Dental prophylaxis in children and adolescents

Dental prophylaxis comprises a range of methods and procedures that can be carried out in the dentist’s surgery to prevent gum disease and tooth decay. It is the first and most important thing we can do when it comes to oral health.  

A key distinction to be made when discussing dentistry is between prevention and treatment. When we talk about prevention, we are referring to a routine, a set of procedures that can help us avoid dental problems and, consequently, costly treatments.  

During childhood, milk teeth play an important role in the subsequent development of the permanent set of teeth; at the same time, this is the period when the first habits relating to both oral hygiene and a healthy diet are formed.

There are a few steps we need to follow to ensure a healthy and beautiful smile right from childhood:

1. A daily dental care routine at home: brushing and flossing, with help from parents
2. Developing healthy eating habits, limiting sweet snacks and fizzy drinks.
3. Regular check-ups accompanied by professional cleaning at the dentist’s surgery, once every 6 months.

A dental prophylaxis session at the dentist’s surgery involves the following procedures:

1. Professional tooth brushing, which involves cleaning the teeth with special toothpaste and toothbrushes.
2. Ultrasonic and manual scaling, depending on the children’s age and their level of cooperation.  
3. Airflow treatment, which uses a device with a jet of water and powder; this is particularly suitable for children over the age of 5 and is effective at removing stubborn stains, discolouration and bacterial plaque.
4. Sealing, which is carried out at the end of the hygiene session using special gels or varnishes, tailored to each child’s needs, to help strengthen the tooth enamel. 

The process of oral hygiene at home should begin right from birth by cleaning babies’ tongues, cheeks and gums after feeding, using a sterile gauze pad or special wipes.

Later, once the first tooth appears, you can move on to a soft-bristled toothbrush and special toothpaste suitable for the child’s age.  

This is also the time when the first visit to the dentist should take place, as soon as the first tooth appears, but no later than the age of 1. During this visit, parents can receive important advice on children’s dental care, the best choices for toothbrushes and toothpaste, as well as on nutrition and healthy habits. At the same time, this visit helps to build a bond between the dentist and the child before any dental problems or pain arise, which would make cooperation much more difficult.

So, the first visit to the dentist isn’t just about teeth; it’s about prevention, education and trust. The earlier dental care begins, the greater the chances that your little one will have healthy teeth and a positive relationship with the dentist in the long term.

By the age of 3, a child should have a full set of milk teeth, be becoming increasingly independent, and be starting to develop their first conscious habits regarding healthy practices, which must be properly established and supported by parents.  

Teeth should be brushed correctly twice a day, for at least 2 minutes, in the morning and in the evening, under the close supervision of parents. For a toothbrush, we recommend either a manual toothbrush with soft bristles, which should be replaced every 3 months, or an electric toothbrush, the brush head of which should be replaced every 3–6 months.  These toothbrushes can also be used alternately: a manual toothbrush in the morning and an electric toothbrush in the evening.  

Toothpaste also plays an important role in children’s dental care, so it is advisable to use a toothpaste with an age-appropriate fluoride level – a minimum of 1,000 ppm fluoride, but no more than 1,450 ppm, depending on the dentist’s recommendation. As this is the stage when the child is learning to rinse their mouth, the amount of toothpaste on the brush should be about the size of a pea, and the tube of toothpaste should be kept out of the child’s reach.  

In terms of technique, brushing should be carried out using gentle circular or vertical movements, covering the front, back and chewing surfaces of the teeth. It is recommended that brushing takes place under parental supervision, or even carried out by the parents themselves, until around the age of 7–8, when the child has sufficient dexterity to do it on their own.  

At the same time, this is also the period when the eruption of the primary teeth is complete; the teeth are becoming increasingly close together and so it is advisable to use dental floss as well, to prevent the development of cavities between the teeth. The risk of interdental decay is very high in children, and flossing therefore helps to reduce this risk.  

As mentioned earlier, this is also a period when eating habits are formed; it is therefore advisable, as far as possible, to limit the consumption of sugar (chocolate, sweets, toffees) and carbohydrates (crisps, pretzels, pastries). It is also recommended to avoid fizzy drinks, as well as excessive amounts of natural fruit juices.  

To maintain oral health, it is also important for children to have a professional dental hygiene session at the dentist’s surgery once every six months. This session primarily involves assessing the child’s toothbrushing technique using plaque disclosing agents. This allows the child and parent to see which areas are not being brushed properly so that they can improve this at home. This is followed by professional cleaning using special brushes and cups, which clean even hard-to-reach areas of the teeth. Dental floss is then used so that the dentist can demonstrate to the child and parent how to use it correctly, ensuring it is incorporated into the child’s daily routine at home. If the dentist also notices tartar build-up, they use a gentle, manual technique to remove this tartar, or any bacterial plaque that is more difficult to remove. The preventive care session concludes with fluoridation using topical varnishes or gels, appropriate for the child’s age, to strengthen the enamel.

At the age of 6, the milk teeth begin to fall out and the permanent incisors start to erupt. It is also at this time that the six-year molar erupts – a small molar that grows behind the milk teeth, without replacing any of them, and which will never be replaced itself. This tooth is special, both in terms of its structure and the fact that it is located in an area highly susceptible to tooth decay.  

The six-year molar has deep, funnel-like grooves on its surface, which trap food and, consequently, lead to the early development of tooth decay. These teeth are at increased risk of rapidly developing deep caries, which can cause toothache and further complications.  

It is precisely to protect this molar that the concept ohttps://dentestet.ro/en/blog/types-of-dental-caries-and-their-comf dental sealing was developed, which involves applying a protective material (sealant) to the chewing surface of this molar. Sealing is recommended immediately after eruption, to prevent deep grooves and pits from trapping food debris and bacteria in places where a toothbrush cannot reach.  

For the sealing to be effective, it must be carried out as soon as the tooth has fully erupted, before it is affected by tooth decay. Dental sealing is a minimally invasive procedure carried out around the age of 6 for the first permanent molar, and between the ages of 9 and 12 for the premolars and 12-year molars.  

This procedure, combined with proper oral hygiene at home, as well as professional dental cleaning and regular check-ups every 6 months, helps to delay or even prevent the onset of tooth decay and maintain a healthy smile over the long term.

With regard to the professional cleaning session, as mentioned earlier, in addition to professional brushing, ultrasonic scaling is also carried out. This procedure is recommended when bacterial plaque and food debris that are difficult to remove are observed on certain surfaces of the teeth – particularly on the tongue-facing side – on both permanent and milk teeth.  

These bacterial plaque deposits can cause gum inflammation, bleeding during brushing, and bad breath (halitosis) in the child over a prolonged period.

Furthermore, from the age of 6, the Airflow procedure is also recommended. This is a non-, painless and gentle on the enamel, which uses a powerful jet of water to remove bacterial plaque, stains caused by bacteria or certain foods or teas, as well as food debris that is difficult to remove. A prophylaxis session that includes Airflow, carried out once every 4–6 months, depending on the dentist’s recommendations, helps to keep teeth and gums healthy. 

1. Preventing tooth decay

• Regular removal of bacterial plaque reduces the risk of tooth decay.
• Sealing permanent teeth and regular fluoridation strengthen the enamel.
• Children learn to look after their teeth properly, which reduces the risk of recurrent tooth decay.
• As a result, in the long term, we see fewer fillings, fewer dental emergencies and fewer costly treatments, thereby helping to keep natural teeth healthy for as long as possible.  

2. Keeps gums healthy

• Prophylaxis reduces gum inflammation and bleeding by removing plaque and tartar.
• Early education prevents harmful habits that lead to gingivitis and periodontal disease.

3. Positive impact on general health

• Healthy teeth help ensure a balanced diet, clear speech and psychological well-being, enabling us to enjoy better general health and a more balanced lifestyle.

4. Increased confidence and self-esteem

• A child with healthy teeth and a beautiful smile has greater self-confidence and is less susceptible to social stigma, thus enjoying a more positive self-image, more open communication and better social integration.

5. Building a positive relationship with the dentist

• Children who visit the dentist for routine check-ups, not just when they are in pain, will develop a relationship of trust with their dentist.
• This reduces fear of the dentist and encourages regular visits. Consequently, in the long term, they can enjoy adult life as cooperative individuals, mindful of their own oral hygiene and adopting a preventative approach, with healthy habits formed from childhood that they will maintain throughout their lives.

Therefore, dental prophylaxis is not just about ‘brushing your teeth’, but about forming good habits and preventing dental problems before they arise. Through regular check-ups and consistent care, today’s child will become tomorrow’s adult with healthy teeth, a beautiful smile and no fear of the dentist.  

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