The Issues Faced by Paediatric Dentists and Children's Dentists When Dealing With Children's Tooth Decay

A visit to the dentist can be quite a traumatic experience for children. Often, the child will be nervous, anxious or scared and, as a result, uncooperative with the dentist. As dental treatment is mainly contingent on patient compliance, many general dentists will struggle to treat children in this instance. They may also struggle with time constraints as treating children can take longer if uncooperative. Because of this, they will often refer the child to a Paediatric Dentist or children's specialist to treat that child.

What is a Paediatric Dentist?

A paediatric dentist - also known as a children's dentist - specialises in the care and treatment of children from birth to adolescence. They deal with dental issues, including tooth decay, toothaches, scout crowded/crooked teeth, and perform oral surgery where needed. Critically, they are set up expressly to treat children and have expertise in this area.

The Challenges Faced by Children's Dentists

Let's think about a child apprehensive of the dentist who does not readily comply. There are a few considerations most paediatric dentists will make in this instance:

1. What is the most effective way to achieve compliance?
   
2. How do we minimise the child's chances of returning for additional treatment?
   

The answer to those questions are typically as follows:

1. By administering general anaesthetic (so as to have total compliance).
   
2. By doing as much treatment as possible within the one appointment, and being especially thorough in the treatment - perhaps even doing some pre-emptive treatments.
   

The Unintended Consequences of Treating Children Teeth Decay

This approach, however, can lead to some unintended downstream consequences. This is especially common when dealing with children's tooth decay. 

The first caveat is obvious; there are risks associated with a general anaesthetic, and it should be avoided wherever possible. But there are also consequences to the style of treatments being done - specifically with fillings and crowns.

Often, kids will have decay in a tiny area of the tooth - rarely is it so significant that it affects a large area or all of the tooth. And, because the child may be non-compliant, the paediatric dentist wants to reduce the likelihood of the child needing further treatment down the line. This will often lead paediatric dentists to place a crown over the entire tooth. 

This treatment is done with the best intentions; however, crowns alter the bite, resulting in a crooked bite and misalignment of the jaws. An uneven bite can manifest in TMJ dysfunction further down the line, which is known to cause such things as:

• Clicking jaw
  
• Jaw pain
  
• Head and neck pain
  
• Locked jaw
  
• Chewing difficulty

Some children's dentists will place another crown on the opposite side to even the bite out to avoid this. The issue now is that you have a pervasive treatment for what was likely a small amount of decay in one tooth. You can imagine how this process plays out when a child has decay in multiple teeth - the treatment is extensive, and so are the potential consequences.

A Better Alternative to Treating Children's Teeth Decay

This approach gets one thing right. It seeks to prevent the need for further treatments. However, there is a better way to prevent children's tooth decay and alleviate the need for further treatment - diet. 

But, we must first understand what causes children's tooth decay to understand this. It doesn't just occur at random, and we certainly do not subscribe to the belief that decay is a normal bodily function all children experience.

Tooth decay is mostly driven by the overconsumption of sugar and carbohydrates and lack of quality protein. So, if this is the case, first principles thinking would suggest that the single best way to prevent tooth decay lies in correcting the diet. It's that simple - if you fix your diet, you can prevent tooth decay. And, if you prevent tooth decay, you can prevent children from having to visit the dentist for treatment frequently and from the unintended consequences of some treatments.

What Diet Will Prevent Tooth Decay in Kids?

A healthy diet that will help prevent tooth decay in kids consists of high fat and protein content and fewer carbohydrates and sugars. For more information on how a high fat, high protein diet is beneficial for oral health and preventing tooth decay, click here.

Our Approach to Children's Teeth Decay

When it comes to children's tooth decay, our approach at Eric Davis Dental is that less is more. What do we mean by this?

• We prefer to use happy gas (if absolutely necessary) instead of general anaesthetic
  
• We prefer to do simple fillings only on the part of the tooth that is affected as opposed to placing extensive crowns
  
• We prefer to place as little foreign material in a child's mouth as possible
  
• We encourage parents to think about their child's diet because prevention is the best treatment

If you have any questions about our approach to treating children's teeth decay, or would like to learn more about our philosophy on children's dentistry, please contact us.