Pediatric Dentistry: Common Oral Conditions & Treatment Options

What is Pediatric Dentistry?

Pediatric dentistry is defined as the practice, teaching, and research of preventative oral care in children from birth through adolescence. Pediatric dentists encompass all aspects of oral health care for developing children. They also offer specialized dental treatment for sick and disabled children.

After a teenager turns 18 years old, they will no longer receive treatment from a pediatric dentist. Instead, he or she will visit a general or family dentist.

Children should visit their pediatric dentist twice a year. These visits should begin within six months of an infant’s first tooth eruption. Common oral conditions that affect children include:

  • Dental caries, which are also called tooth decay or cavities
  • Gum diseases, including gingivitis (mild) and pediatric periodontal disease (advanced)
  • Dental erosion, also referred to as enamel erosion
  • Tooth development interruptions and other abnormalities, such as a cleft lip and palate
  • Early orthodontic treatment corrects severe bite issues in children before all of their permanent teeth erupt
  • Physical damage to the face caused by traumatic injuries, such as car accidents

Children should see a pediatric dentist every six months for a pediatric dental exam and teeth cleaning. These exams help reduce the chance of disease by keeping the mouth and teeth healthy throughout life.

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Early Childhood Caries (ECC)

Cavities are the most common dental condition that affects children of all ages.

From 1970 to 1990, cavities in baby teeth decreased in children between 2 and 11 years of age. Although, since the mid-1990s, research has shown an increase in baby tooth decay in young children.

The oral habits a child develops in the first three years of life (when baby teeth have fully erupted) may not be concerning to parents at the time. But these habits can be difficult to break, even though the majority of children outgrow them over time.

42 percent of children (2 to 11 years) have had cavities in their baby teeth.

23 percent of children (2 to 11 years) have untreated cavities in their teeth.

Preventive Pediatric Dental Treatments

Preventive dental treatments for children include sealants and fluoride. Both of these treatments help protect the teeth from cavities.

sealant1

Sealants & Cavity Protection

If a child has deep pits and grooves in their baby (primary) teeth, a sealant might be placed to prevent tooth decay. However, sealants are usually not placed on permanent teeth because they aren't strong enough.

fluoride

Benefits of Fluoride

If children establish dental care practices at home, they are less likely to develop cavities. These habits include fluoride use, brushing twice a day, and flossing regularly. If a child does have a cavity, it’s crucial to seek restorative treatment, such as fillings or crowns.

Since the introduction of fluoride, there has been a decrease in dental caries in children and adults.

The right amount of fluoride in drinking water is 0.7 parts per million (ppm). However, excessive fluoride consumption can lead to dental fluorosis. Fluorosis is the hypomineralization of tooth enamel, which leads to abnormal enamel development (white or brown spots). The condition is commonly found in children, specifically during the first few years of tooth development.

Proper water fluoridation is also backed by over 70 years of research and is proven to be safe, effective, and healthy.

Fluorosis does not pose health problems because the symptoms are mild and curable. Although, pediatric dentists specialize in fluoride treatment for children who have fluorosis or low fluoride intake.

Their are two forms of fluoride:

Dietary Fluoride Supplements

This type of fluoride treatment comes in a tablet form. It is only recommended for children who consume drinking water that is low in fluoride or have a high risk of developing cavities.

Topical Fluoride Therapy

This type of fluoride treatment is for children between 3 and 6 years of age. This includes self-applied fluoride toothpaste and professionally applied treatments, such as gels, pastes, and varnishes. Topical treatments are used to prevent dental decay and are completed during a pediatric dental exam or teeth cleaning.

Other Common Childhood Dental Conditions

Dental erosion, gingivitis, and periodontal disease can also affect children of all ages.

dental erosion

Dental Erosion

Dental erosion is the irreversible loss of tooth enamel. It is caused by excessive exposure to acidic liquids and food (with a pH below 5.0-5.7). Baby (primary) teeth are more prone to erosion than permanent teeth. This is because the primary teeth enamel is thinner and less mineralized.

The presence of dental erosion in children ranges from 10 to 80 percent. In most cases, treatment isn’t needed. Your pediatric dentist may recommend changes in lifestyle, behavior, and diet. Although, if the condition becomes severe, fillings are typically necessary.

gingivitis gum disease

Gingivitis

Gingivitis is characterized by inflammation occurring in the gingival tissues with no loss of bone or attachment.

While gingivitis is a serious condition, it appears less in the early primary dentition (baby teeth). This is because children have less plaque buildup than adults. For children who do have gingivitis, a pediatric dentist will recommend professional dental care treatment, brushing, and flossing.

scaling root planing

Pediatric Periodontal Disease

If gingivitis is left untreated, it can turn into pediatric periodontal disease (PD), a serious oral disease affecting the gums and jaw bone. Common symptoms of periodontal disease include red, receding, and bleeding gums.

This condition is also mostly diagnosed in teenagers and adults. Treatment options for PD include scaling and root planing. This treatment is the process of cleaning between the teeth and gums (deep cleaning).

Restorative Pediatric Dental Treatments

Using fluoride daily is essential for every child, especially in the early stages of life. Fluoride helps reduce plaque buildup. It also prevents tooth decay and even tooth loss.

However, if a child already shows serious signs of tooth decay or other oral diseases, more invasive preventive treatments are necessary. Depending on the dental condition you child has, pediatric treatment options may include:

cavity filling

Cavity Fillings

Cavity fillings are the most common restorative treatment for children who have minor cavities. They are also minimally invasive and completed within one dentist visit.

root canal

Pediatric Pulp Treatment

Pulp treatment is known as a baby root canal or pediatric pulp therapy. In short, it is used by pediatric dentists to treat, save, and restore a child’s decayed baby (primary) teeth.

tooth crown

Stainless Steel Crowns (SSCs)

Stainless steel crowns are used to protect a child’s molars (back primary teeth) that haven’t formed properly or are heavily decayed. Although, sometimes pediatric dentists have to put SSCs on front teeth.

tooth

Tooth Extractions & Space Maintainers

Tooth extractions, or the removal of a tooth, is usually caused by trauma, disease, crowding, or tooth decay. Space maintainers are then placed where the extracted tooth was to ensure the child’s permanent tooth grows in correctly.

Resources

American Academy of Periodontology. Gum Disease In Children | Perio.org, www.perio.org/consumer/gum-disease-and-children.

“Dental Caries (Tooth Decay) in Children Age 2 to 11.” National Institute of Dental and Craniofacial Research, U.S. Department of Health and Human Services, www.nidcr.nih.gov/research/data-statistics/dental-caries/children.

“Fluoridation FAQs.” Fluoridation FAQ, www.ada.org/en/public-programs/advocating-for-the-public/fluoride-and-fluoridation/fluoridation-faq.

“Fluoride and Healthy Teeth.” Paediatrics & Child Health, Pulsus Group Inc, Oct. 2002, www.ncbi.nlm.nih.gov/pmc/articles/PMC2798600/.

Koch Göran, et al. Pediatric Dentistry: a Clinical Approach. John Wiley & Sons Inc., 2017.
Nowak, Arthur J. Pediatric Dentistry: Infancy through Adolescence. Elsevier, 2019.

Taji, S, and W K Seow. “A Literature Review of Dental Erosion in Children.” Australian Dental Journal, U.S. National Library of Medicine, Dec. 2010, www.ncbi.nlm.nih.gov/pubmed/21133936.

“The Use of Fluoride in Infants and Children.” Paediatrics & Child Health, Pulsus Group Inc, Oct. 2002, www.ncbi.nlm.nih.gov/pmc/articles/PMC2798610/.

Zou, Jing, et al. “Common Dental Diseases in Children and Malocclusion.” International Journal of Oral Science, vol. 10, no. 1, 2018, doi:10.1038/s41368-018-0012-3.

Updated on: May 27, 2020
Author
Alyssa Hill
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Medically Reviewed: October 11, 2019
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Lara Coseo
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