Basics in managing children in pediatric dentistry

The child is not a little man !

Most dentists agree that the preschool child clearly requires the most energy and talent for effective management!

Preappointment experience
Entails bringing the child to the dental office for a tour and orientation With nothing being done The child meets the receptionist, dental assistant, and dentist

 Certain dental equipment can be shown and explained In childish language

The First dental visit

Should be kept as pleasant and simple as possible An examination and fluoride treatment

Parents attendance in the

Dental Operatory

Should parents stay with the child during the procedure or remain in the waiting room?

Less than 8% of dentist want parents in attendance during the treatment The parent is seen as a contributor to management or behavior problems

However
66% parents wished to be present They can act as an advocate for their child and verify his or her safety

There are several options:

depending on the dentists office policy

Routinely exclude parents If the parent wishes, allow him to enter With the exception of parents of very young child patient with developmental disabilities

Four age groups

Conception to age three The primary dentition years: 3 to 6 years The transitional years: 6 to 12 years adolescence

Conception to age three

The child from conception to age 3 historically has not been involved in professional dental provision In fact ,until recently dentistry has never actively encouraged children of this age to be involved in professional care

Age 3 has for many years been the customary entry age of children to the dental experience It is deeply believed that prevention programs must be started well before age 3 to ensure success Therefore, focus on the needs of an age group the has been virtually overlooked previously

The primary dentition years: 3 to 6 years

Deal with children with a complete primary dentition To understand the morphology and anatomy of the primary dentition How to preserve dental arch integrity How to intercept malocclusions in the primary dentition Restoration Pulp therapy

The transitional years: 6 to 12 years

The majority of children shed all of their primary teeth and gain all of their permanent teeth except the third molars Treatment needs of young permanent teeth Orthodontic considerations Esthetic considerations Prevention needs of the preschool child Children responsibility for their own oral hygiene

Adolescence
Prevention Treatment Dental and facial esthetics Periodontal disease

Early child caries (ECC)

Bottle caries

Bottle caries in an old Child showing arrested Caries

Rampant caries

Remarkable advances in dental restorative materials in the 1980s and 1990s are irrevocably changing pediatric Restorative dentistry

Restorative techniques

Pulpal therapy

Not conservative

Crown

Space maintenance

Interceptive orthodontics

Pits and fissure sealant

Child abuse and neglect affect millions of children in the United States each year. Health care and dental professionals are in unique positions to identify the possibly abused child and must be knowledgeable in the recognition, documentation, treatment, and reporting of suspected child abuse cases. To appropriately intervene, professionals must be willing to consider abuse or neglect as a possibilityif it is not considered, it cannot be diagnosed.

PHYSICAL ABUSE

SEXUAL ABUSE

NEGLECT

EMOTIONAL ABUSE

NOTICE Dentistry is an ever-changing field. Standard safety precautions must be followed, but as new research and clinical experience broaden our knowledge, changes in treatment and drug therapy may become necessary or appropriate. Readers are advised to check the most current product information provided by the manufacturer of each drug to be administered to verify the recommended dose, the method and duration of administration, and contraindications. It is the responsibility of the licensed prescriber, relying on experience and knowledge of the patient, to determine dosages and the best treatment for each individual patient. Neither the publisher nor the authors assume any liability for any injury and/or damage to persons or property arising from this publication.