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Copyright 2003, Elsevier Science (USA). All rights reserved.

Pediatr ic Dentistry

Chapter 57

Copyright 2003, Elsevier Science (USA).

All rights reserved. No part of this product may be reproduced or transmitted in anyform or by any means, electronic or mechanical, including input into or storage in any

information system, without permission in writing from the publisher.

PowerPoint presentation slides may be displayed and may be reproduced in print

form for instructional purposes only, provided a proper copyright notice appears on

the last page of each print-out.

Produced in the United States of America

ISBN 0-7216-9770-4


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Introduction

Pediatric dentistry is the specialized area ofdentistry that is limited to the care of childrenfrom birth through adolescence, with particularfocus on providing oral health care to patients

with special needs.


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The office should display cheerfulness, apleasant environment with a nonthreateningdecor.

Treatment areas are designed with an openbay concept.

Dental personnel dress in bright coordinatingcolors.

The Pediatr ic Dental Off ice


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Chronologic age The child's actual age in terms of years and

months.

Mental age The child's level of intellectual capacity and

development.

Emotional age

The child's level of emotional maturity.

The Pediatr ic Patient


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Ages 3 to 5 years This child needs to be allowed to develop

autonomyand initiative.

This child requires control and structure inhis or her environment.

Able to follow simple instructions.

Welcomes an active role in the treatmentexperience.

Stages of Childhood contd


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Ages 6 to 11 years Period of socialization.

Learning to get along with people.

Learning the rules and regulations ofsociety

Learned to overcome fears of objects andsituations.

Stages of Childhood contd


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The Dif f icul t Patient

Premedication Prescribed to calm and ease the patient

prior to treatment.

Nitrous oxide oxygen

Method of mild sedation that can help calma patient for treatment.

Physical restraint

Used to prevent a possible injury to thechild, dentist and or assistant.



Mental retardation Mild mental retardation describes individuals

with IQs ranging from 50-55 to 70.

Moderate mental retardation describesindividuals with IQs ranging from 35-40 to50-55.

Severe mental retardation describesindividuals with IQs ranging from 20-25 to35-40.

Profound mental retardation describesindividuals with IQs ranging from below 20to 25.

Special Patients



Down syndromeAlso named trisomy 21. These individuals

have a chromosomal aberration thatusually results in certain abnormal physical

characteristics and mental impairment. Themental impairment may range from mild tomoderate retardation.

Special Patients contd



Cerebral palsy is a nonprogressive neuraldisorder caused by brain damage that occurredprenatal, during birth, or postnatal before thecentral nervous system reached maturity.

Characterized by paralysis, muscle weakness,lack of coordination, and other disorders ofmotor function.

Special Patients contd



Medical and dental history

Past hospitalizations and surgeries.

Date of child's last visit to the physician.

Medications, daily medications.

Unfavorable reaction to any medicine, allergies.

Weight at birth and any problems at birth.

Level of learning.

Main concern about the child's dental health.

Finger, thumb, or pacifier habits.

Fluoride and toothbrush habits.

Inherited family dental characteristics.

Diagnosis and Treatment Planning


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Clinical examination Radiographic examination

Extraoral examination

Intraoral soft tissue examination Clinical examination

Diagnosis and Treatment Planningcontd


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Sealants Applied to the teeth to help keep them

cavity-free.

Oral/Facial development

To identify malocclusion, crowded orcrooked teeth, bite problems, andactively intervene.

Sports safety

Protective face equipment worn duringany recreational sport that might injurethe mouth area.

Preventive Dentistry contd


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RestorativeAmalgam

Composite

Endodontic procedures Pulp capping

Pulpotomy

Prosthodontic procedures Stainless steel crowns

Operative Procedures


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Causes of dental injuries to childrenAutomobile accidents

Bicycle accidents

Sports injuries Child abuse

Traumatic I njur ies


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Fig. 57-16 Educating school personnel about traumatic injur ies.


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Types of I njur ies

Fractured anterior teeth Documentation of the accident includes:

Clinical examination

RadiographsVitality testing


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Traumatic intrusion The tooth is forcibly driven into the

alveolus so that only a portion of the crownis visible.

Types of I njur ies contd


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Extrusion and lateral luxation Teeth are actually displaced from their

position, causing damage to theperiodontal ligaments.

Displaced teeth repositioned.

Temporary splint placed.



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Avulsed teeth The process of a tooth being torn away, or

dislodged completely by force.

Recover the tooth immediately. Wrap the tooth in a moistened gauze.

Go immediately to the dentist's office.



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Child abuse must be suspected when:

Injuries are in various stages of healing.

Chipped or injured teeth.

Scars inside the lips or on the tongue and tears of

the labial frena. Battering or other injuries around the head andneck.

Facial bruises, swelling of the facial structures, or

black eyes. Bite marks.

Injuries not consistent with the explanationpresented by the parent.

Child Abuse


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C i ht 2003 El i S i (USA) All i ht d

Required information The name, address, gender, age, height, and weightof the child.

The name and address of the adult with custody ofthe child.

A description of the current physical and emotionalabuse or neglect of the child.

Evidence of previous injuries or negligence.

Any information that may assist in establishing the

cause of the injuries. Sketches or photographs documenting the nature

and location of the injuries.

Reporting Child Abuse

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