三至六歲 Tooth growth and development, 3 to 6 years
此時期的小朋友乳齒大多已經萌發完成,如果有大範圍齲齒的牙齒應該以牙冠復形,以免空間喪 失,乳齒自己就是最好的空間維持器。如果因為外傷或是嚴重齲齒導致提前乳齒喪失,應該找兒童牙科醫師諮詢乳齒義齒或是空間維持器的必要性,避免因為乳齒提 前喪失而造成以後換牙空間的不足。
三至六歲的小朋友大部份已經戒除吸奶嘴的習慣,但是還有少部分的小朋友尚未戒除,有的會習慣性吸手指。
長期吸奶嘴或吸手指可能會導致前牙開咬,影響牙弓發育(發展成尖形V-shape的牙弓)最終影響牙齒排列。
另外一個會影響牙齒排列的是吞嚥時舌頭往前伸的習慣,這會導致口腔周圍肌肉不協調、前牙開咬、顎骨發育異常與呼吸道的狹窄,進而增加後續齒顎矯正的困難度與矯正後維持的穩定性。
兒童牙科醫師在臨床上看到這樣問題會建議家長儘早幫小朋友改正不良習慣,習慣的改變相當不容易,某些類型的矯正裝置搭配肌肉訓練課程可以協助小朋友與家長改正這些問題,但是能否成功還是取決於小朋友的配合度與毅力。
近年來空氣汙染嚴重,小朋友有鼻子過敏問題的比例也愈來愈高。鼻子過敏、呼吸道不通暢慢慢會讓小朋友養成口呼吸習慣。
家長對於小朋友口呼吸的問題只是覺得嘴巴開開的不美觀,殊不知小朋友是處於呼吸不順暢的痛苦中,長期呼吸不順也會影響到學習與睡眠。
長期口呼吸會導致口腔周圍肌肉不協調,進而影響牙齒排列與顎骨發育,也就是臉會變醜。
要改正口呼吸:
- 第一步是要先排除呼吸道通暢度的問題,鼻息肉、鼻中膈彎曲、腺樣體肥大、扁桃腺腫大、因過敏導致分泌物增加都有可能導致呼吸道不通暢,這些問題要請耳鼻喉科醫師幫忙解決。
- 牙科部分,我們可以使用功能性矯正裝置搭配呼吸訓練,小朋友在長期持續的訓練下大多可以慢慢改掉口呼吸問題。
During this period most of the primary teeth have erupted. If a primary tooth is severely decayed, it's recommended to be fitted with a crown to preserve the space. A primary tooth itself is the best space maintainer. If a primary tooth is lost prematurely due to trauma or severe cavity, please consult a pediatric dentist to inquire if a prosthesis or space maintainer is needed to avoid a lack of eruption space for the permanent tooth.
Most children aged between 3 to 6 years have stopped using a pacifier with a few exceptions. Some may still maintain a thumb sucking habit.
Prolonged use of pacifiers or thumb sucking may cause open bite and harm the growth and development of the dental arch(into a V shape) and teeth.
Another factor that affects tooth alignment is tongue thrust during swallowing. This condition causes oral muscular disharmony, open bite, abnormal bone development, and a narrow airway, all of which will complicate subsequent orthodontic correction and retention.
When a pediatric dentist clinically identifies a tongue thrust problem, parents will be advised on how to stop contributory bad habits. It's not easy to change habits and there are certain orthodontic devices, in combination with myofunctional therapy, that can help children and parents to correct these problems. The key to success lies in the children's cooperation and perseverance.
In recent years air pollution has increased the allergy rate found in children. Nose allergies and a congested nose will slowly lead to a mouth breathing habit.
Parents may regard mouth breathing as an esthetic issue because of the mouth opening. What they fail to recognize is that it can cause a chronic discomfort for children due to problems with breathing. It also affects school performance and sleep.
Chronic mouth breathing causes oral muscular disharmony and affects the growth and development of tooth alignment and facial bones.
How to stop mouth breathing?
First, remove factors that cause nose congestion, including nasal polyps, nasal septum deviation, adenoid vegetation, tonsil hypertrophy and increased mucus due to allergies. Please consult an EMT doctor first.
From a pediatric dentist's perspective, we recommend long-term training using functional orthodontic devices, together with myofunctional therapy to correct a mouth-breathing problem.