Dentistry for babies is a branch of pediatric dentistry provided to children from birth to around 36 months of age, aiming to maintain or re-establish a good oral health status and create a positive attitude in parents and children about dentistry. [1] [2] Although concerns about dental treatment directed to babies have been reported at the beginning of the twentieth century, only recently has the dental community started to focus on this area of dentistry, due to the high dental caries (decay) prevalence observed in young children.
The first[ citation needed ] setting for providing dental care exclusively to babies started in 1986, at Londrina's State University (Brazil), [3] changing the concept from early treatment of carious lesions and their consequences to early educative-preventive attention. These concepts were disseminated throughout the entire country introducing new clinics with a similar philosophy such as the Baby Clinic of Araçatuba Dental School, São Paulo State University (UNESP), [4] and also abroad.
The general aim is to provide dental assistance to 0-3-year-old children, through an educative-preventive oral health program directed to parents and children comprising the diagnosis, prevention, treatment, and control of the most common clinical situations at this age range (dental caries, dental trauma, alterations of tooth development, etc.).
At the Baby Clinic of Araçatuba Dental School, parents are required to enroll their babies from birth up to 6 months of age. Prior to the first clinical session, parents attend a lecture providing general information about:
Meetings occur on a regular basis. At the end of them, parents are shown how to clean the baby's mouth and how to use a fluoridated solution. Afterward, the baby's first appointment is booked.
A general clinical examination evaluates the baby's health as a whole. If necessary, the baby is referred to professionals in other areas for further examination. Caries risk is determined by correlating information gathered through anamnesis, clinical examination, and environmental factors:
Specific educative orientation will be directed to parents according to the needs of the baby's caries risk. Caries risk must be determined in this first appointment. The type of assistance to be provided to the baby will depend on the risk.
For low caries risk children, the aim is to maintain the baby's oral health. Clinical sessions include hygiene with hydrogen peroxide (1 part of H2O2 + 3 parts of boiled or filtered water) and application of 0.1% sodium fluoride (NaF) solution using cotton swab. At home, parents and caregivers are instructed to keep the same dietary and hygiene habits, and apply a 0.05% NaF solution once per day with a cotton swab at night time before the baby sleeps. Follow-up appointments are booked quarterly. At the first follow-up session, the caregiver is asked to perform the hygiene procedures and to apply the fluoridated solution under professional supervision to evaluate how skilled they are in performing those tasks, as well as to correct possible mistakes. If caries risk remains low, a quarterly scheme can be kept.
For high caries risk children, the aim is to revert the baby's caries risk, as well as to increase tooth resistance. Clinical sessions include the identification and reversion of risk factors for caries – parents are oriented on how to control (either eliminating or reducing) caries risk factors. Tooth resistance will be increased by applying a 0.1% NaF solution over all tooth surfaces. At home, parents and caregivers will adopt measures for oral hygiene and diet control, as well as eliminate bad oral hygiene and dietary habits that increase the risk of caries development. Daily application of a 0.05% NaF solution is also recommended. Follow-up appointments are booked every 1 or 2 months. As with low caries risk children, the caregiver will be asked to perform the hygiene procedures and to apply the fluoridated solution under professional supervision to evaluate how skilled they are in performing those tasks, as well as to correct possible mistakes. Caries risk must be evaluated again. Parents will be evaluated on how the recommendations done in the first session are being followed, which could potentially reduce the baby's caries risk.
For children with caries lesions, the aims are to re-establish oral equilibrium, by eliminating or reducing causal factors, as well as by increasing tooth resistance. Four clinical sessions, with a 1-week interval, are performed, so the dentist is able to act over causal factors (instructing parents), to increase tooth resistance (hygiene with diluted H2O2 solution and gauze; application of fluoride varnish over white spot lesions and softened carious lesions), as well as to restore tooth cavities with glass ionomer cement (atraumatic restorative treatment). At home, parents and caregivers will adopt measures for oral hygiene and diet control, as well as daily application of a 0.05% NaF solution. The first follow-up appointment is booked after 1 month, when caries risk must be re-evaluated to determine the appropriate periodicity for checkups. At the first follow-up session, the caregiver will be asked to perform the hygiene procedures and to apply the fluoridated solution under professional supervision to evaluate how skilled they are in performing those tasks, as well as to correct possible mistakes.[ citation needed ]
Caries risk assessment will be performed on a regular basis regardless of the initial caries risk evaluation, so changes in the protocol can be implemented whenever necessary.
"Pediatric Dentistry: A Clinical Approach" [5] aims to provide information about dental problems, and related conditions. The developments of oral health in infants impacts the overall risks, health conditions and issues.
Dental caries are the most significant cause of health problems among babies. The meta analysis of dental caries in children, a sample size of 80,405 was 46.2% (95% CI: 41.6–50.8%), and the prevalence of dental caries in permanent teeth in children in the world with a sample size of 1,454,871 was 53.8% (95% CI: 50–57.5%). [6]
“Early Childhood caries update: A review of causes, diagnoses, and treatments” [7] aim is the factors and causes to treat adolescents early dental care. “Tooth extraction is a common and necessary treatment for advanced carries of one or more decayed” found in a child 72 months of age or younger.
A dentist, also known as a dental surgeon, is a health care professional who specializes in dentistry, the branch of medicine focused on the teeth, gums, and mouth. The dentist's supporting team aids in providing oral health services. The dental team includes dental assistants, dental hygienists, dental technicians, and sometimes dental therapists.
Tooth decay, also known as cavities or caries, is the breakdown of teeth due to acids produced by bacteria. The cavities may be a number of different colors, from yellow to black. Symptoms may include pain and difficulty eating. Complications may include inflammation of the tissue around the tooth, tooth loss and infection or abscess formation. Tooth regeneration is an ongoing stem cell–based field of study that aims to find methods to reverse the effects of decay; current methods are based on easing symptoms.
Water fluoridation is the addition of fluoride to a public water supply to reduce tooth decay. Fluoridated water contains fluoride at a level that is effective for preventing cavities; this can occur naturally or by adding fluoride. Fluoridated water operates on tooth surfaces: in the mouth, it creates low levels of fluoride in saliva, which reduces the rate at which tooth enamel demineralizes and increases the rate at which it remineralizes in the early stages of cavities. Typically a fluoridated compound is added to drinking water, a process that in the U.S. costs an average of about $1.32 per person-year. Defluoridation is needed when the naturally occurring fluoride level exceeds recommended limits. In 2011, the World Health Organization suggested a level of fluoride from 0.5 to 1.5 mg/L, depending on climate, local environment, and other sources of fluoride. In 2024, the Department of Health and Human Services' National Toxicology Program found that water fluoridation levels above 1.5 mg/L are associated with lower IQ in children. In 2024, U.S. court rulings have raised concerns about the potential health risks of water fluoridation, including findings by the EPA and new risk assessments that suggest the benefits may be waning. Bottled water typically has unknown fluoride levels.
Dental sealants are a dental treatment intended to prevent tooth decay. Teeth have recesses on their biting surfaces; the back teeth have fissures (grooves) and some front teeth have cingulum pits. It is these pits and fissures that are most vulnerable to tooth decay because food and bacteria stick in them and because they are hard-to-clean areas. Dental sealants are materials placed in these pits and fissures to fill them in, creating a smooth surface which is easy to clean. Dental sealants are mainly used in children who are at higher risk of tooth decay, and are usually placed as soon as the adult molar teeth come through.
Abrasion is the non-carious, mechanical wear of tooth from interaction with objects other than tooth-tooth contact. It most commonly affects the premolars and canines, usually along the cervical margins. Based on clinical surveys, studies have shown that abrasion is the most common but not the sole aetiological factor for development of non-carious cervical lesions (NCCL) and is most frequently caused by incorrect toothbrushing technique.
Fluoride therapy is the use of fluoride for medical purposes. Fluoride supplements are recommended to prevent tooth decay in children older than six months in areas where the drinking water is low in fluoride. It is typically used as a liquid, pill, or paste by mouth. Fluoride has also been used to treat a number of bone diseases.
Dental fluorosis is a common disorder, characterized by hypomineralization of tooth enamel caused by ingestion of excessive fluoride during enamel formation.
Early childhood caries (ECC), formerly known as nursing bottle caries, baby bottle tooth decay, night bottle mouth and night bottle caries, is a disease that affects teeth in children aged between birth and 71 months. ECC is characterized by the presence of 1 or more decayed, missing, or filled tooth surfaces in any primary tooth. ECC has been shown to be a very common, transmissible bacterial infection, usually passed from the primary caregiver to the child. The main bacteria responsible for dental cavities are Streptococcus mutans (S.mutans) and Lactobacillus. There is also evidence that supports that those who are in lower socioeconomic populations are at greater risk of developing ECC.
Dental Public Health (DPH) is a para-clinical specialty of dentistry that deals with the prevention of oral disease and promotion of oral health. Dental public health is involved in the assessment of key dental health needs and coming up with effective solutions to improve the dental health of populations rather than individuals.
Oral hygiene is the practice of keeping one's oral cavity clean and free of disease and other problems by regular brushing of the teeth and adopting good hygiene habits. It is important that oral hygiene be carried out on a regular basis to enable prevention of dental disease and bad breath. The most common types of dental disease are tooth decay and gum diseases, including gingivitis, and periodontitis.
Fluoride varnish is a highly concentrated form of fluoride that is applied to the tooth's surface by a dentist, dental hygienist or other dental professional, as a type of topical fluoride therapy. It is not a permanent varnish but due to its adherent nature it is able to stay in contact with the tooth surface for several hours. It may be applied to the enamel, dentine or cementum of the tooth and can be used to help prevent decay, remineralise the tooth surface and to treat dentine hypersensitivity. There are more than 30 fluoride-containing varnish products on the market today, and they have varying compositions and delivery systems. These compositional differences lead to widely variable pharmacokinetics, the effects of which remain largely untested clinically.
Tooth remineralization is the natural repair process for non-cavitated tooth lesions, in which calcium, phosphate and sometimes fluoride ions are deposited into crystal voids in demineralised enamel. Remineralization can contribute towards restoring strength and function within tooth structure.
Pediatric dentistry is the branch of dentistry dealing with children from birth through adolescence. The specialty of pediatric dentistry is recognized by the American Dental Association, Royal College of Dentists of Canada, and Royal Australasian College of Dental Surgeons.
Minimal intervention (MI) dentistry is a modern dental practice designed around the principal aim of preservation of as much of the natural tooth structure as possible. It uses a disease-centric philosophy that directs attention to first control and management of the disease that causes tooth decay—dental caries—and then to relief of the residual symptoms it has left behind—the decayed teeth. The approach uses similar principles for prevention of future caries, and is intended to be a complete management solution for tooth decay.
The Hall Technique is a minimally-invasive treatment for decayed baby back (molar) teeth. Decay is sealed under preformed crowns, avoiding injections and drilling. It is one of a number of biologically oriented strategies for managing dental decay.
Tooth wear refers to loss of tooth substance by means other than dental caries. Tooth wear is a very common condition that occurs in approximately 97% of the population. This is a normal physiological process occurring throughout life; but with increasing lifespan of individuals and increasing retention of teeth for life, the incidence of non-carious tooth surface loss has also shown a rise. Tooth wear varies substantially between people and groups, with extreme attrition and enamel fractures common in archaeological samples, and erosion more common today.
Silver diammine fluoride (SDF), also known as silver diamine fluoride in most of the dental literature, is a topical medication used to treat and prevent dental caries and relieve dentinal hypersensitivity. It is a colorless or blue-tinted, odourless liquid composed of silver, ammonium and fluoride ions at a pH of 10.4 or 13. Ammonia compounds reduce the oxidative potential of SDF, increase its stability and helps to maintain a constant concentration over a period of time, rendering it safe for use in the mouth. Silver and fluoride ions possess antimicrobial properties and are used in the remineralization of enamel and dentin on teeth for preventing and arresting dental caries.
Molar incisor hypomineralisation (MIH) is a type of enamel defect affecting, as the name suggests, the first molars and incisors in the permanent dentition. MIH is considered a worldwide problem with a global prevalence of 12.9% and is usually identified in children under 10 years old. This developmental condition is caused by the lack of mineralisation of enamel during its maturation phase, due to interruption to the function of ameloblasts. Peri- and post-natal factors including premature birth, certain medical conditions, fever and antibiotic use have been found to be associated with development of MIH. Recent studies have suggested the role of genetics and/or epigenetic changes to be contributors of MIH development. However, further studies on the aetiology of MIH are required because it is believed to be multifactorial.
Pediatric crowns are dental crowns that provide full coverage for primary teeth. They can be made of different materials including stainless steel, polycarbonate, zirconium, or composite resin.
Atraumatic restorative treatment (ART) is a method for cleaning out tooth decay from teeth using only hand instruments and placing a filling. It does not use rotary dental instruments to prepare the tooth and can be performed in settings with no access to dental equipment. No drilling or local anaesthetic injections are required. ART is considered a conservative approach, not only because it removes the decayed tissue with hand instruments, avoiding removing more tissue than necessary which preserves as much tooth structure as possible, but also because it avoids pulp irritation and minimises patient discomfort. ART can be used for small, medium and deep cavities caused by dental caries.
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