Dr. Zeynep Bașak YILMAZ RESUME
Born in Ordu/Turkey in 1979, Dr. Basak Zeynep Yilmaz has completed her primary and secondary studies in Ordu Anatolian high school. In 1998, she started her dentistry education in Hacettepe University Faculty of Dentistry and graduated in 2003. After 2 years of work in a private health organization, in 2005 she started her speciality training in Pediatric Dentistry section of Ankara University Faculty of Dentistry. In 2010, she completed the residency programme with high degree of success, by certification of her doctoral thesis. Subsequently, after working for 1 year as academician in Ankara University, she started to work for Perla Private Polyclynic of Oral and Dental Health. Being a member of Turkish Association of Pediatric Dentistry, Zeynep Bașak Yılmaz has a number of articles published in various international and national journals. Alongside; she has given verbal and posters presentations in various international and national congresses.
Articles Published in International Journals:
• Yılmaz, ZB., Okte Z. (2011). In vitro dentin bond-strength and microleakage of nano-ionomer restorative in comparison with compomer. Materials Research Innoviations., 15:314-318.
• Özer, L., Yılmaz, ZB., Küçükyavuz, Z. (2011). Effects of Deep Sedation on Behavioral Changes in Children Undergoing Treatment with or without Extraction. Pediatric Dent., 33: 546-552.
• Yılmaz ZB., Songür E., Tulga Öz F. (2010). Dental Treatment of a Xeroderma Pigmentosum Patient Under Deep Sedation: A Case Report. Eur J Gen Med. Date of ratification: 12. 2010.
• Yılmaz, ZB., Çetinbaș, T., Özer, L., Sönmez, H. (2009). Treatment of Aggressive External Root Resorption with Calcium Hydroxide Medicaments: A Case Report. Dent. Traumatol., 25: 527-31.
Articles Published in National Journals:
Yılmaz, ZB., Özer, L. (2009). Vital pulp therapy for complicated crown fracture: Case report.
ADO Journal of Clinical Sciences. 3: 380-384.
Presentations and posters presented at Scientific Meetings:
• Memiș B., Yılmaz Z.B., Özgül Ö., Özer L. "Treatment of a multiple complicated crown-root fracture: 2 years follow up: A case report." Balkan Association of Maxillofacial Surgery 2nd Congress, 5th ACBID International Conference, Antalya,Turkey,2011.
• Özer L., Özkan P., Yılmaz Z.B., Tulga Öz F. "Effects of media and toothbrushing on microhardness of restorative materials". International Association of Paediatric Dentistry 23rd congress, Athens, Greece, 2011.
• Yılmaz Z.B., Ökte Z. "Comparative evaluation of compomer and nano-ionomer material for primary teeth restoration under in vivo conditions". Turkish Association of Pediatric Dentistry 18th National Congress, Istanbul, Turkey, 2011.
• Kızılırmak A., Yılmaz Z.B., Şeberol E., Özalp N., Ökte Z. " Evaluation of the Effect of non-carious dentin and caries-affected dentin on microtensile bond-strength". Turkish Association of Pediatric Dentistry 18th National Congress, Istanbul, Turkey, 2011.
• Şeberol E., Yılmaz Z.B., Kızılırmak A., Özalp N., Ökte Z. " the effects of grape seed extract on dentin bond strengths". Turkish Association of Pediatric Dentistry 18th National Congress, Istanbul, Turkey, 2011.
• Zeren A.E., Yılmaz Z.B., Özalp N. " White-coat Phenomenon in Children". Turkish Association of Pediatric Dentistry 18th National Congress, Istanbul, Turkey, 2011.
• Gergin, B., Yılmaz Z.B., Batak, B., Özer, L., Ünsal, E., Akaltan, F. " Papillon-Lefevre syndrome: Case report". Turkish Society of Periodontology 40th Scientific Congress, Izmir, Turkey, 2010.
• Yılmaz Z.B., Gergin, B., Batak, B., Özer, L., Ünsal, E., Akaltan, F. " Papillon-Lefevre syndrome: Case report". Turkish Society of Periodontology 17th National Congress, Mardin, Turkey, 2010.
• Yılmaz, Z.B., Özer, L., Küçükyavuz, Z. "Evaluation of effectiveness and reliability of deep sedation procedure applied in children’s dental treatment ". Turkish Society of Periodontology 16th National Congress, Izmir, Turkey, 2009.
• Yılmaz, Z.B., Özer, L., Sönmez, H., Özçobanoğlu, G. " Vital pulp therapy in crown fractures: Case report". Aegean Region Chambers of Dentist International Scientific Congress and Exhibition, Fethiye, Turkey, 2009.
• Özer, L., Yılmaz, ZB., Küçükyavuz, Z. "The effects of extraction on recovery characteristics in deeply sedated pediatrıc patients". The 22nd Congress of the International Association of Paediatric Dentistry, Munich, Germany, 2009.
• Yılmaz, Z.B., Özer, L., Sönmez, H. "Treatment with calcium hydroxide containing gutta-percha, of the fast developing external root resorption after intrusion: Case report". Turkish Society of Periodontology 6th National Symposium, Isparta, Turkey, 2006.
At what age should your child visit a dentist for the first time?
Your child should be under control of a dentist at the first tooth eruption in order to avoid development problems in teeth, also in jaw and face. Meeting a dentist before the formation of dental caries brings many advantages. Besides of correct brushing and nutrition instructions given by your dentist; dental problems will be suppressed via short-term and simple preventive methods applied. In the meantime, your child will get used to visit a dentist and the dental phobia will be avoided before its creation.In addition, since the dental health problems that may occur will be detected at early stage; the treatment delays will be prevented.Even if generally, it is recommended for 6-month checkups; your dentist will determine the control frequency to follow, according to the situation of your child's dental health.
What is Pediatric Dentistry, who called paedodontist?
Pediatric Dentistry is a specialty of dentistry concerned with children's oral health. A paedodontist is a title given to a specialist dentist who – after a 5-year university education on dentistry – completes a residency programme during minimum 4 years on pedodontics. A pedodontist is concerned with solving and preventing the children's dental and oral problems over the period from infancy to adolescence. In addition; pedodontists provide dental treatment to handicapped patients if necessary; under deep sedation or general anaesthesia regardless their age.
Topics that Pedodontics is concerned with can be grouped under two main headings:
Treatment of children's oral and dental health problems
• Treatment of tooth caries in primary teeth and permanent teeth and crown plating in case of excessive loss of substance;
• Root canal therapy for primary teeth and permanent teeth,
• Dental extraction- exodontia
• Treatment of traumatically broken teeth due to falling or accidents.
• Tooth discoloration removal.
Preventive dentistry for children
In principal we can distinguish two sections in dentistry services, the preventive dentistry and the therapeutic applications. Preventive Dentistry is an ongoing process beginning 6 months after the first tooth eruption and during a lifetime. Preventive Dentistry applications require parents cooperation with dentist in order to protect the oral and dental health of whole family and the child.
When should you start brushing your child's teeth? What kind of brush and toothpaste should be used?
With the appearing of the first tooth in the mouth (approximately 6 months of age) children will be under dental caries risk.Therefore, parents should start to clean the teeth of the child as soon as the first tooth eruption.
Primary teeth are more susceptible to caries due to their low mineral ratios.
Therefore primary teeth will decay quickly and the caries progress faster.
Although in this period the baby’s nutrition is too often; twice-daily cleaning will be important to prevent caries.
Mother can clean the baby's first teeth with a clean gauze dressing.
During this period, mothers can also use and find in the market finger toothbrushes to clean the baby’s teeth. After 2.5-3 years of age teeth cleaning should continue by transition to the brush proper to the age of the child.
Of the bristles of the brush to be hard and brushing process should be careful not to be too harsh. Stiff bristles toothbrushes and scratch brushing should be avoided.
Before 3 years of age, the use of fluoride-containing toothpaste is not recommended due to the risk of baby swallowing.
But still in the market, it is possible to find fluoride-free toothpastes suitable for babies, nonfoaming and containing completely digestible enzymes. After 3 years of age, the child can begin using kids’ toothpaste that contains fluoride.
Paying attention only to the use of children up to 12 years toothpaste is important.It is important to pay attention to using only kids’ toothpaste until 12 years of age. As the mechanical cleaning of the teeth is important, greater use of the paste does not mean a better cleaning.It is important to pay attention to the amount of paste, it should be lentil-sized.Also, as the paste will be foamed with saliva; there is no need to wet the paste on the brush under water.
Is it enough that the child brushes his own teeth?
As the children's motor function is not fully developed until the age of 9 years; an effective self-brushing should not be expected. Before 9 years of age; the children are not able to wash themselves as well as to brush their teeth.
But, certainly it should be allowed to the child to brush his teeth alone in order to ensure the child's brushing habits however after parents should definitely make the real effective brushing.The entry of the toothbrush in the mouth won’t be enough for an effective brushing.You can be informed about the correct brushing technique to apply for you and for your child.
Individuals are gaining habits at an early age. Primarily to get your child adopt the tooth brushing habits you should set them an example by brushing your own teeth.
How many times a day should you brush your child’s teeth?
Although, children’s meals are more frequent compared to adults, twice daily effective tooth brushing - at bedtime and in the morning will be sufficient to prevent the formation of caries. Especially at night, teeth become more sensitive due to the salivary flow decrease thereof, it is recommended to brush teeth before going to bed at night.
Preventive treatment applied to obviate the problems
• Oral hygiene education,
• Parent information and education,
• Information about healthy nutrition,
• Flouride applications,
• Fissure sealants applications,
• Protective and inhibitor orthodontic treatments,
• Application of occlusal splints used for prevention of nocturnal bruxism,
• Application of mouth guards used during sport competitions.
Why Are Primary Teeth Important?
Baby’s primary teeth begin to erupt about 6-8 months of age, completed between 2-2,5 years of age and stay in mouth till 10-12 years of age. There is a total of 20 primary teeth, 10 in the lower and 10 in the upper jaw. This period is the most active stage of the child's growth and development therefore the primary teeth play a major role in child's healthy nutrition.Primary teeth are necessary for chewing,nutrition and accordingly for growth and development.
Furthermore, for the children’s maxillofacial development and ability to speak correctly; the primary teeth should be healthy.At the same time, besides of these functions, primary teeth are doing eruption guidance for the permenant teeth. Therefore, after the first teeth eruption, there are some points that the parents should pay attention in order to protect the tooth health of the children.
Is it important the timely tooth eruption? Do babies born with teeth?
Although, 6-8 months of age is considered normal eruption timing for the primary teeth; this can vary from child to child depending on genetic factors. Even so 1-2 months early or late tooth eruption do not causes problems; the changes seen in longer term may lead to various problems. The biggest problem due to early tooth eruption or natal teeth is the feeding difficulty.Due to the irritation by the baby’s natal teeth, mother can experience breastfeeding problems.Beyond, natal teeth are often needless and rootless and also they shake. This can cause a dislocation of the tooth during the breastfeeding which will occur the risk of swallowing the tooth by the baby.At the other hand, delay of the tooth eruption causes feeding problems in transition period to solid food.The underlying reason of a longterm delayed tooth eruption can be systemic or genetic disease. Consequently, it is recommended to consult a paedodontist in order to permit an early diagnosis and treatment of potential problems.
What should be done for anxiousness due to primary teeth eruption?
With the primary teeth eruption, it can be observed increase in salivary flow, gums redness, loss of appetite and insomnia due to the disturbance of the baby.In order to overcome easily this period, the parents can use teethers or they can apply a massage with a cold and clean gauze dressing.The use of the teethers and the massage will improve blood circulation in this area which will ensure the acceleration of the teeth eruption and will relieve the itch and the discomfort of the baby. The important point to remember about the use of the teether is that this one should be cold but absolutely not frozen. Again, in this period, it can be observed rarely fevers/high temperatures in children. Usually this period can pass with fever reducers but it is recommended to visit a physician in order to examine and understand deeply the reason of the fever. Also, the various anesthetic creams suggested by your physician could be used to provide a comfortable feeding to your child.But surely all this medicines must be used in a conscious way and on the advice of a physician.
What to pay attention to prevent the dental phobia ?
Children's brains are like sponges, taking and recording all kinds of information.
Therefore, a negative memory about your dentist’s experiences that you tell in front of your child will be recorded by the child’s brain and will create the phobia.
Also, frighten the child by a tooth extension or by having an injection or visiting a dentist; can cause the emergence of deep fears. For this reason, do not tell your child your own negative experiences and never scare him in this way.
When you decide to take your child to the dentist, you should tell him this information for 1-2 days in advance.
To say 1 or more week before is not recommended as this means more time to increase the concerns of your child.It would be ideal to give general and simple answers to the question about what will be done to him at the dentist visit. Concerning the treatment, the general answers like: “I do not know, when we’ll be there, the dentist will tell us what should be done” will help to prevent the fear by imagining the wrong things.
Like all people, children are afraid of the unknown and taking pain.Therefore, if your child is informed by a paedodontist who received special trainings in children's psychological approach, the results will be more reliable.
It is very important to start the treatments after wining the heart and the mind of the child without creating anxiety and fear. Therefore, a child's first encounter with the physician is very important.In the first encounter; the aim is to endear the environment and the physician to the child.Physician will prevent fears by introducing himself also the equipment and tools to be used.Then, the physician will tell to the child in a game way and by using a pedagogic language the reason and the procedures of the dental treatment.
Then, it will be started from the tooth that requires a simple treatment.The aim is to accustom the child in time to these treatments by starting from the easier treatments and going towards those harder. As the child will realize that he have great fun while the dental treatment; dental phobia will completely disappeared.
What is a dental sedation? It is applied to whom and under which conditions?
In some of the children, despite of every kind of professional approach; dental fear cannot be removed. In these cases, to intervene by force to the caries; causes the growth of the dental phobia. Furthermore, this kind of treatment’s result won’t be at the desired quality.Alongside, canceling the treatment will cause serious damage’s risk for oral and dental health of the child.
It is possible to apply a anesthetisia sedation procedure in this kind of children who cannot overcome the dental fear or in handicapped children and even in adult patients who have systemic disorders as high blood pressure problem or who cannot overcome their dental fear.
Sedation procedure allows the treatment when the patient will be asleep or calm down by the help of various drugs given to the patient via vascular access.But certainly, this procedure should be applied by a dentist, together with an anesthesiologist and an experienced team.
In a similar manner, the availability of all the necessary equipment is very important to this procedure.
Orthodontics for children
This is a speciality in the field of dentistry which is concerned with the diagnosis, treatment and prevention of orthopedic and orthodontic problems that occur in teeth and in the skeletal structure of head and neck area.In addition to the aesthetic problems, this kind of disorders strated at an early age; affects the lives of individuals in a very negative way due to the anomalies of masticatory functions.
Orthodontic treatment, although it is known as the correction of misaligned teeth; orthodontic specialists have an important role for the treatment of many diseases as skeletal irregularities and anomalies, cleft palate in infants, sleep apnea in adults (OSA).
According to the condition of the patient; it is possible to use some fixed or mobile instruments in the dental and orthodontic treatments of skeletal structure disorders.
Thanks to advancing technology; the brackets used today are lighter and contain less metal.In order to motivate children, colorful brackets and tires are avaible as well as the transparent one for the adults.
Conditions Requiring Orthodontic Treatment in Children
As the disorders in the child's mouth and teeth structure could threaten the child in terms of health; eventually it will disturb in the way of appearance over time.
Therefore, situations that require treatment can be listed as follows;
• Located ahead perplexed teeth,
• Early and late loss of primary teeth,
• Unbalanced mouth and jaw structure,
• Difficulty in closing the mouth in terms of chewing and speech functions,
• Jaw structure far left behind or too ahead,
• In case of incorrect contact with each other of the upper and lower teeth, an orthodontic treatment will be applied. ”
The Right Time Treatment
Dișler, kemik ve diș etleri sağlıklı ise hemen her yașta tedaviye olumlu yanıt alınabilir. Ancak ilk ortodonti kontrolünün yedi yașından geç olmamasında yarar var.
Bu yașta dișler düzgün sıralanmıș görünse de gizli bir kapanıș problemi söz konusu olabilir. Eğer problem saptanırsa, diș hekimi tedaviye bașlamak için en uygun zaman konusunda sizi yönlendirir. Bu yașlarda uygulanacak ortodontik tedaviler önleyici ve koruyucu ortodontik tedavi olarak adlandırılıyor. Çocuk 7 yașını geçse bile, ortodontik muayenesinin yapılması çok önemli. Çoğu çocukta ortodontik tedaviye 9-12 yașları arasında bașlanıyor. Bu tedavi yönteminde erken teșhis, diș kaybını ve çene yapısındaki bozukluklarını önlemek adına gerekli.
Orthodontic Treatment Types
According to the results obtained from the first orthodontic consultation performed at 6-7 years of age:
1- Early falling primary teeth (teeth of infancy) places should be protected by fixed or mobile placeholders until the eruption of the permenant teeth. Thus, the uneruption (buried) or disordered eruption toward the lip or cheek of the permenant tooth will be prevented.
2- Skeletal problems are detected at this age and families will be informed about the treatment.(E.g: Advanced lower jaw).
3- If the upper jaw backwardness is detected; by using at least six months a simple device as a face mask, the backwardness of the jaw will be improved substantially.
4- Jaw tightness is corrected easily by means of fixed or movable screwed expansion equipments. In order to adapt the child more easily; these equipments could be made in various colors.
For instance, for boys; it can be in his favorite team colors or for girls; in pink, purple, and silvery or with Barbie doll illustrations.
5- In case of opposite side closing teeth; the problem can be resolved by means of mobile devices. In other words; if the lower are standing slightly protruding; this can be corrected with a simple treatment of a few months.
6- The treatment of front open closing teeth disorder due to long-term use of nursing bottles, pacifiers and the finger sucking habit will be applied via habit breaker instruments.
According to the results obtained from the orthodontic consultation performed at 10-11 years of age;
1- The treatment of skeletal problems should be initiated at this age. Your doctor may suggest waiting a little longer for the boys. By using extraoral devices such as headgear and functional devices such as bionater the growth of the jaws are guided.
If the disorder is not detected and treated in younger age; the face mask will be effective in this age also for correcting upper jaw backwardness.
2- Fixed orthodontic treatment is started at this age. Teeth are corrected by the help of glued brackets and dental braces.
What happens if orthodontic treatment is not applied?
If orthodontic problems are not treated during childhood; in advanced ages it can be observed several problems such as aesthetic disorders and associated psychological problems, tooth bleeding, gum disease, speech difficulties, bad breath, tooth loss and cleaning challenges.
Time of Eruption of Permanent Teeth? "What should be noted for this period?"
Permanent teeth begin to erupt at 6 years of age.
A total of 32 units’ eruption will be completed by the eruption of third molars.
The first permenant teeth are erupted at 6 years of age, but as they appear on the back of the mouth the parents do not often realize the eruption or they can not distinguish the difference between the primary teeth.
Depending on the brushing quality of the area; these teeth may be under serious risk of decay. Therefore, a preventive dental procedure called fissure sealant is recommended.
What are fissure sealants (tooth polisher)?
Fissure sealants are a type of fluid filler covering the chewing surface of the teeth which are still in eruption.This material applied to teeth without causing any damage prevents the decays and the food residues’ accumulation in this area by covering the chewing surfaces of teeth.
In particular, the new permanent teeth are more susceptible to decay due to uncompleted mineralization. For this reason it is necessary to apply the fissure sealants especially to these teeth.
What are the common bad habits of children?
Bad habits frequently encountered in children such as pencil biting, thumb sucking, lip and nail biting cause dental damages and deterioration of dental structures. The prevention of these habits has a great importance to avoid the damages.Your dentist can make various instruments to help outgrowing bad habits.
What is fluorine, How can I be sure that my child gets the adequate amount?
Fluorine is an element found in air, water and rocks.It has an effect over-protective by increasing the resistance to tooth decay and therefore a small amount of fluorine is added in toothpastes.In order to obtain a strong preventive effect, professional practices containing a higher amount of fluorine are applied by your dentist in clinics as fluoride polish or fluoride gel with 3-6-12 month intervals.
However, your dentist will decide the frequency and type of these practices by a special program developed for your child.
Oral and dental trauma in children
1. What should you do if your child's front tooth is broken?
In case of broken front teeth, if there is not any serious problem with the child's overall health; you should contact urgently your dentist.If you can find the piece of broken tooth, bring it in a clean napkin to the dentist, if ever your dentist finds suitable, he could paste back the piece.
2. What should you do if the front tooth is dislodged?
Keep the tooth from the head, be careful to do not touch the tooth root and clean it under running water.However, in order to protect the living tissues of the root; do not do any action such as scrubbing, soaping or brushing.
If you can, try to place the tooth back.If you can’t; put the tooth into plain milk and please contact your dentist immediately.
As the time factor is very important for reposition of the displaced tooth; to consult the dentist as soon as possible improves the success of results.
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