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  • It is a science in dentistry deals with children teeth problems and their treatments from newborn to 12yrs.
  • Child’s teeth start forming in uterus from 6th week of intra uterine life
  • First tooth to erupt are lower central incisor followed by upper central incisor from 4th month onwards which can vary depending on child’s maturity and growth potential
  • Children teeth eruption will be completed by 2 to 2 ½ yrs
  • Before teeth erupts, baby’s will have irritation on gums and they bite on all items which comes on their way will make them sick and will have diarrhea.
  • Before teeth erupts, baby’s gum should be kept cleaned
  • Once teeth appear regular brushing can be started.
  • Parents should look after teeth during childhood

Child with Lower incisor

Brushing Child’s teeth

Tooth Development chart

Child with all teeth

  • Permanent molar teeth start erupting to mouth around 6 yrs followed by central incisiors.
  • By 14 yrs most of permanent teeth except wisdom teeth erupts between 18 to 21 yrs.
  • Most mothers complain that when child had milk teeth, it was well aligned with size suiting to the child’s face. But, when permanent teeth erupts, size do not fit into the child’s face. There is nothing to worry because big sizes teeth are the teeth to be fitted into the face, when child becomes an adult.

Ugly Duckling Stage

Ugly Duckling Stage

  • When upper 2 central incisor erupts, there will be space between centrals and both teeth are tilted each other. This stage is called “Ugly Duckling stages”. At later stage when next tooth erupts, this stage will be corrected and midline space will disappear.
  • First child’s dental visit starts from 6 to 12 months of age.
  • Parents should supervise the brushing habits
  • Pedodontist recommend regular fluride tablet which can strengthen the enamel after checking the fluride level if less than one PPM(part per million) in the drinking water in the area where child lives
  • Topical fluride application can strengthen teeth to avoid dental decay

Dental Sealant

Dental sealants are applied to sharp grew of chewing surface with light cured composite filling material can provide protection against cavities

Rampant Caries

Some children will have rampant caries. May be due to mother giving bottled filled with sweet liquid while sleeping in order child to stop crying.

Dental Abscess

  • Caries (decay) are caused when child’s teeth are exposed to sugary liquid, chocolates, fruit juice or sweetened milk.
  • Tooth decay starts as when plaque which is a thin sticky film which covers the teeth, where bacteria can survive and with sugar the bacteria produce acid, which will attack the teeth for several minutes will lead to tooth decay(caries)
  • If decay abscess and involves pulp, will lead to Dental abscess
  • If decay abscess and involves pulp, will lead to Dental abscess
  • If decay occurs and pulp(nerve) not involved, direct filling can be done.


if pulp is exposed and if tooth is vital (live) can do pulpotomy, where pedodontist remove the coronal part of pulp and given medications, so nerve in root will be alive for development of the root.

Infected tooth

Expose Pulp X-Ray


Pulpotomy Procedure


If pulp (nerve) is exposed and if tooth is non vital (dead), pedodontist does pulpectomy where he cleans the root and pulp chamber and give permanent filling.

Peri Apical Infection

Peri Apical Infection

Once Pulpectomy is done to a tooth, it will become Nonvital(dead), so there is a chance of fracture of crown, so can be given pre fabricated Nickel Chromium Pedo crown for the strength of the crown.

Procedoure for pulpectomy

Procedoure for pulpectomy

Pedo Metal Crown

Orthodontia Care

If upper front teeth are protruded, can be damaged due to accident while playing or it effect’s child’s pronunciation, early orthodontic care is advised.

Space Maintainers

Space Maintainer

  • If child looses the teeth at early age, before actual shedding time, will lead space left for long time. This condition can cause neighboring teeth may lean to space and will prevent the permanent teeth to erupt to the space
  • This will make permanent tooth to be impacted
  • In such cases may need surgical removal of tooth
  • If space maintainer are given, by fixing the appliance to adjacent tooth of lost tooth, space is left open until permanent tooth erupts into space in proper erupting time.

Skeletal Problem

If child has Skeletal growth problem, can be detected between 8 t0 14 yrs

Reverse Pull Head gear

Reverse Pull Headgear

  • Given to child with deficient growth of upper skeletal jaw(maxilla) with normal growth of lower jaw(mandible)
  • Child will ware for 14 hrs at night taking the advantage of release of growth hormone during night time

Chin Cap

Chin Cap

  • If excessive growth of lower jaw(mandible) called prognanthisam is since, where the maxilla (upper jaw) is normal
  • Child ware for 14 hrs at night taking the advantage of release of growth hormone during night time

Instructions to Mothers

  • Avoid sugary drinks; snacks in regular child’s diet
  • Do not dip pacifiers in sweet liquid
  • Avoid nursing bottle filled with sugary liquid.
  • If child is thirsty between meals, give plenty of water in bottle or cup.Avoid nursing bottle filled with sugary liquid.
  • Avoid nursing bottle filled with sugary liquid.
  • If child is thirsty between meals, give plenty of water in bottle or cup.Avoid nursing bottle filled with sugary liquid.
  • Some parents have bad thinking that any how milk teeth are going to be shed off, why spend money for milk teeth by doing filling, pulpectomy, pulpotomy giving space maintainers, metal crown. But it is a false thinking.
  • If dental care not given, child will have chronic pain, dental decay
  • Child will stop eating food, which effect child’s growth.
  • Repeatedly giving antibiotics will make child to drug resistance
  • Chronic dental decay can lead to cardiac problem affecting the child’s heart valves.
  • Decayed teeth appearance creates inferiority complex to child from other classmates

Dental Care in Children

Brushing 4 photos

Child Brushing

Mother helping child for Brushing

  • Child can lie on its back with head nearest to you or if older child can sit in your lap leaning head on your arm
  • Good tooth brushing is the first step to healthy teeth.
  • Brush twice a day, morning and night before going to bed
  • Choose a tooth brush with small brush head and gentle filaments
  • Apply small amount of tooth paste and brush inside, outside and biting surface.
  • Filaments placed along 450 angle
  • Brush with slight pressure using small movements.
  • Clean the germ line area, in the grew, where bacteria is easily build up
  • Biting surface is irregular so more chance to decay, so important to brush properly
  • Children need help to brush until the age of 10
  • A small child does not have manual skills to brush and do not know the consequences
  • Create a positive atmosphere while brushing by giving a song or story could make it a fun.
  • Every time child eat or drink, bacteria starts producing acids that corrode their teeth
  • So it is important to let your teeth rest between meals because with in half an hour, saliva helps to neutralize the acids
  • So regular eating sweets, drink gives your teeth, no chance to recover.
  • So avoid snacking or sugary or acid drinks between meals
  • Water is the thrust quencher given between meals and night
  • Child must goes to sleep with clean teeth.

First teeth (Milk Teeth)

  • First primary teeth or milk teeth start emerging around 6-8 months is the front teeth in lower jaw
  • By 2 to 2 ½ years all milk teeth will be erupted
  • Upper jaw will have 10 milk teeth and lower jaw 10 milk teeth with total number of 20 teeth.

Permanent Teeth

  • First permanent tooth to erupt is all 1st molar by age of 6 years behind the last milk teeth.
  • By age of 14 years most of the primary teeth are replaced with permanent teeth
  • By age of 18-21 yrs all wisdom teeth will erupt