In children, dental periods can be examined in three different periods:
1) 0-6 age : Milk tooth period:
Milk teeth may vary, but after an average of 6 months, they often erupt from the lower front area and may vary but will be completed at approximately 3 years old .During this period, a total of 20 milk teeth (10 of them at submaxilla , 10 of them at maxilla ) are placed symmetrically.
2) 6-12 age : Mixed dentition period:
At the same time, it is the age range in which both the teeth , molar milk tooth and incisor permanent tooth are seen in the mouth .Over time, the molar milk tooth leave and small molar tooth will replace it as a transition to the Continuous period of dentition.
3) 12 years old and after : Continuous period of dentition:
This period is the period when the milk teeth have completely fallen and are now constantly getting permanent teeth in the mouth and the balance and contacts between the teeth , interdental balance and contact are formed .
Beginning in infancy, in order to have healthy teeth in the period of milk tooth, it is necessary to adhere to the correct nutritional forms and to protect from the special type of caries called "bottle decay” .Milk teeth are important in terms of correct extraction of vowels and letters in the new speech function that will be started in this period, as well as appearance, bite and eating functions. Milk teeth also serve as a placeholder and erupt direction on the jaws for the permanent teeth that will come to their place. For this reason, tooth extraction during the period of milk tooth should be a treatment alternative need to be evaluated as a last resort .
In the early period , If enough oral hygiene initiatives are not achieved in children whose teeth decay in their mouths and it has been identified in studies that the risk of caries is higher in the elderly during the Continuous period of dentition . Milk tooth extraction made in the early period can lead nutritional disorders and to weight loss in the child . Can change the eruption period of permanent teeth and can prevent them being placed correctly .
This is why “space maintainer " must be applied in order to preserve the space required for permanent tooth eruption after early tooth extraction .
In the period of growth and development, it is more important to provide oral and dental health in children specially with any systemic disease (heart disease, asthma, kidney disease, problems with blood values… , etc.) , it should not be forgotten that any infection that may occur with caries in the mouth may be vital in these situations .
Feeding during childhood is of great importance in terms of growth and development starting from infancy. Especially in the feeding period with bottles to feed with sugar containing honey , molasses , jam or biscuit added milk or fruit juice is the most important factor to increase the risk of decay during infancy . Instead of these foods, feeding only milk or water with the bottle will be a safer approach in terms of caries formation. As a result of the use of foods containing such sugars to make sleeping easier before bedtime , this carbohydrate content during sleep can accelerate the formation of caries by creating acid attacks in the oral environment.
In this period, the concept of "balanced nutrition" and "dental care" are at the beginning of the points to be considered in terms of oral health. It is necessary to take advantage of all food groups equally for balanced nutrition and to consume carbohydrate foods, especially those which are known as caries maker , frequently except for main meals. Snack between meals , sugary foods or chips , crackers containing starch and food sticking to the teeth contribute to the preparation of the caries-inducing environment as metabolised during the period before our children brush their teeth. During feeding with baby bottles, not giving any liquid containing fruit juice , molasses milk , honey milk , biscuit milk or carbohydrate in general (especially during sleep) to baby with baby bottle, will also help to protect baby from bottle decay at that time. Finally, brushing teeth with the help of a mother before sleeping, at least clean the tooth surfaces with a clean cheesecloth or gauze, if it is not possible , final water should be given .
One of the protective measures against tooth decay is fluorine application. Fluoride chemically and physically changes the structure of the tooth germ by entering into the structure of the enamel , and as a result, the dissolution of the enamel in the acid medium is reduced. For this reason, during development, it has been thought that fluoride should be taken systemically, such as vitamins and minerals. However, it is argued that the decay-reducing effect of fluoride after tooth erupt and in adults is more important and effective in terms of the local effect of called fluoride "topical effect".
The greatest risk of using fluoride tablets is the yellow-brown staining of dental floss, which is called "dental fluorosis", according to the amount of fluorine taken. Studies have shown that children of mothers receiving fluoride tablets during pregnancy do not differ in resistance to decay .
More often nowadays , fluoride treatments applied more frequently by dentists at clinics and doctor’s office and / or at by individuals at home have become more current. These applications can be performed with agents such as tooth pastes , jellies, gargles, solutions, polishes and foams. The goal in these applications is to prevent the development of caries and to reverse the process .
Especially with fluoride gel applications , frequency of caries highly decreased and it is stated that the frequency of caries is decreasing with the applications performed twice a year .The fluoride mouthwashes and toothpastes that individuals can apply at home are also ideal protective methods of application. Fluoride toothpastes should be used with caution because of the risk of being swallowed by children . It is stated that toothpastes in standard concentration (1000 ppm and above) are said to be suitable for use in children at high risk. In the period between 6 months and 2 years age ; toothpastes with a low concentration less than 500 ppm should be preferred . Especially in small children , attention is required brushing their teeth with the help of their parents or under the guidance of parents