Pediatric Dental Issues

Good dental care starts about the time a child's first tooth arrives. The American Academy of Pediatric Dentistry recommends a first dental visit by the age of six months, and no later than a year. Pediatric dentists treat infants to adolescents, because this age group presents different issues than the adult patient population. A proper diet, good oral hygiene habits and regular dental checkups can help to prevent some of these common pediatric dental problems.

Early Childhood Caries

• Infants to children under the age of six can get ECC

  The most common pediatric issue is Early Childhood Caries (ECC), which is the presence of decay in teeth in children under the six years old. Tooth decay is 20 times more common than diabetes and five times more common than asthma. ECC is caused by consumption of carbohydrates (e.g., milk, juice, breast milk, or other sweets) that enables bacteria to break down the enamel on teeth. The loss of enamel allows the tooth to decay, resulting in pain and possible tooth loss. According to the Journal of Public Health Dentistry, between the age of two to five, over 70 percent of the decay can be found in only 8 percent of the population. The majority of ECC will be diagnosed in children from poor socio-economic backgrounds or in children who live in countries where limited dental treatment is available.

Eruption, Positioning and Tooth Structure Problems

• Pediatric problems include abnormality in structure and positioning.

  A common problem in pediatric patients is abnormal eruption or positioning of deciduous teeth (also known as "baby teeth"). These problems may be present for genetic reasons, but may also be indicative of developmental problems such as thyroid issues (hyper and hypo), supernumary (extra) teeth, hormonal abnormalities or cleft palate, amongst other possible conditions. Loss of primary teeth can also cause early emergence of adult teeth; deciduous teeth are often lost due to decay or trauma. Structural oddities in teeth can include twinning (two or more teeth fusing together), macrodontia (abnormally large teeth), and microdontia (abnormally small teeth).

Tooth Color Abnormality

• There are two varieties of tooth color abnormalities: intrinsic and extrinsic. Intrinsic stains are caused by the introduction of certain drugs (like tetracycline) during tooth formation, neonatal excess of bilrubin (hyperbilrubinemia) which causes blue/black stains, or blood borne pigments caused by conditions such as anemia and hemolysis. Consuming too much fluoride, commonly found in tap water, can also cause white splotchy stains or discoloration. Extrinsic stains, conversely, are superficial, and caused by food or drink substances attaching to plaque or enamel to discolor the tooth. Extrinsic stains are removed by regular dental cleanings; intrinsic stains will require bleaching, if the stains are removable at all.

Dental Trauma

• Dental trauma is a common problem in children, often requiring a visit to the emergency room or the pediatric dentist. Young children between the age of one to three tend to require emergency dental treatment due to falls or abuse. School-aged children typically experience dental trauma through bicycle, scooter or playground accidents. Adolescents most commonly lose or break teeth from sports, fights or car accidents.