Pedodontics (Pediatric Dentistry)

Pediatric dentistry is the dental specialty that aims to protect and treat the oral and dental health of children from infancy through adolescence (ages 0–13). This field includes the monitoring of primary and permanent teeth, prevention of dental caries, treatment of caries and dental trauma, fluoride and fissure sealant applications, space maintainers, and early orthodontic guidance.

Pediatric dentistry focuses on age-appropriate and psychologically sensitive approaches in order to reduce dental anxiety and to help children develop lifelong healthy oral hygiene habits.

The Importance of Primary Teeth in Children

Primary (deciduous) teeth play a vital role in children’s chewing function, speech development, and facial aesthetics. They also act as natural space maintainers for the underlying permanent teeth, ensuring proper dental alignment.

Premature loss or untreated decay of primary teeth may lead to chewing difficulties, speech disorders, disturbances in jaw development, and orthodontic problems in later life. Therefore, primary teeth should not be neglected with the assumption that they will eventually fall out; regular dental check-ups and timely treatments are essential.

When Do Primary Teeth Erupt and When Do They Exfoliate?

Primary teeth usually begin to erupt around 6 months of age and are typically completed by 2.5–3 years of age. The first teeth to erupt are usually the lower central incisors, and children have a total of 20 primary teeth.

Exfoliation of primary teeth generally begins around the age of 6 and continues until 12–13 years of age. The primary molars, especially those in the posterior region, remain in the mouth until approximately 10–12 years of age, providing chewing function and maintaining space for permanent teeth. For this reason, protecting these teeth from caries and treating them promptly when necessary is of great importance.

Should My Child Be Treated by a Specialist Dentist?

Children’s oral and dental health requires a different approach than that used for adults. Pediatric dentists (pedodontists) are specialists who have received specific training in dental and jaw development in children and who use communication techniques appropriate to child psychology.

This allows examinations and treatments to be planned according to the child’s age, developmental stage, and anxiety level. Especially for children with dental fear, follow-up by a pediatric dentist is crucial in preventing negative early experiences and establishing a positive, lifelong relationship with dental care.

How Should I Prepare My Child for the First Dental Visit?

Preparation for the first dental visit forms the foundation of the child’s relationship with the dentist. Fear-inducing or threatening language should be avoided, and the visit should be described as a “check-up” or a “meeting.”

The child should not be told about pain, injections, or difficult procedures. Instead, it can be explained that the dentist will count the teeth and check their cleanliness. Scheduling the appointment when the child is well-rested and not hungry, and maintaining a calm and positive parental attitude, will facilitate the process.

A well-managed first visit helps the child continue regular dental check-ups without developing dental anxiety.

How Is the Dental Examination Performed in Children?

Dental examinations in children are conducted gradually and gently, according to the child’s age and level of cooperation. Initially, communication is established with the child, and the environment and instruments are introduced to build trust.

During the examination, the number of teeth, presence of caries, gingival health, and jaw development are evaluated. If necessary, radiographic imaging may be performed, and all procedures are explained in a language the child can understand.

The goal is to assess oral and dental health without causing fear and to develop an appropriate treatment plan for both the child and the family.

Fluoride Applications

Fluoride applications are preventive treatments used to strengthen enamel and reduce the risk of dental caries in children. Fluoride increases enamel resistance to acids and helps prevent tooth decay.

In clinical settings, fluoride is applied in the form of varnish or gel and is completed in a short time. When applied at regular intervals, especially in children at high caries risk, it significantly contributes to maintaining healthy teeth. Fluoride applications are safe, painless, and effective preventive measures.

 Fissure Sealants

Fissure sealants are preventive treatments applied to seal the deep grooves and pits on the chewing surfaces of posterior teeth in order to prevent caries. These areas are difficult to clean with a toothbrush and are therefore more susceptible to decay in children.

The application is painless, does not require removal of tooth structure, and is completed quickly. It forms a protective barrier against external factors. When applied at the appropriate time and followed with regular check-ups, fissure sealants make a significant contribution to long-term dental health.

Space Maintainers

Space maintainers are preventive appliances used to preserve the space required for permanent teeth when primary teeth are lost prematurely due to caries, trauma, or other reasons.

Primary teeth serve as natural guides for permanent teeth. Early loss may cause adjacent teeth to drift into the space, leading to space loss and orthodontic problems such as crowding. Space maintainers help prevent these complications and support the proper eruption of permanent teeth.

They also contribute to maintaining chewing function, balanced jaw development, and improved aesthetics.

Space maintainers may be planned as fixed or removable, depending on the child’s age, oral structure, and the number of missing teeth. Fixed space maintainers are bonded to the teeth and remain in the mouth continuously, making them particularly suitable for younger children. Removable space maintainers require patient cooperation. The type of appliance is determined by the pediatric dentist and must be monitored through regular follow-up visits.

Primary Tooth Treatments (Fillings and Pulp Therapy)

Dental caries in primary teeth are treated with fillings or primary tooth pulp therapy, depending on the condition of the tooth. The main objective is to maintain the primary tooth in the oral cavity in a healthy state until its natural exfoliation, thereby preserving masticatory function and its role as a space maintainer. Untreated caries in primary teeth may lead to pain, infection, and premature tooth loss. For this reason, timely and appropriate treatment of primary teeth, just like permanent teeth, is of great importance.

Dental Traumas

In children, dental trauma such as fractures, displacement, or tooth loss may occur as a result of falls, impacts, or accidents. Prompt and appropriate intervention in cases of dental trauma is crucial for the health of the tooth and surrounding tissues. Depending on the type and severity of the trauma, follow-up, restorative procedures, or advanced treatments may be planned. Therefore, it is recommended to consult a pediatric dentist without delay in the event of any dental trauma.

Treatments Under Sedation and General Anesthesia

In some children, routine dental treatment under standard clinical conditions may not be possible due to severe dental anxiety, very young age, lack of cooperation, or special healthcare needs. In such cases, after appropriate evaluations, dental treatments may be planned under sedation or general anesthesia. These methods ensure the child’s comfort and safety while allowing necessary dental procedures to be completed in a single session. All procedures are carried out safely by specialized teams in adequately equipped centers.

EMERGENCY SITUATIONS IN PEDIATRIC DENTISTRY

1. My child has a toothache. What should I do?

If your child has a toothache, this condition is usually associated with dental caries, infection, periodontal problems, or trauma and should not be ignored. First, the painful area should be kept clean, and the child should be prevented from chewing on the affected tooth. Antibiotics or analgesics should not be administered without consulting a dentist. Severe pain, toothache that wakes the child at night, swelling of the face or gums, or accompanying fever are considered emergencies. Prompt consultation with a pediatric dentist is essential for accurate diagnosis and appropriate treatment planning.

2. Is it an emergency if the toothache suddenly starts at night?

Yes, a toothache that suddenly begins at night is generally considered an emergency. Tooth pain that worsens at night or awakens the child from sleep often indicates deep caries, pulp involvement, or infection. If the pain is accompanied by gingival or facial swelling, fever, or general malaise, a pediatric dentist should be consulted immediately. Early intervention helps control pain and prevents more serious complications.

3. What does swell of the face or gums indicate?

Swelling of the face or gums is most commonly a sign of a dental infection. It may result from advanced caries, untreated dental infections, or trauma. If the swelling is accompanied by pain, fever, redness, or fatigue, it is considered an emergency, and immediate evaluation by a pediatric dentist is required. Such swellings do not resolve spontaneously; timely and appropriate treatment is essential to prevent the spread of infection and more serious health problems.

4. Should I wait if my child’s tooth has been displaced after a fall?

No, displaced teeth should not be left untreated. Tooth displacement following a fall or impact indicates damage to the supporting tissues and requires immediate evaluation. If the tooth appears elongated, intruded, or shifted sideways, urgent consultation with a pediatric dentist is necessary. Early intervention is critical to preserving the tooth and preventing permanent damage. Even in the absence of pain, the tooth must be examined.

5. Is treatment necessary if a primary tooth is fractured?

Yes, a fractured primary tooth must be evaluated by a pediatric dentist. Depending on the extent of the fracture, follow-up alone may be sufficient, or restorative or other protective treatments may be required. Untreated fractured primary teeth can lead to pain, infection, and damage to the developing permanent tooth. Therefore, primary teeth should not be neglected with the assumption that they will eventually exfoliate.

6. What should I do if a permanent tooth is completely avulsed?

If a permanent tooth is completely avulsed, this is considered a dental emergency. The tooth should be handled by the crown only, without touching the root. If possible, it should be gently repositioned into its socket, or stored in milk, saline solution, or the child’s saliva, and transported to a pediatric dentist as quickly as possible. The first 30–60 minutes are critical for the success of reimplantation.

7. When is gingival bleeding considered an emergency?

Mild bleeding during tooth brushing is usually not an emergency. However, persistent, heavy bleeding following trauma or bleeding accompanied by swelling requires urgent evaluation. If gingival bleeding is associated with pain, discoloration, or facial swelling, immediate consultation with a pediatric dentist is recommended.

8. Should I still visit the dentist if my child does not feel pain after trauma?

Yes. The absence of pain after trauma does not necessarily mean that there is no damage to the tooth or supporting tissues. Some dental injuries may not show immediate symptoms and can cause problems later. Therefore, even if there is no visible fracture, displacement, or discoloration after a fall or impact, a control examination by a pediatric dentist is strongly recommended.