Engana-se quem acredita que, como as crianças perdem dentes na primeira infância (a chamada dentição “de leite”), elas não precisam de cuidados específicos ou de acompanhamento especializado. Embora, de fato, a primeira dentição da criança seja provisória, ela tem funções importantes como guiar o nascimento do dente permanente e garantir o bom desenvolvimento da mastigação no início da alimentação sólida.
Hoje, o trabalho com crianças é muito voltado para a prevenção, garantindo que a criança venha ao consultório para manter a saúde dental, não apenas para tratar alguma urgência ou lesão”, explica o dentista Luiz Evaristo Ricci Volpato, atual tesoureiro do CFO (Conselho Federal de Odontologia) e professor de Odontologia da UNIC (Universidade de Cuiabá). O especialista afirma que a recomendação atual é que os pais ou responsáveis levem a criança ao dentista a partir do nascimento do primeiro dente. “A microbiota da boca muda com o nascimento desse dente e é preciso fazer a limpeza para evitar o surgimento de lesões, as famosas cáries”, afirma.
A importância dos dentes de leite
Em média, os primeiros dentes do bebê começam a sair por volta dos seis meses de idade. É o início da dentição “de leite”, que a criança vai começar a perder por volta dos seis anos para dar lugar aos dentes permanentes.
Por ser “provisória”, é comum se falar que essa dentição não precisa de tantos cuidados e que cáries não são um problema nessa fase. Mas isso não é verdade.
Para começar, os primeiros dentes do bebê têm uma estrutura semelhante a do dente permanente. Isso significa que, em caso de cárie profunda, o bebê vai sentir dor e pode precisar de um tratamento de canal.
A primeira dentição também é fundamental para o sucesso da introdução alimentar e para desenvolver a musculatura orofacial (por meio da mastigação) —o que vai influenciar diretamente no desenvolvimento da fala também.
Os dentes de leite ainda são importantes para “guiar” os dentes permanentes. Por isso, quando ele cai na hora errada —por um trauma como uma queda, por exemplo, ou até por extração após uma cárie mal cuidada— é importante acompanhar a criança para ver se haverá problemas no futuro.
“Em alguns casos, usamos até um dente mantenedor, uma espécie de prótese, que ajuda a manter o espaço correto na arcada para que o dente permanente desça no local correto”, afirma Amanda Oliveira, odontopediatra e consultora de amamentação, do Rio de Janeiro.
Cuidados básicos
É na primeira consulta que os pais ou responsáveis aprendem a escovar os dentes do bebê de forma correta. A atividade deve ser feita com uma escova de cerdas macias ou extra macias e cabeça compatível com o tamanho da boca da criança.
O uso de creme dental com flúor também está liberado. O ideal é procurar por produtos com a concentração convencional de flúor (1 mil partes por milhão de flúor), já que são as únicas que atuam prevenindo as cáries.
É preciso garantir que se use uma quantidade pequena, já que os bebês não sabem cuspir e vão engolir a água”, explica Clarissa Lucena Gomes de Souza, odontopediatra do Hospital Universitário Lauro Wanderley da UFPB (Universidade Federal da Paraíba), da Rede Ebserh.
O recomendado é usar o equivalente a um grão de arroz na escova para bebês, quantidade segura e que não provoca intoxicação. Quando a criança crescer e aprender a cuspir, pode-se aumentar a quantidade para o equivalente a um grão de ervilha.
Outro acessório fundamental é o fio dental, que deve ser usado a partir do momento que houver mais dentes e eles estiverem encostados uns nos outros.
Se tudo estiver normal, as visitas ao consultório podem ser feitas a cada seis meses. Isso, no entanto, pode variar, de acordo com a avaliação do profissional.
Cáries e alimentação
Uma das orientações mais importantes que os pais recebem nas primeiras consultas com o dentista é a influência da alimentação na formação das cáries.
“A sacarose é a principal causa de cáries em crianças”, explica Amanda Oliveira. Ela lembra que alimentos ultraprocessados —como alguns tipos de iogurte infantil, alguns pães e compostos lácteos— podem ter o açúcar “escondido”, em sua formulação, aumentando o risco desse tipo de lesão.
Por isso, o recomendado é que o consumo de açúcar seja evitado ao máximo (mesmo após os dois anos), para que a criança não crie o hábito de consumir alimentos com o ingrediente.
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