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Paediatric dentistry: Tooth preservation and non-invasive intervention have priority
Healthy teeth for a lifetime: The foundation for this is laid by thorough care and control of the baby teeth. How has paediatric dentistry changed and what is its focus today? On the occasion of the German Day of Dental Health on 25 September, which has the motto "Healthy starts in the mouth - in kindergarten and school", dentist and Junior Scientific Affairs Manager at Kulzer Nejra Kosic talks about the treatment of young patients and how dental materials can make treatment easier.
What are the most common complaints and dental diseases that children come to the dental practice with?
The most common complaints we see in the practice still include caries, malocclusions and anterior tooth trauma of all kinds, which usually happen as a result of falls or accidents. For some time now, more and more children have also been presenting with molar incisor hypomineralisation – in Germany more than every third twelve-year-old child is now affected. The reasons for this are still unclear. It is assumed that numerous factors influence the development of the so-called chalk teeth, e.g. chronic diseases, but also the intake of certain medications (e.g. antibiotics); already during the mother's pregnancy. The intake of BPA through food is also suspected.
How has the importance of paediatric dentistry changed in recent years?
For years, the focus in treatment has been increasingly on prevention; in particular, education on oral hygiene at home to prevent caries. In the treatment of carious lesions in children, there has been a change in thinking in recent years: in 2020, the European Organisation for Caries Research, together with the European Federation of Conservative Dentistry and the German Society for Dental Conservation, issued new consensus recommendations for the management of deciduous tooth decay. Functional aspects and the preservation or restoration of a high quality of life for children are now in the foreground. Non-invasive interventions to arrest carious lesions through optimised oral hygiene, fluorides and, if necessary, silver diamine fluoride preparations are at the forefront of caries management. In the case of invasive restorations, the treatment goal is to preserve deciduous teeth as safely as possible and without further treatment measures until they are exfoliated. In the case of approximal or larger caries lesions of deciduous teeth without irreversible pulpitis, the Hall technique can be more successful than conventional restorations. The Hall technique is a more minimally invasive procedure in which no caries excavation is made and the tooth is restored with a fabricated steel crown. In some cases, when the degree of destruction is advanced, multiple lesions and other factors are present, extraction followed by gap management may also be the most appropriate therapy to restore the child's quality of life.
| If you want to know more about the recommendations on caries management, you can find the consensus recommendations here: here. | ||||||||||||||
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How can dentists sensitise children and their parents to go for regular check-ups, even if they have no complaints, and thus lay an important foundation for children to go for regular check-ups later on as adults?
It is important to educate patients and their parents about the importance of oral health for overall health and how regular check-ups with the dentist can help prevent future problems. There are some diseases that can be detected in the mouth or that can already be prevented through good oral hygiene. It is best if pregnant women are already informed during their routine dental check-up that it makes sense to visit the dentist regularly with the baby from the time the first teeth erupt. In this way, the child and parents can establish a routine and the child associates a positive feeling with the visit to the dentist.
What contribution can dental materials make to ease treatment for young patients, but also for the dentist?
As children have a shorter attention span than adults, this can affect the treatment depending on the effort required. There are materials that make treatments easier and quicker and thus place less stress on children. For a posterior restoration, for example, a bulk-fill material can significantly reduce treatment time. The new Venus Bulk Flow ONE, for example, can be applied in layers up to 4mm thick. It also no longer needs to be covered by a conventional occlusal, which additionally helps the dentist to keep treatment time as short as possible. Due to its adaptive shade matching, the Venus Bulk Flow ONE also matches the surrounding tooth shade. This is mostly important for parents who often prefer inconspicuous restorations for their children. Adhesives that can be used self-etching, such as iBOND Universal, save children the unpopular rinsing off of phosphoric acid with the "etch&rinse technique". The treatment is also faster and the risk of cavity contamination by saliva is minimised. Often, absolute drainage is not possible with small children.
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