Important Issues
Timing and importance of first visit to the paediatric dentist 

The first visit to the paediatric dentist should be scheduled as soon as the first baby teeth erupt in the mouth of the infant. Ideally this is around the first birthday. Informing the parents ought to start as early as possible in order to explain that the risk of caries can appear from this age. The appropriate methods of teeth cleaning according to child age, the correct products and the healthy, tooth-friendly dietary habits should be explained as early as possible and not after damage has occurred!

This early first visit has numerous advantages for the parents  as they:

  • learn about the possible side effects of teething and other issues of eruption
  • receive information on teeth problems due to  unhealthy dietary habits
  • are trained on the correct tooth-cleaning methods and appropriate toothpaste selection
  • are instructed how to deal with oral habits namely digit or dummy suckling
  • are taught how to act in an emergency related to trauma to their children’s teeth 

The very first visit in the dental clinic is probably the most important amongst all the others that will follow in the future.

The use of fluoride in the prevention of caries 

According to the World Health Organisation, the use of fluoride is of vital importance for caries prevention and has been evidence based through research for more than 70 years.

Fluoride is the most effective element for caries prevention and safe for the individual’s general health as long as the instructions given by the dentist regarding the appropriate doses per age are followed. It is a trace element found in nature (certain areas of Greece have naturally fluoridated drinking waters) as well as in everyday foods. It has also been added artificially in drinking water as well as salt and milk in other countries (only as a pilot project in our country).

The anti-caries effect of fluoride comes mainly from its topical application directly on teeth. It strengthens their enamel layer making it stronger against acid attack starting soon after a sugary meal but it also has an antimicrobial effect inhibiting the metabolism of plaque germs. 

Fluoride exists in toothpastes and mouthrinses used at home  and in professionally applied gels and varnishes used by the dentist in the clinic.

The importance of baby (primary) teeth 

Primary teeth are extremely important in maintaining oral health. Keeping them in the mouth until they exfoliate is imperative as they help in:

  • stability of the dimensions of both arches
  • aesthetic balance of the face
  • maintaining a healthy oral environment and thus a healthy body
  • correcting people’s wrong idea that «by extracting baby teeth one solves the problem» (it has been found that mothers of children with early childhood caries exhibited more positive behavior towards prevention when their children’s teeth were restored rather than extracted)
  • prevention and relief from pain
  • physiological masticatory and phonetic function

Decayed (rotten) baby teeth produce an environment full of microorganisms with unfavourable consequences for the health of the oral cavity, the permanent successors but also the body as a whole. They can lead to acute pain, abscesses, sleepless nights and days out of school for the children and off work for the parents.

Children have a right to a healthy, beautiful smile and we have an obligation to protect them from the nightmare of toothache! For all the aforementioned reasons the diagnosis and treatment of caries (before pain shows up) are much easier and more preferable than treating an excruciating toothache!

Instructions for parents


Toothache in children and teenagers together with dental trauma are the two most important reasons for seeking dental treatment in order to alleviate pain. 
What do you do:

  • Give your child an anti-inflammatory analgesic in the correct dose
  • Floss the cavity or area where food is stagnated in order to avoid pain due to food impaction
  • Call your dentist in order to give you more detailed instructions
  • Do not use aspirin nor apply alcoholic solutions over inflamed  gums or cavitated teeth that hurt
  • Do not give antibiotics without dental instructions

Dental trauma

Primary (baby) teeth. Trauma to the baby teeth is frequent and might have unfavourable consequences for both the traumatised baby tooth as well as the permanent successor. It usually occurs between 18 and 24 months when walking is still unstable.

Dental trauma to primary dentition needs immediate examination by the paediatric dentist in order to treat if necessary and give instructions to parents/carers as well as explain the sequelae  (necrosis, change of colour, abscess, fistula).

ATTENTION: In case of complete exarticulation of the tooth, DO NOT REPOSITION IT BACK INTO PLACE (as we must do for the permanent avulsed teeth) but seek for a paediatric dentist who will select the best treatment option for the patient. 

Permanent teeth. Crown fractures are the most common type of trauma. If the tooth fragment is found it should be kept moist in saline or tap water. The paediatric dentist will reattach the fragment or restore with composite if the piece is missing.

If the permanent tooth comes out of its socket it should be repositioned after rinsing it with saline or fresh water without holding it from the root. Stabilise it in place with a gauze on which the child should bite and visit a paediatric dentist as soon as possible. If repositioning the tooth seems impossible, place it in fresh, pasteurised milk and visit the dentist immediately.

Prevention of dental trauma-Sportsguards. These are custom made mouthguards fabricated by the laboratory after the dentist has taken an impression of the athlete’s teeth in order to protect them from blows in the face during team sports (basketball, water polo etc.). 

Digit or dummy suckling

Both habits can lead to anomalies in jaw bone growth and front teeth position when occurring in full strength and for extended periods of time (anterior openbite when back teeth clench, tongue thrusting during swallowing , rabbit-like front teeth, narrow and protruded upper jaw).

Dummy suckling is gradually self-limited and stops until the age of four. All the above discrepancies are therefore self-cured. On the contrary digit suckling is more difficult to stop and might need intervention either verbal (diary of psychological support and reinforcement after registering the child’s efforts to stop the habit) or with the use of an appliance (tongue crib cemented on back teeth preventing the finger from entering the mouth).

Description of the appropriate dummy

The selection of the appropriate pacifier can reduce the possible anomalies to teeth and jaws of the infant.  The size of the dummy should be correct so that it prevents entrance of the whole body of it in the child’s mouth.  The nipple of the dummy should be soft with thin and flexible neck. Its shape should be anatomically symmetrical so that it is always correctly positioned in the baby’s mouth. It should be compressed and of low height in order to reduce pressure on the palate. The protective shield should be curved to fit the lip area appropriately and have many wide holes for air to pass through in order to keep the skin around the lips dry. The pacifier should be fabricated in such a way that it could never be dismantled by a child. Holding it with a ribbon that could be strapped around the neck is strongly prohibited.

Never cover the dummy with a sweetener (honey, sugar, maple syrup etc) as this will lead to decay of the front teeth. Never clean the dummy by licking it. The use of a pacifier should not be forcefully discouraged as it can counteract the need for finger suckling which is more detrimental for the teeth and jaws.