Συχνές ερωτήσεις για παιδιά

The child’s first visit to the pediatric dentist is recommended when the first teeth have erupted in the child’s mouth, i.e. at the age of 12-18 months.

Many times parents wonder: “Does the visit to the dentist need to be done so early? Since he hasn’t got all his teeth?”

Very correctly. The eruption of teeth at this age is not complete. But the early visit of the parents to the pediatric dentist is important, because the parents are informed in time about:

The next visit should be done at the age of 2-2.5 years, when all the teeth in the child’s mouth will have erupted. Then the dentist will check if the children’s teeth are brushed properly and diligently by the parents. If not, he will give the necessary advice. In addition to this visit, the pediatric dentists will examine whether there are decayed teeth and will point out any abnormalities in the child’s teeth (e.g. supernumerary teeth, peculiar shape, etc.).

From the age of 3 onwards, an annual visit to the pediatric dentist is recommended. Always depending on the needs of each child and the advice of the dentist, small patients are usually examined 1-2 times a year.

Children’s teeth brushing should start with the eruption of the first tooth, i.e. between 6-8 months. It is important that oral hygiene starts so early, so that both the teeth that have erupted and those that will appear in the future in the child’s mouth, are shielded with fluoride. Fluoride is what will protect the teeth from tooth decay, as it is what prevents the action of carious microbes in children’s mouths. In short, fluoride is the teeth’s shield against tooth decay.

On the other hand, when tooth brushing is started so early, the little patient subconsciously gets used to the idea of ​​brushing. Day by day, brushing teeth becomes part of his daily routine and in the future the child will ask for it on his own. There are not a few cases that when teeth brushing starts at an older age, i.e. from 2-2.5 years and above, the child reacts negatively as it is something foreign and new in his daily routine. Then he usually shows more easily a refusal to cooperate in brushing. The result is that the mother becomes frustrated, tired and stops trying to brush her teeth.

Therefore, the earlier the child’s oral hygiene starts, the better it is for the protection of the teeth and for the child, as it is easier for him to accept it.

Teeth brushing should be done by the mother until the child learns to write by himself (6-7 years old). This is because research has shown that when the child can write by himself, then his motor skills are gradually completed and he is able to practice oral hygiene on his own. However, it does not mean that when the child (at a younger age) asks to brush his teeth alone, we forbid and discourage him. Instead we give him the toothbrush, encourage him and reward him. A refusal of ours to this desire, the child may perceive it as a rejection or that we do not consider him capable. He may even react with a permanent refusal to brush his teeth in the future. Simply until the age of 6-7 years after the child brushes the teeth by himself, it is recommended that the mother also brush the child’s teeth, so that she can be sure that all the surfaces were cleaned properly.

Teeth brushing starts with the eruption of the first tooth, i.e. at the age of 6-9 months. Of course, this does not mean that the baby’s mouth should not be cleaned before the appearance of new teeth. After drinking the milk, it is good for the parent to gently clean the baby’s gums with a wet gauze pad. In this way, on the one hand, the child’s mouth is kept clean and on the other, the child subconsciously gets used to the idea of ​​oral hygiene, even though he is so young.

Until the child celebrates his first birthday, the frequency of brushing once a day is enough. After a year, the new teeth (which are now more) must be brushed twice a day. If possible, it is also recommended to brush the teeth after lunch, otherwise 2 times a day are necessary for the child to have satisfactory oral hygiene. Of course, the parent who has taken it upon himself to help the child brush his teeth should do it correctly and not be satisfied with the idea “after I brush twice a day my child’s teeth are fine”. Many times it is the quality and not the quantity that matters.

In the market there are many toothpastes with different flavors and aromas for small patients. But the most important of all is the fluoride content of the toothpaste, always depending on the age of the child.

At the age of 6 – 9 months to 2 years, the child should use a toothpaste with 500 ppm fluoride.

At the age of 2 – 6 years the toothpaste should have a 1000ppm fluoride content

From the age of 6 years the child can brush his teeth with the toothpaste of adults, which has 1450 – 1500 ppmFluoride. But usually the taste of the toothpaste used by parentsis not pleasant to the taste and smell of children, and sometimes it can also cause them to gag. For this reason, there areon the market toothpastes with a fluoride content of 1500ppm in various flavors (banana, bubblegum, etc.), so that brushing the teeth is a pleasant process for the child.

Brushing the teeth is done by the parents until the child grows up and has the ability to hold the toothbrush well and handle it (2.5-3 years old). However, even at older ages (4.5 – 5 years old) when the child can theoretically brush alone, it is good for the parent to also brush after the child’s teeth to be sure that all dental surfaces have been thoroughly cleaned. In general, the parent should also brush the child’s teeth until the child learns to write correctly, because then his motor skills are completed and he can handle the toothbrush well.

The teeth should be brushed twice a day using fluoride toothpaste. It is good for the process to last 2-3 minutes and to follow the same sequence in which the teeth are brushed each time to ensure that all dental surfaces are cleaned.

When the parent brushes the child’s teeth the mouth should be wide open so that there is good eye contact. It is recommended that brushing starts from the outer surfaces of the back teeth by making small on-site vibration movements. The toothbrush is placed at an angle of 45 degrees (oblique) so that its bristles come into contact with both the surface of the teeth and the gums. While brushing the teeth, the brush should cover 2 – 3 teeth (no more) and the small vibrating movements should be from pink (gums) to white (teeth). The process continues with the outer surfaces of the front teeth. The inner surfaces of the back teeth are then cleaned. In the same way as described above, the brush is placed diagonally and small on-site vibration movements are made, counting to ten. For the inner surfaces of the front teeth, the brush is placed vertically with up-down movements. Again the brush should touch the gums and here it should move tooth to tooth. The process ends with brushing the chewing contacts of the back teeth making in-out movements (or back and forth). After the brushing of the lower teeth is finished, the process continues on the lower teeth as well. It is desirable that after cleaning the surfaces of the teeth, the surface of the tongue should also be cleaned with movements from back to front.

There are many children’s toothbrushes on the market that parents can choose for brushing their child’s teeth. Some companies divide the brushes according to the age of the child and have a correspondingly different shape of head and handle. Regardless of the age of the child, the toothbrush should have at least 4 rows of soft bristles and the head should be as small as possible to be comfortable in the child’s mouth.

At the age of 0 – 2 years brushing is mainly performed by the parent so the size of the handle does not play such an important role. In the next stage of 2 – 6 years brushing starts to be partially done by the child, so the handle of the brush should be sufficiently large and ergonomic so that the child can hold and handle it easily.

In addition to manual brushes, there are also electric toothbrushes, some of which work with a rotary motion and others with a pulse. The ones that are more easily accepted by children are the brushes with a rotating head compared to the others that pulsate.

Electric brushes are recommended when the child is not so cooperative in brushing the teeth. In this case, brushing the teeth with the electric brush can be more easily and quickly accepted by the child as he sees the whole process as a game. In this way, brushing can be integrated into his routine without denials and objections (as it was in the past), while at the same time the teeth are cleaned more quickly and efficiently compared to a hand brush.

In conclusion we must say that all brushes are good when used regularly and in the right way.

The eruption of the first baby tooth is normally expected between the 6th and 8th month and it is the central sectors (incisors) in the lower jaw. However, there are several variations, with the result that many times the first tooth makes its appearance in the 12th or even the 14th month, without this being alarming.

Then the lateral sectors, first molars, canines and second molars appear in order.

The eruption process is completed with the upper second molars at the age of 2.5 years.

Is it necessary to treat baby teeth?

The opinion that children’s teeth do not need care and treatment is wrong. Listed below are some of the reasons that necessitate the restoration of baby teeth:

• The baby teeth appear in the mouth approximately when the child is 6 months old and their eruption is completed at the age of 2.5 years. It is then gradually replaced by the permanent teeth, from the age of 6 to the age of 13. This means that baby teeth remain in a child’s mouth for years. Therefore, a “‘sick” (carious) tooth cannot remain with a “hole” for years in a child’s mouth and should be treated immediately by making a filling. Suspension of a treatment e.g. of a filling can only bring negative results and worsen a situation, i.e. cause the caries to spread to other teeth in the child’s mouth.
• Children’s teeth are necessary for chewing, proper nutrition and therefore for the development of the child.
• They are important for speech development and correct speech.
• The presence of damaged teeth negatively affects a child’s psychology. A damaged tooth is likely to cause pain, which pain in turn causes the child to whine and be in a bad mood.

• Finally, the new teeth maintain the space in which the permanent teeth will emerge in the future.

The neogilon teeth fall out to be replaced in turn by the corresponding permanent teeth. It is understandable that it is difficult to fit 32 permanent large teeth in a small child’s mouth.

A 2.5-year-old child, whose baby teeth have erupted, has 20 baby teeth. Baby teeth are essential for chewing, proper nutrition, speech development and proper speech. But apart from these basic functions, they prepare the space for the eruption of permanent teeth. As the child grows over the years, his jaws also grow. Baby teeth exist as long as it takes for the jaws and permanent teeth to complete development. Then the roots of the baby teeth are gradually absorbed and when the permanent teeth are ready to emerge, the baby teeth “fall out”.

Children’s teeth appear in the child’s mouth with a pattern and a sequence. Below is an indicative table that refers to the eruption times of the new teeth.

Upper jaw

Central Domains	8 – 12 months
Side domains	9 – 13 months
Canines	16 – 22 months
First molars	13 – 19 months
Second molars	25 – 33 months

Lower jaw

Central Domains	6 – 10 months
Side domains	10– 16 months
Canines	17– 23 months
First molars	14 – 18 months
Second molars	23 – 31 months

Usually the two lower front teeth erupt first. Then follow the 4 sectors (incisors) in the upper jaw. The eruption process continues gradually with the last upper second molars at the age of 2.5 years. It is also worth noting that the teeth emerge in pairs, i.e. one on each side of the jaw.

As shown in the table there is a lot of variation (3 – 4) months about when a tooth will appear in the child’s mouth. There are children who “get” their teeth faster and others in whom the eruption process proceeds at a slower rate. Neither case is worrisome. The gender of the child also plays a role. Girls’ teeth “come out” earlier than boys.

Parents should be patient with the eruption of children’s teeth. A difference of 3-4 months compared to other children should not scare them. Only when any of the baby teeth have not erupted by the age of 3, it would be good for parents to consult a pediatric dentist.

Apoptosis of the baby teeth starts at the age of 6.5 – 7 years and lasts until the child is 12-13 years old. In this period of 6-7 years, the child has the so-called “mixed gap”, because in his mouth there are both baby teeth and permanent teeth.

Baby teeth fall out in the same order and sequence in which they emerged in the mouth. The first teeth that say goodbye to the child’s mouth are the lower central sectors. Then follow the lateral sectors, the first molars, the canines and finally the second molars. Baby teeth fall out in pairs (just as they come in in pairs). Usually, when a tooth falls out on one side of the jaw, the same tooth falls out on the other side in about the same period of time.

The baby teeth fall out when the corresponding permanent ones, which are going to replace them, have finished growing. Over the years, the child’s jaws have grown enough to accommodate the adult teeth. Then the baby teeth fall out and give way to the permanent teeth which will grow and take their final position in the mouth until the child has the final permanent barrier. The child acquires the permanent barrier with the loss of the last baby tooth, i.e. around the age of 13.

The eruption of neogila (children’s) teeth is completed at the age of 2.5 – 3 years depending on whether the child “took out” his first teeth quickly or slowly. So the total of the child’s first teeth is 20, ten in each jaw. Baby teeth are divided into the following categories:

• Sectors (incisors). There are 4 in each jaw (2 central and 2 lateral). The 2 central sectors in the lower jaw are the first teeth to appear in the mouth. The child, like the adult, uses them to cut food.
• Communications. There are 2 in each jaw and they also play a role in shredding food.
• Molars. There are 4 in each jaw and they are the large back teeth, which are useful for chewing food.

Children lack premolars, which appear in the permanent dentition.

When the child pulls out the baby teeth, he feels discomfort and irritation. Many times he does not want to eat and the pain does not let him sleep. All this has an impact on the family as well, who suffer and suffer with him. Listed below are some ways to relieve the child from the symptoms that bother him during the eruption of his first teeth.

Soft teething toys. In the trade there are special soft toys, which the child bites and relieves himself. If you put them in the fridge for a while and they cool down, they act even more soothingly.

Silicone ring. It is a small plastic pouch that the parent wears on their index finger and rubs the child’s gums with it, relieving it.

Painkiller. In case of intense anxiety that does not allow the child to eat or sleep, it is recommended to administer a painkiller, always of course in consultation with the pediatrician to obtain the correct dosage (according to his weight).

Chamomile. Chamomile has an anti-inflammatory and soothing effect, so it can be used either for the child to drink or to soak a gauze with which the parent will gently massage the child’s gums.

Mucosal ointments. In the trade there are many ointments, which are placed locally in a small amount in the child’s mouth and ease the pain. Their action is temporary, but many times they satisfactorily relieve the child. In other cases, they do not produce any particular effect.

Gaza. During the day, the parent can wet a gauze with either water or chamomile and rub the child’s gums.

Cold foods. Anything cool and hard is soothing to the child. A cold banana or a cool carrot can also provide relief to a struggling baby.

It is important that parents do not use drugs or anything else they have heard (which might relieve the child) without first asking the doctor’s opinion.

Η χρονική περίοδος κατά την οποία ένα παιδάκι βγάζει τα πρώτα του δοντάκια είναι ίσως από τις πιο δύσκολες τόσο για το ίδιο όσο και για τους γονείς. Το πρώτο δόντι εμφανίζεται στην ηλικία των 6- 9 μηνών και το τελευταίο όταν το παιδί έχει κλείσει τα 2 – 2,5 χρόνια. Υπάρχουν παιδάκια που δεν εκδηλώνουν συμπτώματα πόνου και η όλη διαδικασία ανατολής των παιδικών δοντιών τους είναι τελείως ανώδυνη. Στην πλειοψηφία όμως των περιπτώσεων τα περισσότερα μωρά υποφέρουν χωρίς καν να έχουν τη δυνατότητα λεκτικής έκφρασης στους γονείς τους για το τι τα ταλαιπωρεί. Τα συνηθέστερα συμπτώματα που συνοδεύουν την ανατολή των νεογιλών δοντιών είναι τα παρακάτω:

Σιελλόροια. Όταν ένα παιδάκι βγάζει τα πρώτα του δόντια παρατηρείται αύξηση του σάλιου του. Είναι χαρακτηριστική η εικόνα ενός μωρού που τρέχουν τα σαλάκια του. Κάποιες έρευνες υποστηρίζουν ότι η σιελλόποια είναι πρόνοια της φύσης για να πονάει λιγότερο το μωρό, γιατί κατά την εμφάνιση των παιδικών δοντιών σχίζονται τα ούλα του. ότα το σχίσιμο των ούλων γίνεται σε ένα περιβάλλον μες αυξημένο σάλιο πιθανόν να πονάει λιγότερο απ΄ότι αν γινόταν σ΄ένα πιο ξηρό περιβάλλον.

Εκνευρισμός. Είναι λογικό όταν ένα παιδί βγάζει ένα νέο δόντι να αισθάνεται ενόχληση και δυσφορία. Αρκεί κανείς να σκεφτεί ότι και για έναν ενήλικα ο πονόδοντος είναι πολλές φορές δυσβάστακτος. Πόσο μάλλον για ένα μωρό που δεξ ξέρει πολύ καλά τι του συμβαίνει και ούτε μπορεί να μιλήσει για να πει στους γονείς του τι αισθάνεται. Όλα τα παραπάνω είναι λογικό να προκαλούν μια νευρικότητα στο παιδί, το οπίο πολλές φορές δε ξέρει τι θέλει. Πράγματα που υπό φυσιολογικές συνθήκες δεν το ενοχλούσαν τώρα μπορεί να του επιφέρουν έντονο εκνευρισμό.

Πρησμένα ούλα. Τα ούλα πριν από την ανατολή ενός δοντιού πρήζονται, διογκώνονται και κοκκινίζουν. Μία τέτοια εικόνα των προμηνύει ότι σύντομα τα ούλα στο σημείο εκείνο θα σχιστούν και θα εμφανιστεί ένα νέο δόντι.

Κνησμός γύρω από τα αυτί. Πολλές φορές όταν πρόκειται να εμφανιστεί ένα δόντι ο πόνος αντανακλά στο αυτί. Το παιδάκι πολλές φορές παίζει νευρικά με το αυτί του και άλλες φορές το ξύνει. Εφόσον αποκλειστεί το ενδεχόμενο μιας ωτίτιδας, τότε πρόκειται για την ανατολή ενός νέου δοντιού.

Αϋπνία. Είναι αναμενόμενο ο πόνος και η δυσφορία που αισθάνεται ένα παιδάκι όταν βγάζει δόντια να προκαλεί διαταραχές και στον ύπνο του. Ο πόνος το αναστατώνει και είτε δεν το αφήνει να κοιμηθεί είτε το παιδάκι ξυπνάει προκειμένου να βρει κάποιο τρόπο να ανακουφιστεί από τον πόνο που το ταλαιπωρεί.

Μειωμένη όρεξη. Είναι λογικό όταν ένα μωρό πονάει στο στόμα του να μη θέλει να φάει. Δεδομένου οτι το παιδί έχει ένα μόνιμο δυσάρεστο πόνο σε συνδυασμό με το γεγονός ότι δεν ξέρει τι του  συμβαίνει είναι αναμενόμενο να διαταράσσεται και η όρεξη του να φάει.

Δάγκωμα αντικειμένων. Πολλές φορές τα παιδάκια όταν βγάζουν τα πρώτα τους δοντάκια δαγκώνουν διάφορα σκληρά αντικείμενα καθώς τους ανακουφίζει από τον πόνο.

Πυρετός. Πολλές φορές η ανατολή των παιδικών δοντιών συνοδεύεται από δέκατα, τα οποία οφείλονται  περισσότερο στην ταλαιπωρία του παιδιού. Ποτέ όμως δεν παρουσιάζεται υψηλός και επίμονος πυρετός.

Διάρροια. Η διάρροια οφείλεται στο γεγονός οτι το παιδί σ΄αυτή τη φάση βάζει στο στόμα του οτιδήποτε βρει προκειμένου ν΄ανακουφιστεί. Αυτό μπορεί να εξηγήσει την εμφάνιση μιας ενδεχόμενης διάρροιας, δεδομένου οτι κάποιο αντικείμενο / παιχνίδι μπορεί να μην ήταν και πολύ καθαρό.

Τα παιδιά δε θα πρέπει να αντιμετωπίζονται σαν κάτι το διαφορετικό απ΄ότι είμαστε εμείς οι ενήλικες. Είναι πολύ βοηθητικό αν σκεφτούμε πως θα αντιδρούσαμε εμείς οι μεγάλοι σ ένα συνεχόμενο πονόδοντο για να καταλάβουμε τι αισθάνεται ένα μικρό παιδάκι που βγάζει δόντια. Θα είχαμε σίγουρα την ίδια αντίδραση συμπεριφοράς με τα προαναφερθέτα με ίσως μία μεγαλύτερη δόση υπερβολής στην έκφραση των συναισθημάτων μας. Το ίδιο είναι και τα μικρά παιδιά. Πονάνε όταν βγάζουν τα νέα τους δόντια και προσπαθούν με κάθε τρόπο να μας το πουν και να μας το δώσουν να το καταλάβουμε γιατί έχουν και ένα επιπρόθετο πρόβλημα: δε μιλάνε! Σε αυτή τη χρονική περίδο ενός παιδιού οι γονείς θα πρέπει να οπλιστούν με πολύ υπομονή και να αγκαλιάσουν τα παιδάκια τους με όσο μεγαλύτερη τρυφερότητα και κατανόηση μπορούν.Τα νέα δόντια σύντομα θα βγουν στο στόμα και όλα θα έχουν περάσει.

The first permanent teeth that emerge in a child’s mouth are the first molars (table teeth) at the age of 6. These teeth are usually not noticed by the parents, because they appear behind the baby teeth (baby teeth) without a baby tooth “falling out”.

Afterwards, the apoptosis of the lower and upper front teeth gradually follows and their replacement by the corresponding permanent teeth. This first phase of changes in the child’s teeth (permanent molars, 4 front teeth in the upper and lower jaw) is completed by the age of 7.5-8 years. In the next 2 years or so, a phase of calm prevails in the child’s mouth, during which no change is made in order to balance the front teeth with each other. During 9-12 years, the final changes take place with the appearance of premolars, second molars and canines. The last permanent teeth that usually appear in a child’s mouth are the upper canines. In the distant future at the age of 18, the 4 wisdom teeth (one on each side) will appear in the mouth, as long as they are present and fit.

The permanent teeth do not hurt when they erupt in the child’s mouth, which is why they are often not noticed by the parents. The first permanent teeth to appear are the first molars, which come out behind the last baby teeth (see photo). It is typical that most parents are surprised when the dentist informs them that their child already has his first four permanent teeth.

The only time a child may complain of pain when a new tooth erupts is when the permanent tooth has already erupted and the corresponding baby tooth remains in place. Then the intervention of the dentist and the immediate extraction of the tooth is necessary.

Permanent teeth are those that appear in the mouth at the age of 6. These teeth replace the baby teeth (baby teeth) and are the ones we will have in our mouths for the rest of our lives. The eruption of the first permanent tooth begins with the first molar at the age of six and is completed at 18 with the appearance of the wisdom teeth.

There are 32 permanent teeth in total, but many times the wisdom teeth (2 in each jaw) either have difficulty erupting in the mouth (occluded, semi-occluded) because there is not enough space in the patient’s jaw, or are not present at all (genetic deficiency).

Permanent teeth are divided into the following categories

Sectors. In the mouth there are 4 sectors in theupper jaw (2 central and 2 lateral) and 4 in the lower jaw. They are also called cutters, because we use them to cut food.

Canines. They also belong to the front teeth and there are a total of 4 (2 in each jaw). They are also used for cutting food.

Premolars. They belong to the back teeth and succeed the first baby molars. Children don’t have premolars, only molars. There are 8 in total (4 in each jaw).

Molars. They are the back large teeth (table teeth) and are used for chewing food. Unlike the rest of the teeth, they have 2 (lower molars) or 3 roots (upper molars). The molars emerge behind the baby teeth, which is why it is often not noticed by the parents that the child has already acquired his first permanent teeth. In total we have 12 molars (including wisdom teeth). In most cases, however, there are 8 (4 in each jaw), because the wisdom teeth do not emerge in the mouth and remain locked or semi-locked.

Permanent teeth should be brushed twice a day with fluoride toothpaste. These are the adult teeth that the child will have in his mouth for a lifetime, so maintaining perfect oral hygiene is very important.

Brushing the teeth is a habit that should not be alien to the appearance of the permanent teeth (age 6-7 years), but should be adopted much earlier when the first baby teeth appear in the child’s mouth (6-9 months). Baby teeth are the precursors to permanent teeth and it is important to keep them healthy.

The first permanent teeth that emerge in the child’s mouth are the first molars (table teeth), which appear without any symptoms of pain and without any new teeth having previously fallen tooth. This is also the reason why many parents do not realize that their child has already got his first permanent tooth.

After the appearance of the first molars, the order of eruption of the remaining permanent teeth is listed in the table below:

With the exception of the wisdom teeth, the child at the age of 13 has acquired all his permanent teeth, which in total are 28. In the majority, the teeth numbered in the mouth of most patients are 28 and not 32 (including all 4 wisdom teeth). Wisdom teeth are considered vestigial organs since man had to chew harder foods and therefore needed more teeth. Over the years the third molars tend to disappear. Sometimes they are not present in the mouth at all and other times when they are present they do not have the necessary space to emerge in the correct position. It is often recommended to extract them due to the dental problems (periosteanitis, caries in the adjacent teeth) caused by their position, inclination, etc.

New teeth anatomically are the same as permanent teeth, i.e. they are externally covered by enamel (tooth enamel). The next layer (moving towards the inside of the tooth) consists of the dentin, which surrounds the pulp (nerve) of the tooth. The pulp is located in the center of the tooth.

Morphologically baby teeth are similar to permanent teeth, but they present some differences:

• They are smaller in size both in length and width. This is justified by the fact that the child’s jaws are still small to accommodate large teeth. Over the years, the jaws develop, causing the baby teeth to “fall out” and be replaced by the corresponding permanent large teeth.
• They have finer and less calcified enamel. This means that when a child’s tooth gets caries, a hole (due to caries) is created sooner in the tooth compared to the permanent ones. Therefore, caries in children’s teeth develops at a faster rate due to their morphology, so their treatment should be carried out immediately. A small hole in young teeth can soon develop relatively quickly into a large carious lesion, which in some cases also affects the pulp of the tooth. The sooner a tooth is treated, the more supportive the operation by the dentists will be.
• They have a larger pulp chamber. In other words, the space occupied by the nerve of the baby tooth is larger compared to the permanent ones. This, combined with the fact that their adamantine is thinner, very often results in the nerve of the tooth being attacked by caries. In this case, since the caries has reached the level of the pulp, a pulpotomy is required to treat the tooth.
• They have smaller and finer roots, which over the years will be absorbed. When the absorption of the roots is complete, then the apoptosis of the new teeth follows and their replacement by the permanent teeth.
• In the juvenile dentition there are no premolars, as in adults, only molars (4 in each jaw).

A frequent question and concern of parents is that the permanent teeth are more yellow than the corresponding baby teeth. This is completely normal, because adult teeth have a thicker and yellower layer of dentin. Dentin is the next layer of dental substance after enamel (tooth enamel). Since this layer (the dentin) is thicker and yellower, the permanent teeth are next to be yellower in color, as the yellower dentin under the enamel “shows through”.

The difference is pronounced in the period of the mixed barrier, i.e. in the period of 6 – 12 years. Then in the child’s mouth there are new teeth and permanent teeth and it is expected that the parents will see a strong difference in color between the two categories of teeth. But when all the teeth are changed and the child has only permanent teeth in his mouth, the difference in color disappears and there is no longer an aesthetic problem, since all the teeth are the same color

Using a pacifier in infancy is a normal habit, as the child tries to replace the habit of breastfeeding with it. There are different opinions about when a child should wean off the pacifier. It is important to mention that its use is allowed up to the age of 3.5 – 4 years without it being considered a harmful effect. If the child continues to use it after this age, then orthodontic problems may arise, such as increased maxillary protrusion (the upper jaw protrudes further than the lower jaw) or anterior yawning (gap between the front teeth of the upper and lower jaw when the child closes the mouth). However, parents should not be particularly worried because these orthodontic problems are eliminated relatively soon if the pacifier is used. is interrupted in time. If not then you may need orthodontic treatment. In case the child has difficulty stopping the use of the pacifier, the parents will be able to turn to the pediatrician to suggest some helpful ways.

Very often parents alarmingly report that at night they hear their children grinding their teeth. Teeth grinding is not at all alarming and has the following causes that can explain where it comes from:

Mixed teeth. Children between the ages of 6 and 14 have both baby teeth and permanent teeth in their mouths. This often results in the teeth of the upper jaw not coming into full correspondence with the teeth of the lower jaw. So in their effort to find the point where the upper jaw fits perfectly with the lower jaw, children grind their teeth.

Άγχος και ανησυχία. Τα παιδιά είναι όπως οι ενήλικες. When they have a test at school, when they are saddened by some event at school or at home, they also want to channel somewhere the inner sad feeling that possesses them. So they often clench their teeth in an attempt to “drive away” their anxiety.

Research has shown that hyperactive children grind their teeth.

Teeth grinding can also occur in children who pain, because there are decayed teeth inside their mouth. Finally, children with unwanted behaviors, such as nail biting, cheek or finger sucking many times at night grind their teeth.

Το τρίξιμο των δοντιών δεν έχει συγκεκριμένη θεραπεία. It is important before the child goes to bed to relax either by reading a book or taking a relaxing bath. Parents should not worry at all, because in the majority of cases children stop grinding their teeth when they get all their permanent teeth. After puberty, the phenomenon of teeth grinding is usually no longer observed.

Η παρουσία υπενασβεστιωμένων δοντιών αφορά κυρίως τους μόνιμους γομφίους και σε μερικές περιπτώσεις και τους μόνιμους τομείς. Η ασθένεια αυτή είναι γνωστή ως Υπενασβεστίωση Γομφίων Τομέων (ΥΓΤ). Οι οδοντίατροι πρέπει να είναι πολύ προσεκτικοί στη διάγνωση και θεραπεία αυτών των οδοντιατρικών βλαβών.

Στην ουσία πρόκειται για την εμφάνιση υπενασβεστιωμένης αδαμαντίνης σε 1 ως 4 μόνιμους γομφίους. Σε κάποιες περιπτώσεις η ασθένεια προσβάλλει και τους μόνιμους τομείς.

Η υπενασβεστίωση γίνεται αντιληπτή , συνήθως πρώτα από τους γονείς, περίπου στην ηλικία των 8 ετών οπότε έχουν ανατείελι όλοι οι μόνιμοι γομφίοι και τομείς.

Η αιτιολογία των υπενασβεστιωμένων δοντιών δεν είναι ακόμη σαφής και απαιτείται η διεξαγωγή περαιτέρω ερευνών. Στη βιβλιογραφία αναφέρονται κάποιοι πιθανοί αιτιολογικοί παράγοντες που μπορεί να δικαιολογήσουν την εμφάνιση υπενασβεστιωμένης αδαμαντίνης, χωρίς όμως να είναι απόλυτα τεκμηριωμένοι. Μερικά, λοιπόν, πιθανά αίτια μπορεί να είναι:

• παιδικές ασθένειες ως την ηλικία των 3 ετών.
• ασθένειες της μητέρας κατά τη διάρκεια της εγκυμοσύνης
• πρόωρος τοκετός
• χορήγηση αντιβιοτικών σε παιδιά μικρής ηλικίας κ.α.

Όλα τα προαναφερθέντα αίτια είναι “εικασίες” χωρίς να έχουν τεκμηριωθεί απόλυτα επιστημονικά οτι μπορεί να προκαλέσουν την εμφάνιση υπενασβεστιωμένης αδαμαντίνης.

Ο οδοντίατρος ξεχωρίζει τα δόντια (συνήθως γομφίους) με υπενασβεστιωμένη αδαμαντίνη καθώς εμφανίζουν μία χαρακτηριστική κλινική εικόνα. Πιο συγκεκριμένα οι γομφίοι παρουσιάζουν περιγεγραμμένες περιοχές λευκού, κίτρινου ή καφέ χρώματος συνήθως στο ύψος των φυμάτων. Πιο σπάνια προσβάλλονται και οι τομείς (κοπτήρες) με τη νόσο να κάνει την εμφάνιση της στο κοπτικό χείλος του δοντιού με τη μορφή λευκών κηλίδων ή κίτρινων κηλίδων.

Οι αλλοιώσεις αυτές εφόσον πρόκειται για υπενασβεστιωμένες περιοχές, έχουν μαλακή και πορώδη σύσταση με αποτέλεσμα να είναι πιο επιρρεπείς στην τερηδόνα. Επίσης οι περιοχές αυτές σπάζουν και απομακρύνονται ευκολότερα από το δόντι.

Η ΥΓΤ εμφανίζεται συχνότερα στους γομφίους / τομείς της πάνω γνάθου συγκριτικά με την κάτω γνάθο.

Τα δόντια με ΥΓΤ λόγω της πορώδους σύστασης είναι ευαίσθητα και πονούν ιδιαίτερα κατά τη λήψη θερμών και ψυχρών ερεθισμάτων. Πολλές φορές λόγω της ευαισθησίας τα παιδιά αποφεύγουν τη στοματική υγιεινή, με αποτέλεσμα να συσσωρεύονται τα υπολείμματα τροφών και να αυξάνεται ο κίνδυνος τερηδονισμού των δοντιών αυτών.

Όσον αφορά τη θεραπεία των δοντιών αυτών θα πρέπει να γίνει αρχικά αναφορά στην πρόληπτική θεραπεία που προτείνει ο οδοντίατρος για την αντιμετώπιση  των δοντιών με ΥΓΤ. Οι μικροί ασθενείς θα πρέπει να βουρτσίζουν καθημερινά τα δόντια τους με ειδική οδοντόπαστα που συστήνουν οι οδοντίατροι εξατομικευμένα στον κάθε ασθενή. Επίσης συστήνεται η καθημερινή χρήση στοματικού διαλύματος και η περιοδική τοπική εφαρμογή σκευασμάτων φθορίου.

Η αποκατάσταση των δοντιών με υπενασβεστιωμένη αδαμαντίνη πραγματοποιείται με λευκά σφραγίσματα  ή με ειδικές ανοξείδωτες στεφάνες, ανάλογα με την έκταση των αλλοιώσεων. Η δυσκολία στην αντιμετώπιση των οδοντικών αυτών βλαβών συνοψίζονται στους παρακάτω παράγοντες :

•  Αδυναμία επίτευξης επαρκούς αναισθησίας. Τα δόντια με ΥΓΤ έχουν αυξημένα ευαισθησία με αποτέλεσμα ακόμη και υπό τοπική αναισθησία τα παιδιά να αισθάνονται τον τροχισμό και να πονούν.
• Δίλημμα από την πλευρά του οδοντιάτρου να αποφασίσει πόση ποσότητα υπενασβεστιωμένης αδαμαντίνης πρέπει να αφαιρέσει και πόση να αφήσει.
• Δυσκολία συνεργασίας παιδιού και οδοντιάτρων, καθώς έχει διαπιστωθεί οτι παιδιά με τη νόσο ΥΓΤ είναι ιδιαίτερα αγχωμένα και φοβισμένα, καθώς στο παρελθόν έχουν περάσει αρκετές επώδυνες οδοντιατρικές θεραπείες.

Η έγκαιρη διάγνωση και αναγνώριση δοντιών με υπενασβεστιωμένη αδαμαντίνη από τον οδοντίατρο είναι πρωταρχικής σημασίας για τη θεραπεία των νοσούντων αυτών δοντιών. Όσο πιο γρήγορα γίνει η αποκατάσταση αυτών των δοντιών τόσο λιγότερο ταλαιπωρείται το παιδί κατά την καθημερινότητά του αλλά και κατά τη διάρκεια της οδοντιατρικής θεραπείας.

Many times parents wonder. But my child is very young. Is it possible that he has gingivitis? And yet, from the moment when all the child’s teeth emerge in his mouth, it is possible for gingivitis to appear. Even more often it occurs in mixed dentition, that is when the child is around 7-13 years old and has both baby and permanent teeth in his mouth. The typicalclinical picture of gingivitis is red, slightly to very swollen gums as well as bleeding during brushing. The cause is negligent oral hygiene, which in combination with microbial plaque causes irritation and sometimes pain in the gums. During puberty, intense hormonal changes are added, which in combination with the presence of plaque increase the appearance of gingivitis.

Gingivitis is treated with the standard cleaning of the teeth by the dentist and then the patient is asked to maintain excellent oral hygiene conditions according to the dentist’s instructions. If the dentist considers it necessary, it is possible to recommend the use of special oral solutions or special gels for the fastest and most effective healing of the gums.

In general, gingivitis in children is not a special oral condition. It should not scare parents, since it is often encountered and its treatment is simple.

The appearance of periodontal disease in children is rare, but not non-existent. There are 2 categories of periodontitis in children:

1. The prepubescent, which appears either in the newborn or in the permanent dental barrier. When periodontitis occurs at a young age, there is usually a general health problem in the child and further general examinations are necessary.

2. The adolescent, which you find in teenagers or even in people a little older. This periodontitis is more common and affects only the permanent teeth (usually the sectors). It is mainly due to poor oral hygiene, sometimes combined with general diseases (not always).

The two aforementioned forms of periodontitis can appear either localized (on specific teeth) or generalized (throughout the child’s mouth).

Periodontitis in children is a condition that affects their gums. In its acute phase, the child complains of severe pain that does not allow him to eat and many times he is unable to sleep. His gums are bright red and swollen, while the child reacts strongly to their touch due to pain. In addition, his gums bleed automatically and/or when brushing his teeth, while at the same time he has bad breath (bad breath). Sometimes the child may have a fever or even a fistula or discharge of pus in certain teeth. In advanced situations, tooth mobility or even receding gums may occur.

Childhood periodontitis is usually causedby untreated gingivitis, which in turn was caused by poor oral hygiene. So it all starts with incomplete non-systematic brushing of the teeth. In some cases periodontitis in its acute form can be related to the traumatic closure of children’s teeth.

If a child complains that he cannot eat or brush his teeth due to pain, then an immediate visit to the dentist is necessary for early diagnosis, treatment and prevention of the progression of periodontal disease.

The treatment of childhood periodontitis depends on the degree of gum inflammation and requires:

• The professional teeth cleaning with ultrasound by the dentist. In case of severe pain, local anesthesia is administered, so that small patients do not suffer during the treatment.

• Very good daily oral hygiene always according to the dentist’s instructions. It may also be necessary to use a special mouthwash.

• In advanced cases of periodontitis antibiotics are required.

• In the event that the periodontitis is due to a traumatic closure of the teeth, then an immediate visit to the orthodontist is necessary to deal with the problem as soon as possible.

Patients should know that the sooner a dental problem is treated, the easier and shorter the restoration of the mouth will be compared to a problem that persists.