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CHILDREN'S DENTISTRY

CHILD GROW UP SMILING PLAN
The new Medicare funded Child Grow up smiling plan 2014 also known as Child Dental plan replaces Teen Dental plan from 1 January 2014. The Child Dental Plan provides eligible children with up to $1,000 in benefits for basic dental services, capped over two consecutive calendar years. A child is eligible for the Child Dental Plan if he or she is aged between 2 to 17 years for at least one day in the calendar year, is eligible for Medicare and receives, or is part of a family receiving, a relevant Australian government payment such as Family Tax Benefit Part A.

Services that receive a benefit under the Plan include examinations, x-rays, cleaning, fissure sealing, fillings, root canals, extractions, and partial dentures. Many of these services have claiming restrictions. Opal Dental using HICAPS electronic system Bulk bill Medicare directly for Child Grow up smiling plan also known as Child Dental Plan. This way we can claim on the spot and you do not have to pay any out of pocket expenses up to the cap limit of $1,000 over 2 consecutive calendar years.
YOUR CHILDS FIRST TEETH
Your child’s first teeth will begin to erupt at about 6 months of age. The lower deciduous (baby) incisors (front teeth) erupt first followed by the upper deciduous incisors. These are followed a few months later by the lower, then upper deciduous first molars (back chewing teeth), the deciduous canines (pointed teeth at side of mouth) follow and then finally the second deciduous molars top and bottom. This process takes about 18 months in total. Your child will most likely have all 20 deciduous teeth by the age of 2-2 1/2years, although all children differ in development and this age is a rough guide, give or take 6 months.
What should you do?

Cleaning
There are no hard and fast rules. But you should start to brush your child’s teeth with a soft paediatric toothbrush as soon as they become visible in the mouth. From the age of three you may start using a children’s formulated toothpaste. A small pea sized amount is sufficient, using a gentle scrubbing motion to remove plaque and food debris.

From the age of 6 supervised brushing in the morning and evening is advised. A small amount of adult toothpaste may be used as long as your child is able to spit it out and not swallow it.
Diet
It is not recommended that you let your child go to bed with a bottle. A bottle of milk will contain sugars that will cause tooth decay if continuously sucked upon through the night. It is best if bottles are given in one sitting and then removed. The same principle of one sitting should be applied for soft drinks, sweets and foods containing sugars as your child gets older. It is not the amount of sugar that a food contains but the frequency of consumption that is important with regards to your child’s teeth. The more frequent the sugar intake, the more often harmful acid is produced which can lead to tooth decay. Treats are best given after meals when natural sugars from food are present in the mouth anyway. Some tooth friendly snacks are fresh fruits, rice crackers, nuts and popcorn (not sugared) as alternatives to chocolate, jellies and candies. Milk or water is preferable to carbonated soft drinks. Fruit juices should be watered down and given in moderation and preferably those with no added sugar or sugar free.
Teething
This occurs when your child begins to cut their first tooth. Around this time your child’s innate immunity (given by the mother during pregnancy) begins to wan and their own immune system begins to take over. Colds, fevers, irritability and runny noses etc are common at this time and are often associated with teething, but they are separate events. If you are worried about your child’s health during this period it is best to visit your GP. For teething problems it is not recommended to use pharmaceutical gels as they may contain aspirin and do not have a long duration of action. Also it is very difficult to measure the dose. A simple and effective way to relieve teething pain is to give them a piece of frozen banana, a cold piece of cucumber or carrot (large enough not to swallow), a cold teething ring or hard biscuit such as rusk.
Breastfeeding
Prolonged breastfeeding – 2 years and beyond – may cause dental decay due to the natural sugar in breast milk.
Dummies
Use them only up to the age of 2, then remove them. They are easier to remove than the child’s own thumb!

If you are worried about your child’s dental health then it is best that you bring them for a check up. Your child is never too young to visit the dentist, the earlier this starts the easier they are to treat as they will learn to trust the dentist and the surroundings from an early age. Bring your child with you to your check ups. Then make your child’s first appointment at around 2.5 years of age.

Your dentist will advise you on your child’s development and dental health. You are than welcome to discuss any fears or worries you may have.
FISSURE SEALANTS
Sealants can protect your children's back teeth, so that they may never need to have a filling! They are a protective plastic coating, which are applied to the chewing surfaces of teeth at risk of decay. The chewing surfaces of back teeth have small grooves or fissures which often extend right down into the tooth itself. However well the teeth are brushed, these fissures are very difficult to clean thoroughly. Bacteria and food particles stick to them and eventually cause decay. Fissure sealants completely seal off these grooves, preventing any food particles or bacteria from getting in. They do not affect the normal chewing function of teeth.

It's best to get advice from your dentist or dental therapist if your child would benefit from fissure sealing the permanent back molar teeth
How is it done?
The first permanent back molars are usually sealed between 6 and 7 years of age. If required the rest of the molars are usually sealed as soon as they appear which can be any time between 11 and 14 years
Do the teeth need special care afterwards?
No special care is needed, but the back teeth still need to be brushed regularly with a good toothbrush, preferably using fluoride toothpaste. It's also important to keep going to your dentist or dental therapist for regular check-ups because other teeth might need attention.
PULPOTOMY AND PULPECTOMY
The pulp of the tooth is the hollow inner core of the tooth. The pulp contains nerves, blood vessels, connective tissue, and reparative cells. The purpose of pulp therapy in pediatric dentistry is to maintain the integrity of the affected tooth, so that your child's tooth is not lost, until his/her permanent tooth is ready to erupt.

Dental caries (cavities) and traumatic injury are the two main reasons for your child's tooth to require pulp therapy. Pulp therapy is often referred to as a "nerve treatment," "baby or children's root canal," "pulpotomy," or "pulpectomy."
The two common forms of pulp therapy in children's teeth are a pulpotomy and a pulpectomy
A pulpotomy is a dental procedure that is performed when the decay in a child's tooth reaches into the pulp (nerve) tissue. The infected part of the nerve tissue within the crown portion of the tooth is removed to prevent further inflammation and spread of disease (caries). Next, a sedative material is placed within the tooth to prevent bacterial growth and to calm the remaining nerve tissue.

After the pulpotomy is finished, your child's tooth is restored with a stainless steel crown (SSC) on the back molar teeth to re-establish normal chewing function and to continue to hold the space until the permanent tooth can take its place. This is performed in one visit and causes no more discomfort than placing a routine filling.

A pulpectomy is required when the entire pulp is involved. During this treatment, the diseased pulp tissue is completely removed from both the crown and the roots. The canals are cleansed, disinfected, and in the case of primary teeth filled with a resorbable material. Then a final restoration is placed which would be the same choices as for a pulpotomy on a primary tooth. A permanent tooth would be filled with a non-resorbing material and either a temporary stainless steel crown or an adult ceramic, porcelain, or gold permanent crown would by placed.

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Opal Dental is a Medibank Private, BUPA and CBHS Member's Choice Provider. Medibank, BUPA and CBHS members will receive higher rebates on dental services than if they were to see non member choice providers.

       
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