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pediatric dentistry

At Mondzorgpraktijk Valeriusstraat in The Hague we pay a lot of attention to pediatric dentistry. Read all about this on this page.

child being treated by the dentist

Taking your child to the dentist

It is important that your child visits the dentist on time. Not only does this promote healthy dental development, but it also reduces anxiety later in life. That is why we recommend that you take your child for a check-up as soon as the first tooth has broken through.
This need not be a financial barrier for anyone: the basic insurance reimburses dental costs (with the exception of crowns, bridges and braces treatment) for all children and young people up to the age of 17. You can take your child to your own six-monthly check-up; this way your child sees that you yourself are lying in the chair and that nothing unpleasant is happening.

Tips for your child's dental visit

  • Only take your child to a six-monthly check-up of yourself if you are sure that no treatment will take place.
  • If you are anxious yourself, ask your partner, a family member or another acquaintance to accompany your child on the (first) visit to the dentist.
  • It is good for young children if one of the parents is present during the check-up or treatment. Older children can try to do it on their own. This gives them more confidence. The presence of the parents/carers in the treatment room is usually in consultation with the dentist.
  • If you stay with it as a parent, leave as much as possible to the dentist. Do not make false promises, such as: 'Nothing will happen', 'You will feel absolutely nothing'. If it does hurt, your child may feel betrayed.
  • You can reward your child if he keeps up. Give it a small present, let it stay up an hour longer or come up with something else fun. Always reward afterwards and don't promise anything in advance ("If you do what the dentist says, you get....."). This often leads to difficult negotiations with the child.


Source: Fear of dental treatment (2006) by Prof. Dr. A. de Jongh, dentist for anxiety counseling and NVvK

Why is good dental care so important?

You want to prevent your child from hurting teeth, molars or gums while talking, eating or even constantly. Nevertheless, a hole in the molars has arisen. And if teeth have to be pulled due to neglect, your child may also develop problems chewing in addition to pain. Bad teeth cause many inconveniences and do affect the permanent, adult teeth. Namely:

  • The premature loss of baby teeth or molars (for example because they have to be pulled) can lead to space problems or misalignment of permanent, adult teeth.
  • Inflammations of the primary teeth can spread to the permanent, adult teeth.
  • Cavities in baby teeth or molars can affect the permanent, adult teeth and molars that are already present.

6 tips to keep your child's teeth healthy:

1. Provide a maximum of 7 eating and drinking moments per day.
2. Brush with fluoride toothpaste as soon as the first tooth breaks through.
3. After brushing, do not eat or drink in the evening, except water.
4. Take your child to the dentist as soon as the first tooth has erupted.
5. Brush 2 times a day for 2 minutes and always brush up to 10 years.
6. Do not give bottles with (thick) juice or lemonade to small children.
Did you know that the basic insurance fully reimburses the dental costs for children up to the age of 18, with the exception of crowns, bridges, braces and implants? And there is no deductible.

milk teeth

Prior to permanent teeth, a child first has milk teeth. The first baby tooth erupts on average between 6 and 9 months. Growth continues until a child is about two and a half. Ultimately, a child gets 20 baby teeth/molars.
Poor care of the primary teeth can also affect the permanent teeth.

father brushing teeth with a child

Getting through first milk teeth

The age at which children get teeth varies from child to child. On average, a child gets his first milk teeth between 6 and 9 months. Usually the lower incisors come through first, then the two middle upper incisors and then the teeth on either side. You can feel for yourself whether your child is teething. A hard bulge in the gums often indicates an erupting tooth.

Pain when first milk teeth come through

Most babies become restless and tearful when the first milk teeth erupt. In addition, your baby may not sleep well and may even have a slight fever or changed stools. This disappears again as soon as the tooth has come through. You can slightly relieve the pain by massaging the gums at the site of the erupting tooth. There are also medicines that slightly numb the gums, which reduces the pain. Ask your dentist for advice.

Brushing teeth with your child

You start brushing the teeth from the moment the first tooth has erupted. You can brush your teeth once a day up to 2 years and twice a day from 2 years. The best way to do this is to stand behind your child and rest his head on your hand. The little ones are best brushed lying on the changing table. Use a small, soft-bristled toothbrush and put a small ball of toothpaste on it. Make gentle, massaging motions over both teeth and gums.

As your child gets older, you can give your child more responsibility by having their teeth brushed themselves. Up to the age of 10 it is important to brush the teeth at least once a day, preferably in the evening. Even afterwards it is important to regularly check and supervise the brushing of your teeth.

Use fluoride with deciduous teeth

Fluoride makes teeth stronger and prevents cavities from forming in teeth. That is why most toothpastes contain fluoride. Brushing your teeth is currently seen as the best way to apply fluoride. From the moment that children get the first milk teeth, it is therefore important that you brush with fluoride toothpaste, tailored to the age of your child.

Food and the milk teeth

If you are breastfeeding, you can continue to do so in the regular way. If you are not breastfeeding, make sure that the food products contain as little sugar as possible. Preferably, eating/drinking moments in children are concentrated in a maximum of 5-7 moments per day. A feeding bottle with sweet products is not recommended at night. At the most, give a bottle of water to bed.
Do not give your child anything to eat or drink in the evening after brushing their teeth (just water).

Thumbs up with the milk teeth

Thumbs up isn't bad for baby teeth. Thumbs can, however, cause misalignment of the permanent teeth. That is why it is important that your child unlearns the thumbs in time. You can do this, for example, by giving a pacifier right from the start. The consequences of thumbs and/or teat use are the same, but the advantage of the teat lies in the fact that it is generally easier to unlearn.
The above-mentioned oral habits should preferably be unlearned before the 2nd year and in any case before the 4th year of life.

Switching from milk teeth to permanent teeth

Between the ages of six and fourteen, the milk teeth make way for the permanent teeth.

Source: KNMT, NVvK and Dr. GA van der Weijden, dentist-periodontist/implantologist

sealing

Permanent molars sometimes have deep grooves and pits in the chewing surfaces that are difficult to keep clean with a toothbrush. To prevent cavities, the grooves and pits can be filled with a fissure lacquer. This is what you call sealing.

photo of teeth undergoing a seal treatment

When is sealing necessary?

If the grooves and pits (also called fissures) are very deep, it is difficult or sometimes even impossible to brush properly in the grooves. A sealant (fissure lacquer) fills the groove. This prevents bacteria from nesting, which reduces the risk of cavities. The risk of cavities is greatest when the molars have just erupted. Brushing can then be painful and the enamel has yet to harden.
Sealing usually takes place shortly after the permanent molars have erupted. This is on average around the age of six. But sealing can always be used effectively in children.

In some cases, the teeth of adults are also sealed, but that is the exception rather than the rule. Your dentist can advise you on what is best and whether it makes sense to seal your teeth.

Therapy

First, the molars are thoroughly cleaned with a brush and polishing paste. The molars are then roughened with an acidic agent (etching). The fissure lacquer can adhere well to the molar. After it has taken effect, the etching is washed away and the molar is blown dry. The plastic lacquer is then applied. The paint hardens on its own or is cured with a blue lamp. The treatment usually does not hurt and takes a few minutes per tooth.

Risks

A sealant does not guarantee the development of caries. Brushing twice a day with fluoride toothpaste is still necessary, even with the sealed molars. The paint can give off a bit of a bad taste at first and feel a bit strange when you touch it. This will pass soon.
During the periodic check-up, the dentist checks whether the sealants are still intact and well attached. Sometimes it is necessary to replace a sealant.

Alternatives

Sealing the teeth is a preventive treatment to prevent cavities. You can always opt out of a proposed preventive treatment. Ask your dentist about the possible consequences.

Source: KNMT, NVvK and Dr. GA van der Weijden, dentist periodontist/implantologist

mouthguard

In sports such as hockey or rugby you run a high risk of damage to your teeth. If you wear a mouthguard or mouthguard during sports, the risk of dental injuries is smaller.

mouthguard in a blue box

Custom mouthguard

You can buy a ready-made mouthguard at the sports store, but your dentist can also make one for you. A custom-made mouthguard offers more protection than a ready-made mouthguard.

A mouthguard for a child

You can also buy a mouthguard or have it custom made for a child. A child's teeth change with growth and change. Therefore, regularly check whether the mouthguard still fits.

Source: KNMT and Dr. GA van der Weijden, dentist periodontist/implantologist

cheese selection

Cheese molars are also popularly referred to as 'cheese molars'. They can occur in both primary and permanent teeth. In addition to the first permanent molars, the permanent teeth may also involve front teeth (incisors).

photo of a cheese pick

Are cheese picks common?

Cheese molars occur in the primary teeth of 5 to 10 percent of Dutch children; when choosing cheese in permanent teeth, this concerns 10 to 15 percent of children.

Complaints about cheese selection

Very often the molars are more sensitive when they come into contact with hot or cold food and drinks. The molars also have the color of cheese, hence the name. The molars have spots that are weaker and softer. Sometimes pieces of molar break off and it is easier to make holes in a cheese molar.

Cause of cheese selection

It is not entirely clear what causes cheese molars. A lot of research has been done, but the results of those studies partly contradict each other. It is based on a combination of factors such as illness, fever and medication use. However, pollution and food may also contribute to the development of cheese molars.

Cheese molars already arise at the moment when the molars are formed. In the case of deciduous teeth, this concerns the second half of the pregnancy and the first year of life. In the case of permanent teeth, this concerns the first four years of the child's life. The discoloration is already there when the tooth breaks through.

When choosing cheese, the glaze formation is disturbed. The cells that make up the enamel stop the enamel formation for a while and then continue again later. Why that is and what exactly is happening is not clear at the moment. That has yet to be investigated. But if you've been sick, had a fever and received medication (especially antibiotics), that could be a reason why the enamel formation is disrupted.

How bad is it to have cheese picks?

That depends on the severity of the condition. There are children who have molars with colored spots but are otherwise unaffected. Or children who only suffer from sensitivity. But there are also children whose molars are largely cheese-colored. In the latter case, pieces can break off and holes will appear in the molar more quickly.

Curing or preventing cheese choosing is not possible

You cannot prevent cheese selection, not even by brushing very well. The sensitivity of the tooth can be reduced by using toothpaste for sensitive teeth or by having the dentist apply fluoride to the tooth.

Limiting damage when choosing cheese

It is important to avoid holes in the cheese tooth or break off pieces as much as possible. By brushing well you can ensure that no holes form in the cheese tooth. The dentist can also apply fluoride or tooth mousse (a toothpaste-like paste made from casein, an animal protein found in milk) to the molars.

fluoride

Fluoride is a safe and effective way to prevent caries/cavities. Fluoride makes the enamel of teeth harder and thus helps to provide protection against, for example, acid surges. In addition, starting cavities can be repaired by brushing well with fluoride toothpaste and by using fluoride (applied by the dentist). Fluoride is in toothpastes, special rinses and in gel applications specially applied by the dentist.

Application fluoride

Most toothpastes contain fluoride. By brushing preferably twice a day with fluoride toothpaste, the fluoride is absorbed by the tooth, making the teeth less vulnerable to acids. The dentist or dental hygienist can also advise you to rinse (additionally) with a fluoride mouthwash. In addition, the dental care provider can give a fluoride application in the dental practice.

Is fluoride dangerous?

Fluoride in oral care products is safe. However, the dosage should be taken into account in children. At a young age, too high a concentration of fluoride during the development of the teeth can lead to fluorosis. These are white spots and stripes on the teeth. To prevent this, it is important to use a toothpaste with an appropriate fluoride content for your child that is age-appropriate.

Guidelines for Using Fluoride

From the moment the first teeth break through, you can start brushing the teeth with a fluoride toothpaste. Brushing once a day is sufficient until the second year. From the second year, the teeth should be brushed twice a day. There is special toddler pasta for babies and children up to five years old. Observe the following guideline:

  • 0 to 2 years: brush once a day with toddler toothpaste.
  • 2 to 5 years: brush twice a day with toddler toothpaste.
  • from 5 years: brush twice a day with adult toothpaste.

There are also toothpastes with a higher fluorine content, these can only be used on a dental prescription. For both children and adults, a pea-sized ball of toothpaste on the toothbrush is sufficient.

Source: KNMT, Allesoverhetgebit.nl

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