Cases

A seven-year-old boy, visiting a dental practice for the very first time. His oral hygiene was severely neglected and most of his primary teeth were decayed — a picture that typically develops over a long time, with plenty of sugary drinks and without regular brushing. Sugary sodas, syrups and fruit juices expose the teeth to acid attacks several times a day: the enamel first discolours, then cavities form — and in primary teeth, with their thinner enamel, this happens faster than in permanent teeth.

This is why prevention matters so much: water instead of sugary drinks, brushing twice a day supervised (and finished, if needed) by a parent, and regular dental check-ups from the first year of life. A condition like this is never the child's fault — but turning it around takes teamwork.

Our fourteen-year-old patient arrived with neglected oral hygiene: the gums were swollen and bled easily in several places — the typical picture of gingivitis. The cause is almost always the same: bacterial plaque (biofilm) sitting along the gumline and between the teeth, not removed regularly and thoroughly by brushing.

Treatment was done with our EMS device, following the Guided Biofilm Therapy protocol. As its first step we disclosed the plaque with a dye — in the photos, the vivid coloured layer shows exactly where biofilm remained on the teeth. Disclosing helps the patient as much as us: they see with their own eyes where the toothbrush doesn't reach. The AIRFLOW jet of warm water and fine powder then removed the biofilm gently, without scraping.

The chalky-white to yellowish-brown patches on our twelve-year-old patient's teeth show a developmental disorder of the enamel. Enamel forms while the tooth is still developing, before eruption — if enamel formation is disturbed in this sensitive period, it leaves a permanent mark on the finished tooth. The most common pictures are hypomineralisation (the enamel's mineral content is reduced, making it softer and more porous) and hypoplasia (the enamel is thinner, with a pitted surface).

There is rarely a single identifiable cause: febrile illnesses in pregnancy and early childhood, episodes of oxygen deprivation, premature birth, certain medicines and genetic factors can all play a part. Importantly: this is not a brushing failure. Affected teeth, however, can be more sensitive to hot and cold, wear faster, and the porous enamel decays more easily — so these teeth need closer follow-up.

Our thirteen-year-old patient chipped both central incisors in an accident (the mesial — middle — corners of teeth 11 and 21). Front-tooth fracture is one of the most common dental injuries of childhood — a bike, a scooter, sports or a simple fall is enough. The quickest next step is a dental examination: the depth of the fracture decides whether the pulp is involved, and with it the treatment.

In this case the pulp was unharmed, so we restored the broken corners with aesthetic, tooth-coloured fillings. As the photos also show, the restoration does not aim to "straighten" the teeth or change their alignment — that is an orthodontic task. The filling gives the tooth back its original shape, in the gentlest possible way.