Pediatric dentistry up to what age according to the law. A pediatric dentist: who he is, what is included in his competence, treatment features and basic recommendations. Treatment of children without the presence of parents

When should you go to the dentist for the first time? Is dental fluoridation effective? Do baby teeth need to be treated? Answered these and other questions for us dentist, head of the children's dental department at the Aquus medical clinic, and simply the favorite dentist of many small Nizhny Novgorod residents - Evgenia Olegovna Panasenko.

1. Evgenia Olegovna, tell me, at what age should the first visit to the dentist take place? How will the baby’s first teeth appear or at the first complaints? When should you check your tongue frenulum?

The very first reason for a visit to a pediatric dentist should be to check the frenulum of the tongue. This is usually checked immediately after birth in maternity hospitals or at one of the first appointments with a pediatrician. If this does not happen, then the parents themselves need to take the initiative and pay attention to this point - with a short frenulum, the tongue simply does not rise up and this can prevent the child from latching normally.

Dissection of the frenulum of the tongue is best performed up to 3 months, since during this period it is a thin film without any blood vessels and nerves. From 3 months, the risk of bleeding increases due to the interweaving of blood vessels, which is why many clinics perform dissection under general anesthesia. It is better to avoid this and do the dissection in time.

If the frenulum does not interfere with the child’s feeding, then the next moment when this defect may appear is the age when the child begins to speak, since a short frenulum interferes with the pronunciation of the sounds r, l, w. In this case, the frenulum is cut already at the age of 6, when the jaw changes and permanent teeth appear.

The next dental examination should be done when the four upper central incisors emerge to see the quality of the teeth. It is approximately, 1.5 - 2 years.

2. Evgenia Olegovna, what are the most basic reasons for the development of caries in baby teeth? A common situation is that your teeth have just come out, you look, and there are already black spots on them. What is the reason?

One of the first causes of caries may be improper formation of teeth during pregnancy and, as a result, “bad enamel”. It is immediately visible - it is either bright white or yellow.

Night feedings, even if it is breast milk, no matter how strange it may sound. Most often, a child’s teeth appear during the period of breastfeeding; the child receives breasts when he wants, and especially at night, because mommy wants to sleep. And I’m not at all against breastfeeding, but mothers should know that frequent night feedings cause the same harm to tooth enamel as night supplements with juice, tea, or anything other than water. A pathogenic flora develops in a child’s mouth, creating an acidic environment that very quickly “eats” the still weak enamel of children’s teeth. The situation is especially aggravated if mommy eats carbohydrate foods at night.

To prevent the early development of caries, night feedings should be reduced to a minimum, and even better, replaced with water. Under no circumstances should you offer your child juices, teas or other drinks. Only water. If it is not possible to remove feeding, then try to feed the baby reclining and after feeding, wipe the baby’s teeth with a bandage with any paste (just a little), this will prevent microflora from developing.

Of course, not all children have night feedings that cause the development of caries. It must be remembered that all children are different, and if night feedings do not harm one, another may lose teeth because of them.

Food– also one of the main reasons. After all, what do modern children eat: rolls, waffles, breakfast cereals, chips, sweets with soft caramel - refined, soft, sticky, sweet food. Children's diet contains practically no foods that need to be chewed - whole apples, carrots. And this is important for jaw development.

Poor dental hygiene– a very important point. Children should be taught to brush their teeth from early childhood, especially at night. When the baby still cannot brush his teeth on his own, the simplest thing is to wrap a bandage, squeeze out a little toothpaste and wipe the teeth. All these silicone brushes only iron, I don’t believe in them and prefer to use a bandage the old fashioned way, since it has a porous structure.

Frequent use of antibiotics and anesthesia can also be causes of caries and poor dental condition.

3. Of the currently existing methods for treating caries, which are the most effective? Why are fluoridation and silvering procedures needed?

Silvering- This is a procedure in which I see no point. There is no result from it, except for black teeth and psychological trauma for the child, who will then be teased for these black teeth. The only positive thing is that mom is at least a little reassured that she did something.

Concerning fluoridation. Every children's toothpaste says that it doesn't contain fluoride - what is it written for? For what? Fluoride is a highly toxic substance that tends to accumulate in the body and is harmful to children. In the Nizhny Novgorod region there is no shortage of fluoride, unlike iodine, for example, so our body does not need additional fluoride.

And to be completely honest, how can you believe that they anointed your teeth with some kind of composition and everything became fine? You should always look for the cause and eliminate it, and not smear your teeth with incomprehensible compounds.

I am for sealing- a good old method that has proven its effectiveness. The meaning of this procedure is that a special composition, an analogue of tooth enamel, is applied to the cleaned fissures (grooves on the chewing teeth). By doing this, we seal the tooth and prevent food debris from getting into it. This procedure is done as soon as the 6th teeth erupt. Although, this procedure can also be done for baby teeth.

However, you need to understand that sealing protects teeth only from chewing caries; it is impossible to protect a tooth from contact caries (that which develops between the teeth). Therefore, as soon as you see something strange on your teeth, run to the doctor. Early caries develops very quickly.

4. What are the signs of early caries? Is a small brown dot already a caries?

Period – this is already caries, and not even early ones. Early caries is a white stripe near the gum, which is slightly brighter in color than the main tone of the tooth. As soon as you see something like this, don’t hesitate, make an appointment with a doctor.

Early caries is very easy to cure; it only takes a few minutes. But our parents are so frightened that they wait until the last minute, when all their teeth already have pulpitis. And treating pulpitis in children is not the same as treating it in adults. In case of acute pain, you can give any dosage of painkiller to an adult, but to a child - a strictly age-specific dose, which is calculated per kg of weight. And if, for example, a child has a toothache for two days, then in order to freeze the tooth, an adult dosage is needed. No doctor will take responsibility, because reactions can be different, even the most serious.

As a result, it turns out that the mother was afraid that the child would be hurt, she missed time, and when they came to the dentist, normal anesthesia could no longer be administered. It’s better to come right away, especially since in the largest clinics in the city, dental examinations are free! Find time and bring your child for a checkup. This will save you and your child’s money and nerves.

5. Do baby teeth need to be treated? They will still fall out...

First, I would like to dispel the myth that baby teeth do not have nerves. This is wrong. There are nerves and roots, and in general they are the same teeth as permanent teeth, with the only difference being that the roots dissolve over time. And children experience the same pain from a bad tooth as adults.

Now imagine - the fifth, largest milk tooth, only dissolves by the age of 10 - 11 years. He needs to stand until this age. And if for some reason the tooth had to be removed earlier, then the 6th tooth (already permanent) will take the place of the missing tooth, and when the time comes for the fifth permanent tooth, there is no longer room for it, it goes to the side and is removed. The situation is the same with the upper central incisors - the permanent incisors are larger, so they stand unevenly. Parents come running in panic and ask to remove neighboring teeth. Under no circumstances should this be done! The jaw will grow and the teeth will fall into place. Each tooth has its own function and should fall out when it is supposed to.

6. At what age does the replacement of baby teeth with permanent ones begin?

This happens at different times for girls and boys. In girls, the lower central incisors begin to erupt at 5-5.5 years old, in boys - at about 6.5. I would like to draw the attention of parents to the fact that in 70% of cases, the central lower incisors change in such a way that permanent teeth appear behind the milk teeth that have not yet fallen out. There is no need to be afraid of this. The reason is that permanent teeth are larger in size than baby teeth, making it easier for them to erupt behind the teeth. Then the baby teeth fall out or are removed if necessary, and the permanent teeth fall into place.

06-10-2009

The developers of the document hope that the new rules will ensure the safety of patients and doctors, and first of all, children.

It is no longer possible to treat children in adult dental offices. Medical institutions are required to equip separate blocks for minors with their own reception area and bathroom.

It is not profitable to treat children
However, according to Murmansk experts, the new sanitary rules worsen the situation in pediatric dentistry. Today, doctors and heads of medical institutions have no motivation to provide dental care to children. It is much easier for a doctor to treat an adult at a paid appointment than to persuade a child not to be afraid of the dentist’s instrument.

In addition, due to the lack of a clear regulatory framework, insurance companies pay medical institutions only for the “adult” work of doctors if they have a diploma in general dentistry.

“That’s why today only pediatric dentists (there are 6 of them in the city) and old-school dentists with specialized secondary education work with children. But there are also few of them, and many of them are already over 60,” notes the city’s chief dentist, Emma Tolmacheva. - On the other hand, adolescents aged 15-17 years, who are legally considered children and therefore are treated in pediatric dentistry, can be treated in adult clinics. After all, boys and girls are already physiologically formed. For example, two-meter tall athletes, students, working people or even young mothers come to us. And they are served together with the kids. These guys already have a passport and the right to sign consent for medical intervention. So why not relieve the workload of our pediatric dentists by transferring teenagers to adult clinics?

By the way, now many paid clinics in the city may not accept children - most of them will not equip a separate room for children.

Change patients and gloves
The new document also stipulates a number of requirements for the location of the clinics themselves, the decoration of their premises, equipment, microclimate and lighting. For example, if there are several dental chairs in one office, they must be separated by opaque partitions at least one and a half meters high. According to experts, this part of the rules is feasible for newly built clinics. But not for those who work for many years in adapted premises.

In addition, in dental clinics, each employee must have at least three sets of sanitary clothing, and the doctor must use new rubber gloves for each patient. Also, while treating a patient, the dentist should not take notes, touch the phone, or eat or use cosmetics in the workplace.

Mushrooms relieve toothache
Most Murmansk residents try to get free dental care not in private clinics, where prices are quite high, but in regular clinics at their place of residence. To get to the doctor, patients have to “catch” numbers sometimes for several days. As doctors joke, they can catch their breath only two months a year - in August and September, when Murmansk residents are busy harvesting mushrooms and berries.

“To solve the problem of queues now, we would have to at least double the number of doctors,” notes Emma Tolmacheva. “Under current conditions, this is unrealistic.” In addition, today doctors, when treating adult patients, have to deal with the consequences of imperfect technologies of the 80s and 90s. In addition, public dental clinics bear social responsibility by participating in the preferential dental prosthetics program. Thus, over 8 months of 2009, 5,852 residents of Murmansk have already received such assistance in the amount of 43.8 million rubles. These are war and labor veterans, home front workers, disabled people, rehabilitated people, as well as ordinary pensioners.

Parents often wonder: where to treat the teeth of their children who are already 10 - 18 years old: at a pediatric dentist or at an adult dentist who treats the parents themselves? It seems that the children are adults, and their teeth are already the same as those of adults...

Reasons why teenagers should be treated by a pediatric dentist.

Photo: dental treatment with a rubber dam The tooth is isolated from the oral cavity, from saliva and tongue using a rubber dam. It is convenient for both the doctor and the patient, as it allows the patient to partially cover their mouth to rest during treatment without compromising quality.

• According to the law, only a doctor with a certificate of “pediatric dentistry” has the right to treat children and adolescents under 18 years of age;
• Children's teeth are different from adult teeth. Both baby and permanent teeth in children and teenagers are young and new. The unformed enamel of such teeth is more susceptible to the carious process, which, while occurring unnoticed by the child and parents, is very quickly complicated by inflammation of the nerve of the tooth (pulpitis).
• The smaller the child, the more difficult it is for him to comply with the dentist’s requirements: open his mouth wide, lie motionless in the dental chair, endure various manipulations in the oral cavity (but the child sometimes wants to touch and see what is being done in his mouth). These features require the dentist to have patience and the ability to manage the child’s behavior.
• Young teeth, especially molars, are partially covered with mucous membrane for a long time after eruption, which creates significant difficulties in isolating the surgical field from saliva. In such a situation, the use of special isolating devices, such as a rubber dam, is required. A rubber dam is a special curtain made of latex that allows you to effectively treat a tooth. Carrying out such manipulations on young molars as sealing and placing a filling without isolation with a rubber dam is not possible.
• A pediatric dentist knows the peculiarities of dental development in childhood and adolescence. Often adult therapists do not know how to treat teeth whose eruption is not complete, the root system of which is not formed. This, in turn, is fraught with excessive preparation of healthy tooth tissue and poor quality of treatment; As a result, the teeth do not complete their formation. SUCH TEETH ARE BADLY RESISTANT TO STRAIN AND CARIES;

Many parents have an incomplete and often incorrect understanding of pediatric dentistry. The reason for this is several erroneous opinions that have taken root in the public consciousness. Let's look at just a few of these misconceptions and try to evaluate them.

MISCONCEPTION N1: There is no need to treat baby teeth, since they will be replaced by permanent teeth later anyway.

IN FACT: The quality of permanent teeth depends on the health of baby teeth. Most diseases of baby teeth can spread to permanent teeth, in which case by the time they erupt, they will already be affected by diseases. Another problem is related to the misalignment of baby teeth. This can lead to malocclusion even in adulthood. In this case, the child will definitely develop complexes that will negatively affect his development and life in general. So you need to take care of dental health from the birth of your child.

MISCONCEPTION N2: Any dentist can treat children's teeth, so if problems arise, it is not necessary to contact a pediatric dentist or a specialized children's dental clinic.

IN FACT: Pediatric dentistry is a separate dental field that takes into account all the characteristics of the child’s body. When working with children, dentists use completely different tools, materials and medications. Pediatric dentistry is many times painless, and this is its advantage. In addition, not every dentist can work with children. In general, the requirements for pediatric dentists are much higher, because in addition to excellent knowledge in the field of dentistry, he must also be an excellent psychologist in order to easily find contact with the child, and carry out treatment without pain and blood. This is extremely important for children, especially psychologically. After all, if the first visit to the dentist did not cause him any anxiety or pain, in the future he will visit the doctor very calmly. This approach has long been practiced in developed countries of the world, where visiting a pediatric dentist has turned into something resembling a holiday. Before going to the doctor himself, children play with toys, communicate with other children, watch cartoons, draw and read books, and receive nice gifts. The treatment procedure itself also does not cause any special problems, since they do not use a drill to drill teeth, but a completely painless and silent laser. The same applies to pain relief, for which topical anesthesia is used, for example, a safe and effective lidocaine spray. The child leaves such a clinic with good emotions, healthy teeth and a new toy in his hands. Such a child will visit the dentist all his life without a shudder, carefully follow all his recommendations and take care of his teeth.

MISCONCEPTION N3: Children's carious teeth should not be treated, it is useless. It is better to remove them immediately so that permanent ones appear in their place.

IN FACT: It has long been proven that early removal of baby teeth leads to serious problems. First of all, this concerns difficulties associated with the eruption of a permanent tooth. The fact is that after removing a tooth affected by caries, neighboring teeth begin to move from their places, trying to fill the empty space. In this case, the permanent tooth may erupt out of place. This is fraught with the fact that at a later age the child’s malocclusion will have to be corrected. The absence of baby teeth has an extremely negative impact on chewing food. In addition, the development of the bite, facial skeleton, diction may be disrupted, and cosmetic defects may form. This is why doctors believe that childhood caries must be treated.

MISCONCEPTION N4: Children's teeth cannot be filled with composite materials.

IN FACT: This is not true. It’s just that in many of our dental clinics there are not enough conditions created for the child to sit in a chair for the required time and allow the doctor to carry out treatment normally.
This is only possible in specialized children's clinics, where treatment is combined with play, and modern composite materials are used for filling, which are durable, hygienic and at the same time aesthetically pleasing. If necessary, nitrous oxide is also used - an oxygen mask. All these technologies allow the child to relax, and help the doctor to heal the tooth efficiently. If all the necessary conditions are met, it will not be difficult for the child to get crowns and/or neat removable dentures.

MISCONCEPTION #5: If you scare a child at the dentist, he will take better care of his dental hygiene.

IN FACT: One of the biggest misconceptions, bordering on stupidity. If you do this, the child will carry the fear and negative attitude towards the dentist into adulthood. On the contrary, it is necessary to convince the child that visiting the dentist is a harmless and even pleasant activity. This is what they do in many countries around the world, where the problem of fear of the dentist has long been resolved. In these countries, dental treatment is a very expensive treatment. Therefore, people there are well aware that dental diseases are much easier and cheaper to prevent than to treat later. That’s why it’s not dentists that scare children there. In our country, such parental behavior, unfortunately, is still considered quite normal. However, if we look at the root of the problem, in our country it is often not the parents who are to blame, but the dentists themselves, who, during the child’s first visit, caused him pain and instilled hostility. In this case, you must immediately change the dentist. Ask your friends and acquaintances about specialists in pediatric dentistry. Make sure that this is a good specialist and only then entrust the health of your baby into his hands. Remember, in early childhood, a negative impression of a visit to the dentist can be changed into a positive one, but as the child grows up, this will be almost impossible.

MISCONCEPTION N6: Treatment of a child’s teeth in a specialized children’s clinic is too expensive.

IN FACT: At first glance, this is indeed the case. But only if you don’t consider how much money and time you and your child will save in the future. What if, as an adult, your son or daughter has a panicky fear of the dentist and turns to him only when it is simply impossible to resist the pain? How much will forced visits to the dentist cost him then? You can easily calculate that the amount will be many times more than the prevention and treatment of a child’s teeth in a specialized clinic, where he will not experience any anxiety or fear of the doctor.

MISCONCEPTION N7: It is not necessary for a child to brush his teeth with a special toothpaste; any will do.

IN FACT: Baby's teeth must be brushed with special children's toothpastes, which are designed specifically for baby teeth. These pastes have a pleasant taste, but the main thing is that they contain a protective mineral composition.
You need to start brushing your child's teeth from the moment they erupt. First, use a silicone brush placed on your finger for this, and then, closer to the age of one, you can use a special children’s toothbrush in the shape of a toy. This brush has both gentle bristles and the required size, and the toy will help cheer up the child. But the most important thing is to teach your child to brush his teeth every day, morning and evening, and to do it correctly.

MISCONCEPTION #8: It doesn’t matter how healthy a child eats, the main thing is that he eats enough.

IN FACT: Poor nutrition is one of the main causes of dental disease in childhood. To prevent such problems from arising, immediately after the birth of the child, parents are obliged to do everything to ensure that the child feeds on mother’s milk. Breast milk is the most valuable source of nutrients and protective substances. But even more important is the way in which the child receives it. To achieve this, he makes a lot of effort, and this, in turn, has a huge impact on the growth, development and formation of the child’s dental system.

In general, dairy products are extremely important for the development of a child’s body, as they supply him with calcium - the main element of teeth and bones. So dairy products should always be in the child’s diet, especially until he reaches the age of three, when the formation and formation of the rudiments of permanent teeth is completed. By the way, there is another common mistake parents make when feeding a child with sweet formulas or juices, especially at night and throughout the night. This can cause caries in baby teeth. Therefore, this should not be done under any circumstances.

MISCONCEPTION N9: A child should be taken to the dentist only when he or she develops tooth pain or other dental problems.

REALLY: This is a terrible mistake and can cause serious problems. The child should be taken to the dentist for the first time no later than his first birthday. In the future, if the child does not have problems with teeth, it is recommended to make preventive visits to the dentist 2 times a year, but if the child has such problems, this should be done once every 3 months or more often, as prescribed by the doctor. In this case, all problems and diseases will be eradicated in the bud. After all, in childhood, pathological processes develop very quickly, and their early diagnosis will allow for simple, fast, painless and inexpensive treatment. In addition, preventive dental examinations do not cause a feeling of fear in the child, since the child realizes that he has nothing to be afraid of.

MISCONCEPTION N10: The best way to treat bottle caries is silvering.

FACT: The effectiveness of teeth silvering has not been proven in extensive dental research. Most dentists rightly believe that silvering of teeth for children should only be used if the dental clinic is not equipped with modern equipment and technologies. The fact is that silver plating is effective only for superficial caries. If caries has already penetrated inside the tooth, silvering will not be able to help, since caries will continue to destroy it from the inside. Another drawback of this method is its unaesthetic quality: the silver gradually begins to turn black, and very soon the child begins to feel complex about his smile. Modern medicine has developed many alternative methods for preventing caries, so it is not surprising that many dental clinics have abandoned the silvering of baby teeth.

MISCONCEPTION N11: Children should not have crowns on their front teeth because it is pointless.

IN FACT: Perhaps a few years ago this was indeed the case. In cases where the tooth was significantly damaged, it was proposed to remove it or seal the root with cement. For a long time, medical scientists have been struggling to create a method for saving and restoring damaged front teeth, because, as we have already said, tooth extraction in the future negatively affects the development of the child’s dental system and diction. And so, quite recently, a solution was found: if the tooth root is intact, it can be saved with the help of a crown. Often this is the only chance to save a diseased tooth and extend its service life. Today, this is the most reliable way to preserve a child’s teeth until they are replaced with permanent ones. The very fact that the child will be able to fully bite off food and will not be embarrassed by his smile speaks to the advantage of this method, which is already used in all leading dental clinics on the planet. At the same time, preference should be given to metal-ceramic crowns, which are not only durable, but also externally indistinguishable from surrounding healthy teeth.

MISCONCEPTION N12: Teething in babies is always accompanied by fever, anxiety, upset stomach and other factors.

IN FACT: For many children, the teething process is painless. But most still experience short periods of irritability, pain, and disturbances in sleep and eating patterns. It is very rare that this process is extremely painful for the child. In case of such a relapse, parents should consult a pediatrician or pediatric dentist. As for a slight increase in temperature in a child, it can be caused by swelling of the gums through which teeth are being cut. However, teething itself does not cause a significant increase in temperature or stomach upset. So, if such symptoms appear, it is also recommended to consult a pediatrician, as it is quite possible that they are caused by something else.

MISCONCEPTION N13: A child’s correct bite should be addressed when he completes the replacement of baby teeth with permanent ones.

IN FACT: You need to take care of your child’s correct bite from the very minute you notice a problem. Don't think that malocclusion creates only cosmetic problems. It can also cause much more serious problems - damage to the teeth, their supporting apparatus, and gums. The fact is that crooked and crowded teeth are more susceptible to diseases that can lead to their loss, since such teeth are extremely difficult to clean. In addition, other problems threaten such teeth: increased wear, ineffective chewing, additional stress and diseases of the jaw joints, causing chronic migraines, pain in the face and neck, as well as problems with the gastrointestinal tract and breathing. Modern dentistry makes it possible to eliminate bite problems at any age. However, dentists recommend doing this in childhood, since in children this process lasts much less. It has been proven that children tolerate the presence of orthodontic devices in their mouths much more easily and are not embarrassed, and often even proud of their colorful braces in the form of animals or stars. The best age for a preventive examination of a child by an orthodontist is 6-7 years. It is at this age that the first permanent teeth erupt. Using them, it is already possible to determine whether the child will have malocclusions. If there is a problem, the orthodontist will find ways to influence the direction of tooth growth, correct the speed of development and size of the jaws.

MISCONCEPTION N14: Orthodontic appliances disfigure a child’s appearance.

IN ACTUALITY: Once upon a time this was really true. But now dentistry offers several options to solve bite problems. This can be a removable plate, which is usually used between the ages of 6 and 10 years, when the bite is formed. These can also be special mouthguard trainers that prevent malocclusion. Outwardly, they look like a boxing tire, but are completely transparent. Mouthguards are used between the ages of 6 and 15 years. Children usually wear a mouthguard during the day for 1.5-2 hours. At a more mature age, at 11-12 years, when the formation of the root tips is completed, orthodontists recommend using braces to correct the bite.

MISCONCEPTION N15: Braces are the subject of ridicule from peers and others.

IN FACT: Dentists have long stopped using bulky and ugly braces. Modern braces are so attractive and varied that children and teenagers wear them with pleasure, without fear of ridicule from their peers. Braces systems are small locks that are glued to the teeth from the outside or inside. These locks are connected to each other by a thin metal arc that has shape memory and takes on its original state no matter how it is bent. Today, the child himself can choose the color of his braces, since it is very easy to paint it in any color - from transparent to multi-colored. In addition, another advantage of braces is that it can contain the child’s favorite figures - animals, toys, patterns. By the way, braces are made from different materials and, as a result, have different appearances and varying degrees of effectiveness. Among the variety of metal (steel), plastic, sapphire (made from artificial sapphires) and ceramic braces, dentists prefer metal ones, as they are both high-quality and inexpensive. The latest developments by doctors are translucent and very effective braces, which are even smaller than traditional ones and therefore much less noticeable on the teeth.

How long have you been working (Zubrenok Clinic)?

Our children's clinic "Zubrenok" was one of the first clinics in Moscow, which in 2002 began developing specialized care for children and adolescents.

What is the easiest way to find your clinic?

On foot. From metro Chertanovo, Southern exit. Walk down Balaklavsky Avenue, on the opposite side of the metro, towards the Airbus shopping center.
- by car. Turn onto Balaklavsky Prospekt from Varshavskoye Shosse, first floor of a residential building, after the Rus auto parts store. You can park in the store parking lot.
On the clinic’s website in the “Contacts” section there is detailed information on how to reach us on foot from the metro or by car.

Why should parents be present at the first appointment?

Parents must be present at the reception, since only they, being the legal representatives of the child, make the decision on the choice of treatment method; its cost.

Is it possible for the child to come to the first appointment with his grandmother/grandfather/aunt/uncle/nanny, etc.

This is possible if the accompanying person has a notarized power of attorney from both parents stating that it is this accompanying person who will represent the legal interests of the child and make decisions about his treatment.
It is possible, the initial visit is a consultation that does not involve any manipulation. At the next visit, when treatment is to take place, the child’s legal representative must be present (which is confirmed by a passport and birth certificate) so that there is no disagreement about the treatment method. Informed consent for treatment is signed. By law, only a legal representative can do this.

Why do I need to present my passport and birth certificate?

The law obliges us, the service providers, to make sure that the adult with whom the child came is his parent or legal representative.

Who works best with young children?

All doctors at the clinic have special training in child psychology and know how to establish contact with children. All you have to do is choose a convenient day, time and, if desired, the gender of the doctor.

If a child is afraid, how is treatment done?

We have doctors who always try to find an approach to the child, play with him and persuade him to undergo treatment. It may take several visits to the clinic for the child’s acquaintance with the doctor and the clinic to be successful.
If you cannot establish contact with your child or he already has negative experience with dental treatment, then you can try the following options:
- sedation (the child is injected intramuscularly with a drug that relieves fear, anxiety, and tension. The drug is used only for these purposes and is approved by the Russian Ministry of Health). The child is conscious; some children become sleepy; some continue to cry but do not resist treatment. It is impossible to know in advance how the drug will work. The dosage of the drug is selected depending on the weight of the child. The procedure is performed by an anesthesiologist, who first determines the absence of contraindications to the use of the drug, and then monitors the child’s condition during treatment;
- anesthesia (the child is put into a state of sleep using Sevoran gas). The child does not feel pain, does not remember what was done and how; treatment is carried out in a supine position, which allows you to comply with all technological conditions of treatment and complete the entire scope of work: treatment; deletion; prosthetics. If necessary, after teeth are removed, impressions can be taken to make a replacement prosthesis.

Do you have a psychologist?

We don't have a psychologist at the moment. However, the clinic’s doctors have special training in the field of child psychology and know how to find an approach to any child.

If my child is a little sick, should I bring him to the appointment?

You should not bring your child to the appointment. The child must be completely cured. If a child has a cold, he will be capricious or have difficulty breathing through his nose, which can provoke the urge to vomit. You should not bring a child with herpes, even if several days have passed since its appearance, as a relapse and exacerbation of the disease is possible.

Is there a discount for low-income/large families?

There are no separate discounts. We have a unified discount system for everyone.
There is a cumulative discount, which starts after the first appointment, and weekday discounts: 20% from 9:00 to 15:00 and 10% from 15:00 to 21:00.

Therapy

How much will it cost to treat a baby/permanent tooth?

The cost of tooth treatment depends on its condition. It is impossible to say even approximately, since the cost consists of many parameters that can only be determined by a doctor and only after preliminary diagnosis. You can see the approximate cost of treatment for each diagnosis on our website in the “Prices” section. There are prices for individual manipulations that may be part of the “Treatment of baby/permanent tooth” service.

What anesthesia do you use? How is everything going?

The clinic uses articaine anesthetics in dosages specially selected according to the weight and age of the child; hypoallergenic.
Anesthesia is administered with disposable (individual) syringes (injectors). The injection site is also treated with an anesthetic so that the child does not feel the injection. Anesthetic in the form of a pleasant-tasting and odorless gel. A spray can also be used. The need for one or another pain reliever is determined by the doctor.

What is “manual tooth preparation”? At what age is it indicated and how much does the service cost?

Manual preparation increases the cost of caries treatment by 1,790 rubles. During the work, an individual set of tools and a special gel are used to dissolve carious tissues in order to scrape them out more easily. The procedure takes about 10 – 15 minutes. After which the tooth is filled.
The good thing about the procedure is that there is no noise, vibration, unpleasant odors or sounds, as with traditional boron work. In addition, this procedure is painless, since hand instruments do not touch living tissue, removing only non-viable tissue. The quality of this treatment is similar to that of boron. But in terms of time – longer. There are no age restrictions for this type of cavity treatment. It can be used in any patient who is afraid of pain, the dentist, or in children who come to the doctor for the first time, in order to avoid causing discomfort.

What method is used to treat caries in the clinic?

If we mean filling a cavity by the term “treatment”, then first the cavity is cleaned using one of the following methods: ultrasound/air-kinetic method (without boron; a jet of air under pressure and a special powder)/manual method (special tools and gel for dissolving carious tissues )/burs. Doctors use special burs that can wear off when the treatment reaches the level of healthy tissue. These are disposable burs. They can only remove dead (caries) tissue. All these methods are used to avoid damaging healthy tooth tissue.
Then the cavity is filled. The filling material is selected depending on the condition of the child’s dental tissues. The doctor determines this and first tells the parent what determines the choice of material.
It is correct to understand by “treatment” the elimination of the cause of caries - a systemic disease of the body. For this purpose, the clinic employs a pediatrician who helps to establish the cause of metabolic disorders in the child’s body.

What material do doctors work with?

The materials used for filling teeth are imported; photopolymerizable and more. The choice of materials is made by the doctor depending on the condition of the child’s dental tissues, since they perform a therapeutic function.

What is the guarantee for the seal?

Guarantee on the seal from 3 to 6 months; extended every 3 to 6 months during the entire period of observation of the child in the clinic. The condition for extending the warranty is the completion of treatment with an individual course of prevention; repeating the course of prophylaxis after 3/6 months (according to indications).
The duration of the primary guarantee depends on the activity of caries in the child - the number of carious cavities. For multiple caries – this is 3 months; with a small number of carious cavities and good hygiene – 6 months; if there is only one filling and hygiene is good – 1 year.
Repeating preventive courses is aimed at strengthening tooth enamel; improved hygiene; inactivation of cariogenic flora (microbes that cause caries); improving oral health (which indirectly affects the child’s overall health). If you follow the preventive program, there is no need to re-treat your teeth; redo fillings and treat new caries. The treatment guarantee can last throughout childhood.

How much does it cost to restore a front tooth?

Within 10,000 rubles (including isolation of the working field with a rubber dam; necessary anesthesia, etc.). But only the doctor can determine the final cost of the work and only after its completion. During the consultation, the doctor will draw up a treatment plan and a preliminary estimate; will agree it with you, and will also indicate what options (both increasing and decreasing the cost) are possible during the course of treatment.

Do you use general anesthesia/general anesthesia?

Yes. Our clinic has an anesthesia department equipped with the most modern anesthesiological equipment. Experienced anesthesiologists and resuscitators work; there is a rehabilitation ward (day hospital), where the child is recovering under the supervision of a pediatrician and other medical staff. It is possible for parents to be present in the rehabilitation room. On our website in the “Services/Treatment under Anesthesia” section or in the “Patients/Video” section there is a film that will help answer many of your questions.

Surgery

How much does it cost to remove a baby/permanent tooth and what does it depend on?

Removing a baby tooth costs from 1,520 rubles; permanent – ​​from 2770 rub. Cost depends on the type and amount of pain relief needed; difficulty of removal (which is associated with the condition of the tooth and its anatomical features). A variety of medicinal “inserts” into the socket (after removal) with an analgesic effect may be required; hemostatic; anti-inflammatory (the choice is always individual and is made by the doctor depending on the need). In our clinic, this procedure is performed by certified dental surgeons.

At what age should a child have a transection of the shortened frenulum of the tongue? Why is this being done?

Dissection of the frenulum of the tongue is done in the maternity hospital, when the child cannot clasp the nipple of the mother's breast. This leads to nervousness of the child, as he quickly gets tired when sucking and does not gain the required weight.
If, for some reason, this manipulation was not done in the maternity hospital, it must be carried out in the first weeks of life. In our clinic, pediatric dentists are skilled in this procedure, which is quick and painless for babies.

Is there any warranty period?

None of the surgical procedures in pediatric dentistry provides a warranty period - the procedure is performed simultaneously and does not require repeated intervention. If a second consultation with a doctor is required, it will be carried out. In general, the clinic’s rules for providing services include patronage by medical workers of their patients - until complete recovery.

Hygiene

Why do you need to visit a hygienist if your child’s teeth are fine?

It is necessary to visit a hygienist - a specialist in the field of dental prevention - regardless of whether there are problems with teeth or not. This must be done every six months, and possibly more often (on the recommendation of a doctor). Plaque accumulates daily on a child’s teeth, which over time turns into dense dental deposits that cannot be cleaned with a toothbrush. Under this plaque, the process of softening the enamel and the appearance of caries occurs. Therefore, it is necessary to regularly remove plaque, diagnose tooth enamel and hidden caries so that the teeth are healthy and do not have to be treated in the future.

How much does an initial visit with a hygienist cost?

4200 rub. It includes diagnostics of the quality of cleaning (visual for the child and parent); training in hygiene rules and rules for monitoring its implementation; professional oral hygiene (with a brush and a special paste, which is selected depending on the condition of the teeth or a sandblasting machine (for older children - teenagers); laser diagnostics of initial caries and its latent forms; consultation on the selection of hygiene products (paste, rinse aid, brushes); consultation on healthy eating.

Plates for one jaw cost from 13920 to 16420 rubles. After consulting an orthodontist and deciding on treatment using plates, you must make a 100% prepayment, since the plates are manufactured in the laboratory. Their production begins only after an advance payment has been made.

And we also have metal , ceramic And lingual braces.

Why not a fixed fee for braces?

In our clinic, advance payments are not made for the entire period of treatment, since it proceeds differently for everyone and pre-paid manipulations may not be necessary. This allows parents to control their expenses.
The cost of the braces system is fixed in the price list and changes only when the price list is changed again due to an increase in the purchase prices of braces, of which all visitors are notified through the site in advance. The remaining manipulations are very individual, and we do not see the need for advance payments.

What is myofunctional therapy? In what case is it indicated?

The main goal of myofunctional therapy is the prevention and correction of impaired muscle functions, elimination of bad myofunctional habits, elimination of crowding of teeth and correction of occlusion.
You can read more detailed information on our website in the “Services/Myofunctional Therapy” section.

Is there any guarantee period for orthodontic treatment?

The warranty period is established after the end of the retention period of one year. This issue is also discussed in detail during a consultation with an orthodontist, since orthodontic treatment has its own nuances.