Many parents, when talking about prevention of tooth decay in children, They ask me: Can we do something to prevent it from forming, instead of intervening when the tooth has already been stained? My answer is yes!
Prevention naturally begins with daily oral hygiene, nutrition, and regular check-ups, but at certain points in growth we can complement these with specific tools such as: Dental sealants and fluoride prophylaxis.
They are different procedures with different indications, but they all have the same goal: protecting the teeth during the phases in which they are most exposed to the risk of tooth decay. For this reason, I do not consider prevention to be a uniform protocol for everyone, but rather a path that must be calibrated according to the child, based on their habits and their personal risk of developing cavities.
Why are children's teeth particularly susceptible to tooth decay?
Caries is one multifactorial pathology. Its appearance depends on the interaction between the bacteria present in the oral cavity, diet, frequency of sugar intake, characteristics of the teeth, quality of hygiene, and other individual factors.
However, prevention does not only concern milk teeth. A particularly important moment is coming around 6 years old, When the first permanent teeth begin to appear. Among these are the first permanent molars, These teeth erupt after the last milk teeth and do not replace any deciduous element.
This is an important detail, because it can happen that a parent does not immediately realize that that new molar is already a permanent tooth. Moreover, the chewing surface of the molars naturally has grooves that resemble the grooves of a permanent tooth. wrinkles and furrows. When these irregularities are deep, They can retain plaque and food residues and they are difficult to reach with a toothbrush. It is precisely in situations like this that we can evaluate the’utility of seals.
FIND OUT HOW TO IDENTIFY AND TREAT CAVITIES IN MILK TEETH
What are dental sealants in children?
La Sealing of the teeth It is a preventive procedure that consists of’application of a specific one protective material within the grooves and furrows present on the surface of the tooth. The purpose is simple: to create a barrier that makes these areas less easily colonized by plaque and easier to keep clean.
The guidelines consider seals to be an effective tool in Prevention of tooth decay of the occlusal surfaces of the molars, in children and adolescents. However, this does not mean “covering” the entire tooth. The material targets the anatomical irregularities of the masticatory surface that present a higher risk.
For the child, the procedure is simple: the tooth is cleaned, prepared, kept dry, and the sealing material is applied in the grooves. We are not treating a cavity and, when intervening on a healthy tooth for preventive purposes, It is not necessary to remove dental tissue to perform a normal seal. This aspect reflects well the way I intend prevention: intervening in a targeted manner before it becomes necessary to carry out a more invasive therapy.
At what age are dental fillings made?
There is no standard age for every child. The timing depends primarily on the eruption of the teeth and on the individual risk of caries. A key milestone generally coincides with the appearance of the first tooth. first permanent molars, around 6 years of age. Subsequently, the other permanent teeth that have particularly deep grooves and furrows can also be evaluated.
The most recent guidelines emphasize the importance of considering the risk of tooth decay and the characteristics of each individual tooth, not just age. This is one of the reasons why I recommend not waiting for a noticeable problem to appear before taking a child to the dentist.
La First visit to the dentist It allows children to begin this process earlier: getting to know the little patient, gradually getting them accustomed to the dental environment, monitoring their hygiene and observing the eruption of their teeth over time means being able to identify the right time to intervene, if necessary.
Does sealing the molars mean that they will no longer decay?
No, and it is important to clarify this. The sealing protects primarily scratches and grooves on the chewing surface on which it is applied. It does not make the tooth immune to decay and does not replace either the toothbrush or proper eating habits.
Caries can also develop in other areas of the tooth, for example on the interproximal surfaces, that is, between one tooth and another. For this reason, I consider the Sealing of teeth as part of a broader preventive strategy, which includes:
- proper daily oral hygiene;
- fluoridated toothpaste suitable for the age;
- attention to the frequency of consumption of sugars;
- periodic dental check-ups;
- individual assessment of the risk of caries;
- professional fluoroprophylaxis when indicated.
Prevention does not mean relying on a single procedure. It means creating the conditions over time so that the teeth have a better chance of remaining healthy.
Fluoride in children: what does it really serve?
There are still many doubts about fluoride, especially among parents. The key point is to distinguish between the different ways of using it and to understand that The dose, method and indication must be appropriate to the age and individual child..
The fluorine It plays an important role in the prevention of tooth decay because favors the processes of remineralization and increases the resistance of the enamel to acid attacks.
The’American Academy of Pediatric Dentistry Considers the appropriate use of fluoride toothpaste and, in at-risk individuals, professional applications of fluoride as effective tools in the prevention of tooth decay. This does not mean, however, that “more fluoride” automatically equals “more protection”. It means using fluoride correctly.
Fluoride toothpaste for children: how much to use?
Oral hygiene should begin early and be gradually adapted to the child’s age and ability to independently handle the toothbrush. One of the aspects I emphasize most with parents is precisely this: amount of toothpaste. In young children, it is not necessary to fill the bristles: it is important to use an appropriate amount and supervise the brushing, especially when the child is not yet able to avoid ingesting the product.
The indications regarding the concentration of fluoride and the amount of toothpaste vary depending on age and must be placed in the overall context of the risk of caries. However, scientific recommendations confirm the The central role of brushing with fluoridated toothpaste in prevention. During the visits, I therefore prefer to explain to the parents. How to properly use toothpaste, Instead of limiting myself to simply recommending “a fluoride product,” it is these small, everyday instructions, repeated correctly for years, that have a significant impact on the future health of the mouth.
When is professional fluoride prophylaxis needed?
In addition to toothpaste, in some children we can consider professional application of fluoride. It is not a procedure that I consider automatic for everyone with the same frequency. The decision depends on individual risk of caries.
A child who has already developed cancerous lesions, for example, deserves special preventive attention: a Previous experience of tooth decay In fact, it is one of the elements considered in the evaluation of future risk. Even unfavorable eating habits, difficult hygiene or specific clinical conditions can alter the prevention program.
In these cases the Professional fluoro It can become one of the tools used to strengthening the preventive strategy, Always along with the control of hygiene and daily habits.
Are seals and fluorides the same thing?
No. It is probably the most important concept to remember.
- The seal creates physical protection in the grooves and crevices of the tooth.
- Fluorine intervenes on processes that increase the resistance of the enamel and favor its remineralization.
Therefore, they are two different tools that can be used within the same preventive program. In some children sealing may be indicated. In others we can focus more on fluoroprophylaxis. In others the two strategies can be combined. The choice always starts with the visit.
How long do dental sealants last?
A seal should not be considered something that is applied once and then forgotten.
The material can remain effective for a long time, but it must be Checked during periodic visits to verify that it is still intact and properly adhered. The recommendations actually include reassessing the seals over time and, when necessary, repairing or replacing them.
This is another reason why continuity of control is important even when the child is not in pain and apparently “has nothing”. Prevention works precisely when we manage to arrive before the symptom.
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Prevention of tooth decay in children: the City Life Institute approach
In our approach to the child there is a principle that I consider essential: Before we can treat a tooth, we must build trust..
Al City Life Institute The first meeting can be a moment of pure acclimatization: the child gets to know the study, the doctor and their surroundings, without necessarily turning that first experience into an operational session. When therapy is necessary, we can address it at a later time, respecting as much as possible its time and its ability to cooperate.
We do not seal a tooth simply because the child has reached a certain age and we do not offer fluoride prophylaxis according to a haphazard scheme. We observe the dental eruption, the anatomy of the molars, hygiene, the history of caries, and the habits of the child, in order to building a truly proportionate program to their needs.
Prevention is not an isolated effort; it is a journey that accompanies the child as their mouth grows and changes. Because a tooth that we manage to keep healthy will not need to be treated. And, especially in children, this remains the best result we can achieve.
Information note: This article is for informational purposes and does not replace a direct clinical evaluation. Indications, frequency of check-ups and treatment methods must be determined by a doctor on a case-by-case basis.
Dentist and Aesthetic Doctor, Postgraduate in Implantology, Oral Rehabilitation NYU, Master in Oral Surgery and Implantology UNIBO, European Master in Aesthetic Medicine ICAMP – Milan, Order of Physicians Milan Dental Practitioners Register 5921, Register of Medicine with an Aesthetic focus