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.
This 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 books for children. How many times do you hear the children say "I don’t want to go to the dentist!" ... But the teeth need care and periodic checks from 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?
We interviewed the doctor 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 small patients. The specialization in pedodontics requires a complete preparation also with humanistic discipline exams. Specifically, pedodontics includes: general dentistry, that is, dental treatment for children from birth until the end of growth and preventive orthodontics that includes all those procedures or measures that can be done to prevent malocclusion . Furthermore, facilitate the harmonic growth of the teeth also correcting the spoiled 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 pathway is often necessary to prevent more invasive and longer treatments once the dentition and craniofacial growth have been completed and to possibly avoid the extraction of healthy permanent teeth ".
In your opinion, why are children afraid to go to the dentist?
"Children's fear almost always comes from something they do not know. That referred to the child who goes for the first time to the pediatric dentist is very often connected to the anxieties of the parents or other adults who unknowingly pass them on to the children because they are afraid of the dentist due to trauma suffered in the past. At the base of my profession there is the right approach towards the children in order to prevent them from visiting the dentist as an emergency. Naturally the pediatric dentist must adapt to the individual case with his professionalism and experience ".
What is your secret in approaching children to reassure them and gain their trust?
“Studio il comportamento del bambini dalla sala d’aspetto. Sono 25 anni che svolgo la professione e sono perfettamente in grado di approcciare i bambini a seconda dei loro comportamenti e delle loro paure. Pochissimi piccoli pazienti ho mandato in sala operatoria per sottoporli a cure odontoiatriche in anestesia generale. Parto dall’inquadrare il comportamento di ogni singolo bambino dopodiché propongo una comunicazione basata essenzialmente sul gioco. Dal primo incontro con bambino, a seconda dell’età, dal tipo di visita, se di controllo o in presenza di una sintomatologia, seguo un percorso preciso. Un altro aspetto da non sottovalutare è il condizionamento ambientale. Nella mia stanza c’è un televisore con la proiezione di cartoni animati che rappresenta un valido strumento in grado di rilassare e mettere a proprio agio il bambino”.
How important are the emotions of the little ones in your work?
"They are the basis of my work, the key to success in childcare".
When to make the first visit to the pediatric dentist?
“Il mio consiglio è quello di non aspettare che vi sia un motivo serio per portare il bambino la prima volta dal dentista pediatrico perchè questo potrebbe rafforzare un pensiero negativo. Per far sì che sia un’esperienza positiva, è importante che il bambino arrivi quando non presenta alcun dolore, in modo da avere la serenità di ambientarsi in un nuovo contesto. Se le visite di controllo diventano una routine, a partire dai 2/3 anni di vita, il bambino avrà fiducia e sempre meno paura. In questo modo si agisce sulla prevenzione evitando problemi più seri che richiedono interventi fastidiosi e dolorosi. Per l’American Academy of Pediatric Dentistry la prima visita dovrebbe svolgersi appena spunta il primo dentino. Durante la prima visita si realizza un esame completo, si danno consigli alimentari e d’igiene per mantenere una buona salute dentale e sulle migliori misure di prevenzione. Si raccomanda ai genitori di prestare attenzione all’igiene dei denti dei propri figli a partire dalla comparsa del primo dentino. L’uso della garza umida per pulire la bocca e i dentini va bene fino ai 12 mesi per non ledere le delicate mucose del bimbo, dopo si può iniziare ad utilizzare un piccolo spazzolino a setole morbide Il tutto senza dentifricio. Dai 3 anni il bambino può iniziare a lavarsi i denti da solo con spazzolino e dentifricio al fluoro (poca quantità) specifici per la sua età e sotto la supervisione di un adulto”.
What is your method?
"After the first visit I start to do check ups, cleanings and fluoroprophylaxis every 6 months. It is important to establish a relationship of trust with the little patient from the beginning through dedicated techniques, one of them is the tell-show-do (TSD) that allows children to receive dental care. As the name says, it consists of three phases: TELL: explaining to the child what I’m going to do; SHOW: show the tools and how the dental work will be performed, simulating the intervention on a toy denture or on the fingers of one hand and DO: start the work in the small patient's mouth. With the use of their hands I allow the young patients to lose confidence with their mouth and make them understand that everything I will do will not be intrusive and painful. Start by letting them count the fingers and then the teeth. Then I take a toothbrush and together first clean the nails of their little hands and then do the same operation with the teeth. In short, all actions that reassure the child and help to establish a relationship of trust that will last over time ".
Burning issue: dental anesthesia. In this case?
"Anesthesia? I do not do anesthesia, I have the “cosmic ray gun”! A small trick that I made up just to not traumatize the child. They do not see what I have in my hand, I invite them to close their eyes and explain that they might feel a little mosquito bite and that they will taste a bitter taste in their mouth, nothing more ".
Beware of sugars! What are the most common problems in children?
"Dental caries caused by an excessive intake of sugar and the bad habit of not washing teeth especially before going to sleep. It is important to wash the teeth before going to bed because at night the salivation decreases, the Ph of the mouth becomes more acidic, the sugars ferment and the bacteria become more aggressive ".
Baby bottle and pacifier, how much do they influence tooth formation and growth?
"It depends on (ab) use. The bottle, with milk and sugar, if used excessively during the night can lead to the formation of dental caries. The habit of sleeping with the pacifier for several years can promote the appearance of malformations of the mouth and dental arches and keep the swallowing atypical that instead should disappear with the eruption of the baby teeth. In any case, the use of pacifiers should be eliminated in the second year of life ".
Prevention. What are your tips to protect children's mouth?
"First of all, educate parents about proper dental hygiene for the child: brushing the teeth twice a day in the morning and in the evening before going to sleep; prevent the child from falling asleep with a bottle containing milk, fruit juices and sugary drinks; eliminate pacifier habit as soon as possible; first meeting with the pediatrician dentist around 2 years and continue, in the absence of diseases, with semester meetings "
"Prevention, trust the doctor and follow his advice".
"Prevention, trust and trust the specialist and follow his advice".