Common Concerns in Pediatric Dentistry and Their Solutions

At SACHI Dental Clinic, we hear various concerns about children’s oral health. Here, we introduce common concerns and their solutions.

① Concerned about baby tooth cavities | Early detection and treatment are crucial

Baby teeth (primary teeth) are more susceptible to cavities than permanent teeth, and decay tends to progress faster. This is because the enamel of baby teeth is thinner, less calcified, and the dentin is softer than that of permanent teeth. Furthermore, baby teeth are more soluble in acid, and once a cavity forms, it often progresses rapidly.

Leaving baby tooth cavities untreated can lead to the following risks:

• Pain and swelling, making eating difficult
• Negative impact on the formation of permanent teeth
• Poor alignment of permanent teeth
• Impact on pronunciation

Therefore, it is important not to ignore cavities even in baby teeth, but to detect them early and receive appropriate treatment.

What You Can Do at Home for Cavity Prevention

While there’s no guaranteed way to prevent cavities, daily brushing and regular dental check-ups are most effective. Combining home care with professional care at the dental clinic can significantly reduce the risk of cavities.

Finishing Brushing Methods by Age

• 0-1 year: Establishing brushing habits with gauze wiping Once teeth start erupting, gently wipe them with a damp gauze. At this stage, establishing the habit of tooth cleaning is important. Make it fun by singing songs or talking gently so the baby doesn’t resist.
  

  

• 1-3 years: Thorough check with lap brushing Have the child’s head rest on the parent’s lap for finishing brushing. This position provides a clear view of the inside of the mouth, reducing missed spots. Pay special attention to the back of the upper front teeth, which are often missed. Choose a small-headed children’s toothbrush and use small, gentle strokes. “Tips for finishing brushing” at this age emphasize the importance of parental care.
  

  

• 3-5 years: Practice self-brushing and finishing brush Let your child start practicing brushing their own teeth. First, let them hold the toothbrush and brush freely. Afterward, the parent must always perform a finishing brush to ensure no spots are missed. Teaching the fun of brushing is important at this stage.
• 5-8 years: Be careful when permanent teeth erupt Around age 6, the first permanent molars (6-year molars) erupt at the back. These molars have deep grooves and are prone to cavities, so brush them with special care. The front teeth also start changing to permanent teeth during this time. During the mixed dentition period (when both baby and permanent teeth are present), teeth alignment can be uneven, leading to more missed spots during brushing. Guide your child to brush each tooth carefully while looking in a mirror. Also, establish the habit of using dental floss, as toothbrushes cannot easily reach between teeth. Searching for “children’s floss” can lead to videos demonstrating proper usage for kids.

How to Choose and Use Toothpaste Effectively

Choosing toothpaste with fluoride is effective for cavity prevention. The Japanese Society of Pediatric Dentistry (JSPD) recommends specific amounts and fluoride concentrations based on age.

• From tooth eruption to 2 years: Amount: Grain of rice (approx. 1-2mm), Fluoride concentration: 1000ppmF (900-1000ppmF considering Japanese products)
• 3-5 years: Amount: Pea-sized (approx. 5mm), Fluoride concentration: 1000ppmF (900-1000ppmF considering Japanese products)
• 6 years to adult: Amount: Full length of toothbrush bristles (approx. 1.5cm-2cm), Fluoride concentration: 1500ppmF (1400-1500ppmF considering Japanese products)

To use toothpaste effectively, adhering to the age-appropriate amount is crucial. Let’s find the right toothpaste for your child.

Treatment Methods if Cavities Occur

Treatment methods vary depending on the size and depth of the cavity. At our clinic, we strive to provide pain-conscious treatment so patients can feel at ease.

Treatment for Small Cavities (CR Restoration)

If the cavity is small and has not reached the nerve, only the decayed portion is removed, and the tooth is treated by filling it with a dental plastic called composite resin (CR). CR restoration is characterized by minimal tooth removal and a natural appearance.

The treatment procedure is as follows:

1. Remove the decayed part of the tooth
2. Apply adhesive to the tooth surface
3. Fill with composite resin
4. Harden with a curing light
5. Shape and adjust the bite

CR restoration is typically completed in a single visit. However, if the cavity is large or deep, anesthesia may be necessary. Please rest assured that our clinic uses topical anesthesia and electric anesthesia injectors to minimize pain.

Advantages of CR Restoration

• Minimal tooth removal
• Natural appearance
• Completed in one visit
• No concerns about metal allergies

Disadvantages of CR Restoration

• May chip or detach under strong force
• May discolor over time
• May not be suitable for large cavities

Treatment for Large Cavities (Root Canal Treatment, Extraction)

If the cavity is large and has reached the nerve, root canal treatment is necessary. Root canal treatment involves removing the nerve infected by cavity-causing bacteria, disinfecting and cleaning the inside of the root canal, and then filling and sealing it with medication. Root canal treatment for baby teeth differs from that for permanent teeth, requiring consideration of root resorption and potential effects on the succeeding permanent tooth.

The root canal procedure is as follows:

1. Remove the decayed part
2. Remove the nerve
3. Disinfect and clean the inside of the root canal
4. Fill the root canal with medication

Root canal treatment requires multiple visits. Also, if symptoms do not improve even after root canal treatment, or if root resorption is advanced, extraction may be necessary. Cases requiring “baby tooth extraction” often involve concerns about negative effects on the permanent teeth.

Cases Requiring Extraction

• Large cavity where the tooth cannot be saved with root canal treatment
• Advanced root resorption causing the tooth to be loose
• Pus accumulation at the root tip, potentially affecting the permanent tooth

After extraction, a device called a space maintainer may be inserted to prevent negative effects on the alignment and bite of the permanent teeth.

Ways to Help Children Cooperate with Treatment

At SACHI Dental Clinic, we employ various methods to prevent children from developing a fear of dental treatment. Led by our female dentist, all staff members interact gently and carefully, striving to create an environment where children can relax and receive treatment.

Specific Initiatives

• Before treatment, we show or let children touch the instruments to ease their anxiety.
• During treatment, we proceed while talking to and encouraging the child.
• We offer rewards for children who cooperate well during treatment.

We also carefully explain the treatment details and precautions to parents and provide advice on home care. We are constantly thinking of ways to ensure “children are not afraid of the dentist.”

Response When Children Cannot Cooperate

For children who absolutely cannot cooperate with treatment, or those with systemic diseases making safe treatment difficult, we may refer them to nearby advanced medical institutions or university hospitals. We collaborate with other clinics to provide the best possible treatment for the child.

② Want Regular Check-ups | For Cavity Prevention and Early Detection

Regular dental check-ups are extremely important for preventing cavities and gingivitis and enabling early detection and treatment. During regular check-ups, we perform the following:

• Cavity Check: Check for the presence and progression of cavities.
• Gingivitis Check: Check for gum swelling or bleeding.
• Plaque and Tartar Removal: Remove plaque and tartar using specialized instruments.
• Fluoride Application: Strengthen tooth enamel and prevent cavities.
• Brushing Instruction: Provide guidance on proper brushing techniques.
• Lifestyle Guidance: Offer advice on diet and other habits.

The frequency of regular check-ups varies depending on the child’s oral condition, but generally, visits every 3 to 6 months are recommended. The frequency for “children’s regular dental check-ups” will be adjusted based on age and risk, so please consult with us.

About Fluoride Application

Fluoride application is a method of strengthening tooth enamel and preventing cavities by applying fluoride to the tooth surface. Fluoride application performed at a dental clinic uses a higher concentration of fluoride compared to toothpaste or mouthwash used at home, thus offering potentially higher cavity prevention effects.

Effects of Fluoride Application

• Promotion of Remineralization: Fluoride promotes the redeposition (remineralization) of calcium and phosphate that have dissolved from the tooth, repairing early cavities.
• Strengthening Tooth Enamel: It acts on the surface enamel, forming a stronger tooth structure (fluorapatite) that is more resistant to acid dissolution.
• Inhibition of Cavity-Causing Bacteria: Fluoride suppresses the activity of cavity-causing bacteria and inhibits acid production.

Frequency and Safety of Fluoride Application

In-office fluoride application is most effective when done 3-4 times a year (every 3 months). Although a high concentration of fluoride is applied, dentists and dental hygienists manage the appropriate amount, ensuring safety. However, excessive intake can lead to risks such as dental fluorosis (white spots or streaks on teeth). Therefore, please follow the instructions of your dentist or dental hygienist regarding the amount and frequency of fluoride-containing products used at home. We perform treatments with safety in mind, providing reassurance to those searching for “fluoride application Mita.”

Difference from Home Fluoride Products

Some toothpastes and mouthwashes used at home also contain fluoride. Using these products daily can enhance cavity prevention effects. However, the fluoride concentration is set lower compared to in-office fluoride applications.

Choosing Toothbrushes/Toothpaste According to Age/Situation

To protect your child’s dental health, choosing age-appropriate toothbrushes and toothpaste suitable for their oral condition is important.

JSAPD Recommended Toothpaste Amount and Fluoride Concentration by Age

• From tooth eruption to 2 years: Amount: Grain of rice (approx. 1-2mm), Fluoride Conc.: 1000ppmF (900-1000ppmF considering Japanese products)
• 3-5 years: Amount: Pea-sized (approx. 5mm), Fluoride Conc.: 1000ppmF (900-1000ppmF considering Japanese products)
• 6 years to adult: Amount: Full length of brush (approx. 1.5cm-2cm), Fluoride Conc.: 1500ppmF (1400-1500ppmF considering Japanese products)

Recommended Toothbrushes by Age/Situation

• 0-2 years: Choose an infant toothbrush with a small head and soft bristles.
• 3-5 years: This is the time to practice self-brushing. Choose an easy-to-grip children’s toothbrush with a small head.
• 6 years and older: Permanent teeth start erupting. Choose a children’s toothbrush with a small head and fine bristles to reach back teeth effectively.

Replace the toothbrush when the bristles start to fray. Depending on the oral condition, special toothbrush shapes or supplementary cleaning tools (dental floss, interdental brushes, etc.) may be necessary. Please feel free to consult our staff for details. We also provide information such as “recommended children’s toothbrushes.”

③ Concerned About Child’s Teeth Alignment | Early Consultation Recommended

A child’s teeth alignment changes significantly during the transition from baby teeth to permanent teeth and with jaw growth. “Children’s teeth alignment consultation” is one of the common concerns brought to SACHI Dental Clinic. Please consult us early, especially in the following cases:

• A permanent tooth is erupting from under a baby tooth
• A baby tooth fell out, but the permanent tooth is slow to erupt
• A permanent tooth has erupted in an unusual position
• Concerns about bite, such as underbite or overjet (protruding teeth)
• Habits like thumb sucking or nail biting

Timing for Alignment Consultation

If you have concerns about your child’s teeth alignment, please consult us early. The period of transition from baby to permanent teeth (around ages 6-12) is particularly important as alignment and bite change significantly. Early detection of problems and starting treatment at the appropriate time increases the likelihood of achieving better treatment results. We also accept consultations for “pediatric orthodontics Mita.”

Options if Orthodontic Treatment is Needed

Depending on the child’s alignment condition, orthodontic treatment may be necessary. Available methods include:

• Removable Appliances (Plate Orthodontics): Uses removable devices to encourage jaw growth or move teeth.
• Wire Braces: Attaches brackets to the tooth surface and uses wires to move teeth.
• Clear Aligners (Mouthpiece Orthodontics): Uses transparent, removable aligner trays to move teeth.

The most suitable treatment method depends on the child’s alignment condition, age, lifestyle, etc. Our clinic will propose the optimal treatment method for your child.

SACHI Dental Clinic’s Approach to Pediatric Orthodontics

Our clinic provides orthodontic treatment tailored to the child’s growth and development. Especially by starting treatment early, we can control jaw growth and reduce the risk of needing full-scale orthodontic treatment later. Furthermore, led by our female director, all staff strive to provide gentle and careful service so that children can enjoy visiting the clinic. If you are looking for low-burden orthodontic treatment for your child in the “pediatric orthodontics Shibakoen” area, please consult with us.

Frequently Asked Questions (FAQ)

From what age should children visit the dentist?

We recommend a dental check-up once your child reaches their first birthday. Also, start practicing tooth cleaning when the first teeth begin to erupt.

When should I start brushing my child’s teeth?

Start with gauze wiping when the first teeth erupt. From around 1 year old, begin practicing with an infant toothbrush.

Does thumb sucking affect teeth alignment?

Prolonged thumb sucking can negatively affect teeth alignment and bite. If thumb sucking continues past age 3, please consult a dentist.

If baby teeth get cavities, does it affect permanent teeth?

Leaving baby tooth cavities untreated can negatively affect the permanent teeth that erupt later. Even for baby teeth, it’s important to treat cavities early.

My child is afraid of the dentist. What should I do?

First, it’s important to help them understand that the dentist is not a scary place. Playing dentist at home or reading picture books about dentists can be effective. Also, please rest assured that our clinic employs various methods to help children relax during treatment.