Orsetta has a little wiggling tooth and she is anxiously waiting for it to fall because she’s curious to see the tooth fairy’s gift. But when Mother Orsa takes her to the dentist, little Orsetta is scared only by the idea of getting into the dentists' chair. What are all those tools and what are they for? The dentist, a very nice lady, makes her feel comfortable. Then quickly and without pain, she does her job.
It is the story told in the book "Today we go to the dentist" of the two American authors Stan and Jan Berenstain, among the best known for the creation of children's books.
How often do you hear children say
"No, I'm not going to the dentist!" ...
But teeth from an early age need care and require periodic checks by the pediatric dentist.
What is the right age for the first visit?
What is the oral hygiene that must necessarily be followed for the health of the teeth?
What are the most common problems in children? And above all, what is the right approach with young patients?
To these questions and more, the doctor answered Lidia Francesca Piazzini, specialized in Pedodontics: general dentistry and preventive orthodontics for children in Dubai.
Dr. Piazzini, can children's teeth be treated by all dentists? You are a specialist in Pedodontics, which means?
Children must be followed by a pediatric dentist who specializes in approaching young patients. The specialization in pediatric dentistry requires a complete preparation even with humanistic discipline exams. Specifically, pediatric dentistry includes: general dentistry, i.e. dental treatment for children from birth to the end of growth and preventive orthodontics which includes all those procedures or precautions that can be put in place to prevent malocclusion . Furthermore, facilitate the harmonious growth of the teeth by also correcting bad habits such as: thumb sucking, atypical swallowing (interposition of the tongue between the teeth during swallowing), incorrect breathing, all elements that can generate misalignments of the teeth and malocclusions. This process is often necessary to prevent more invasive and longer treatments once teething and craniofacial growth is complete and to possibly avoid the extraction of healthy permanent teeth.
In your opinion, why are children afraid to go to the dentist?
The fear of children almost always arises from something they do not know. That referring to the child who goes to the pediatric dentist for the first time is very often connected to the anxieties of the parents or other adults who unconsciously transmit them to the children because in turn they are afraid of the dentist for trauma suffered in the past. At the base of my profession there is above all the right approach towards children precisely to avoid that they experience the visit to the dentist as a trauma. Naturally, the pediatric dentist must adapt to the individual case by making use of his professionalism and experience.
What is his secret in approaching children to reassure them and win their trust?
I study the behavior of children from the waiting room. I have been in the profession for 25 years and I am perfectly capable of approaching children according to their behaviors and fears. Very few little patients I have sent to the operating room for dental treatment under general anesthesia. I start by framing the behavior of each individual child and then I propose a communication based essentially on play. From the first meeting with the child, depending on the age, the type of visit, if control or in the presence of a symptomatology, I follow a precise path. Another aspect that should not be underestimated is environmental conditioning. In my room there is a television with the projection of cartoons which is a valid tool able to relax and put the child at ease.
How important are the emotions of the little ones in your work?
They are the foundation of my work, the key to success in childcare.
When to make the first visit to the pediatric dentist?
My advice is not to wait until there is a serious reason to take your child to the pediatric dentist for the first time as this could reinforce negative thinking. In order for it to be a positive experience, it is important that the child arrives when there is no pain, in order to have the serenity to settle in a new context. If the checkups become a routine, starting from 2/3 years of life, the child will have confidence and less and less fear. In this way we act on prevention, avoiding more serious problems that require annoying and painful interventions. For theAmerican Academy of Pediatric Dentistry the first visit should take place as soon as the first tooth appears. During the first visit, a complete examination is carried out, food and hygiene advice is given to maintain good dental health and on the best prevention measures. Parents are advised to pay attention to the hygiene of their children's teeth starting with the appearance of the first tooth. The use of wet gauze to clean the mouth and teeth is fine up to 12 months to avoid damaging the delicate mucous membranes of the baby, after which you can start using a small soft-bristled toothbrush. All without toothpaste. From the age of 3, the child can start brushing his teeth on his own with a toothbrush and fluoride toothpaste (small amount) specific to his age and under the supervision of an adult.
What is your method?
From the first visit begins a journey made up of scheduled meetings every 6 months. It is important to establish a relationship of trust with the little patient from the beginning through dedicated techniques, one of all the tell-show-do (TSD) which allows you to help children receive dental care. As the name implies, it consists of three phases: TELL: explain to the child what you are going to do; SHOW: show the tools and how the work we are going to carry out will be performed, simulating the intervention on a toy denture or on the fingers of one hand and DO: start the work in the mouth of the little patient. With the use of their hands I allow the little patients to lose confidence with their mouth and make them understand that everything I am going to do will not be intrusive and painful. I start by having him count his fingers and then his teeth. Then I take a toothbrush and together we first clean the nails of their hands and then do the same operation with the teeth. In short, all actions that reassure the child and useful for establishing a relationship of trust that will last over time.
Burning issue: dental anesthesia. In this case?
Anesthesia? I don't do anesthesia, I have the cosmic ray gun! A little trick that I devised to avoid traumatizing the child. They do not see what I have in my hand, I invite them to close their eyes and I explain to them that they will feel a little discomfort similar to the pinch of a mosquito and that they will feel a bitter taste in the mouth, nothing more.
Beware of sugars! What are the most common problems in children?
Dental caries caused precisely by an excessive intake of sugars and the bad habit of not brushing your teeth especially before going to sleep. It is important to brush your teeth before going to bed because at night salivation decreases, the pH of the mouth becomes more acidic, the sugars ferment and the bacteria become more aggressive.
Bottle and pacifier, how much do they influence the formation and growth of teeth?
It depends on the (ab) use. The bottle, with milk and sugars, if used excessively during the night can lead to the formation of dental caries. The habit of sleeping with a pacifier for several years can favor the appearance of malformations of the mouth and dental arches and maintain atypical swallowing which should instead disappear with the emergence of the teeth. In any case, the use of the pacifier should be eliminated in the second year of life.
What are your tips for protecting children's mouths?
First of all, to educate parents in a correct dental hygiene of the child: brush the teeth twice a day in the morning and in the evening before going to sleep; prevent the baby from falling asleep with bottles containing milk, fruit juices and sugary drinks; get rid of the pacifier habit as soon as possible; first meeting with the pediatrician-dentist around 2 years of age and continue, in the absence of pathologies, with six-monthly meetings.
"Prevention, trust the doctor and follow his advice".
Prevention, trust and trust the specialist and follow his advice.