in the chair.
They are not forced. The first session can take place on the parent's lap or as an introduction only; familiarity is built up with a few short visits.
Does thumb-sucking affect the teeth?
Thumb-sucking and dummy use that continue after age 4 push the upper front teeth forward and towards an open bite. If it is given up before this age, most of the changes correct themselves.
Are X-rays taken?
Only when necessary (suspected interproximal decay, trauma, monitoring of development), with a low-dose digital device and a protective apron.
When is a child referred to orthodontics?
If there are findings related to jaw development and tooth eruption, referral to an orthodontic specialist is made at around age 7.
What happens if a child cannot cooperate during treatment?
If cooperation is not possible because of the child's age, fear or the extent of treatment, sedation or, if needed, general anaesthesia can be discussed with the parents. The decision is made at the examination, based on the child's general health.
The information on this site is for general guidance only; diagnosis and treatment require an examination by a dentist.