BDS 7128: Introduction to Pediatric Dentistry PDF

BDS 7128: Introduction to Pediatric Dentistry Aim: The aim of this lecture is to give an overview of the specialty of Pediatric Dentistry and how managing children in the dental chair differs from adult patients Subject Title Goes Here Objectives: • Understand what is Pediatric Dentistry • • • •...

BDS 7128: Introduction to Pediatric Dentistry Aim: The aim of this lecture is to give an overview of the specialty of Pediatric Dentistry and how managing children in the dental chair differs from adult patients Subject Title Goes Here Objectives: • Understand what is Pediatric Dentistry • • • • Understand how pediatric patients differ from adults Describe the type of treatments provided by pediatric dentists Have an awareness of the factors influencing management Recognize the importance of primary teeth and how it affects the patient, parent, dentist and community • Check the main reading resources throughout the course Pediatric Dentistry: Definition Pediatric dentistry is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs (AAPD, 2018). NEWGIZA UNIVERSITY Pediatric Dentistry: Definition Pediatric dentistry is defined as “the practice, and teaching of and research in comprehensive preventative and therapeutic oral health care of children from birth through adolescence”. The central element in this definition—and that distinguish it from other clinical fields in dentistry—is children, further qualified as individuals from birth through adolescence. European Academy of Paediatric Dentistry. Definition of paediatric dentistry. Available at: http://www.eapd.gr/50B3B17F.en.aspx. Accessed 2015, March 3. NEWGIZA UNIVERSITY Pediatric Dentistry: Overview A branch of dental science, which deals with the guidance of the primary and young permanent dentition in growth and development as well as the prevention and treatment of pathologic oral conditions, which may occur during childhood. NEWGIZA UNIVERSITY Pediatric Dentistry: Scope Primary focus of most dental specialties is often a particular area of dental, oral, or maxillofacial expertise. Pediatric dentistry encompasses a variety of disciplines, techniques, procedures, and skills sharing a common basis with other specialties but are modified and adapted to the unique requirements of infants, children, adolescents, and those with special health care needs. NEWGIZA UNIVERSITY Pediatric Dentistry: Scope Age specific not technique specific Fulfills the needs of special children Its ultimate goal is mainly prevention NEWGIZA UNIVERSITY Milestones of Pediatric Dentistry 1924 • first pediatric dentistry textbook 1926 • only 5 out of 43 dental schools in the US provides treatment for pediatric patients 1942 • knowing that fluoride helps in caries prevention 1945 • first fluoridation of water supply in Michigan 1947 • AAPD founded NEWGIZA UNIVERSITY Pediatric patients differ from adults: • Until the eighteenth century, children were considered to be small adults • Professionals should recognize that children are NOT “small adults” and that special competency (child competency) is needed, when meeting children • Pediatric patients are growing and developing individuals who are dependent on an adult caregiver NEWGIZA UNIVERSITY Children are different from adults in a number of ways: • Children are individuals in growth and development • • • • • Anatomical/physical Psychological Social Emotional Cognitive • Attitude and Behaviour relating to oral health, is formed during childhood and adolescence • Children’s situation is different from the situation of adults: • they are in the care of and dependent on adults • they are not able to foresee consequences of their own decisions and behaviour • Also read: https://www.rch.org.au/studentorientation/Differences_between_children_and_adults/ NEWGIZA UNIVERSITY Children are different from adults in a number of ways: Anatomical/Physical: • Larger BSA: The smaller the patient, the greater the ratio of surface area (skin) to size • Thinner skin: Their epidermis is thinner and under-keratinized • Rapidly dividing cells (rapid rate of growth) As a result, children are more susceptible to the effects of radiation than adults. • Higher HR and RR: Children may be more susceptible to agents absorbed through the pulmonary route than adults with the same exposure. • Immature blood brain barrier and enhanced central nervous system (CNS) receptivity: Requiring levels of treatment for children that are not indicated for adults • Higher metabolic rate: More susceptible to contaminants in food or water; greater risk for increased loss of water and when ill or stressed • Immature immune systems: Greater risk of infection NEWGIZA UNIVERSITY Children are different from adults in a number of ways: Motor development: • Motor development is completed in infancy; the changes which follow the walking milestone are refinements rather than the development of new skills. • Children aged 6–7 years usually have sufficient coordination to brush their teeth reasonably well. Below that age many areas of the mouth will be missed and there is a tendency to swallow relatively large amounts of toothpaste; therefore preventive guidelines recommend parental involvement in brushing prior to age 7 years and supervision of brushing thereafter. NEWGIZA UNIVERSITY Children are different from adults in a number of ways: • Social: Unlike adults, children and adolescents are still in a period of social development which involves learning the values, knowledge and skills that enable them to relate to others (Adults values/behaviour/social circles are generally far more defined and stable) Social skills are acquired from the surroundings of the child Both Positive and negative influences shape social behaviours NEWGIZA UNIVERSITY Children are different from adults in a number of ways: • Emotional: Infants and young children, emotional bond of affection or 'attachment' to their caregivers, is crucial to their emotional development. Children and adolescents are still developing their ability to recognize and manage their emotions or feelings NEWGIZA UNIVERSITY Children are different from adults in a number of ways: Cognitive & language development: • The cognitive capability of children changes radically from birth through to adulthood • The dentist must be mindful of how he/she communicates with a patient, taking into account level of cognitive development& linguistic abilities of the child patient The Swiss psychologist Piaget formulated the stages view of cognitive development Type of services provided by pediatric dentists: • Pediatric dentistry encompasses all aspects of oral health care for children and adolescents. • It is based on basic knowledge from various odontological, medical, and behavioral sciences that are applied to the unique situation of the developing child and young person. • Prevention is still the cornerstone of pediatric dentistry. Starting prevention in early childhood makes it possible to maintain sound erupting teeth and keep oral structures healthy. • Pediatric dentistry also implies early diagnosis and treatment of the multitude of oral diseases and conditions found in the child’s and the adolescent’s oral cavity, including caries, periodontal diseases, mineralization disturbances, dental erosion, disturbances in tooth development and tooth eruption, and traumatic injuries in otherwise healthy individuals as well as oral health care of special health care needs children. • The realm of pediatric dentistry is constantly expanding, and now includes such areas as early identification of children suspected to suffer from syndromes, and of children suspected to suffer from child maltreatment. Ethical considerations superimpose all these areas. NEWGIZA UNIVERSITY Type of services provided by pediatric dentists: • Successful diagnosis and treatment of the child in the primary, mixed and permanent dentitions • Caries prevention • Supervision of orofacial growth and development • Caring for the medically and developmentally compromised and disabled patients • Proper management through behavior guidance as well as sedation and pharmacological approaches when needed NEWGIZA UNIVERSITY A Pediatric dentist should have: • A specific insight into the dental and oral health for the child and adolescent • An ability to communicate effectively with children, adolescents, and their parents • A positive professional attitude towards children, adolescents, and their parents NEWGIZA UNIVERSITY Factors that may affect management of a child: • Everyone can adopt approaches that put children and parents at ease. • All dental training should include a thorough understanding of how children relate to the adult world, and learn strategies that would help the children cope with their apprehension about dental procedures. NEWGIZA UNIVERSITY Factors that may affect management of a child: • Age -Cognitive development -Emotional development • Parent-child relation • Peer effect (school) • Challenges and special health care needs • Nature of procedure needed to be done N.B: Each patient is a unique individual NEWGIZA UNIVERSITY Other co-factors that influence a child’s behavior in a dental office : • Office decoration • Personnel attitude (Kindness, warmness, smiling, etc..).​ • Knowledge about the patient (e.g. friends, hobbies, nicknames) • Length of the appointment • Rewards at the end of the visit • Dentist’s skills NEWGIZA UNIVERSITY Importance of primary teeth: • Masticatory function: Teeth help in the digestion process (chewing) The mouth is a gateway to the rest of the body • Maintenance of space: Premature loss or extraction of primary teeth may lead to space loss and the possibility of complicating the eruption of permanent teeth NEWGIZA UNIVERSITY Importance of primary teeth • Development of speech: Teeth helps in speech development and some letters depend on presence of teeth for proper pronunciation (e.g. F, V, S, Z and TH) • Psychologically: Absence or decay of the front teeth may affect the appearance of the child, feeling different may affect the child, negatively affecting self esteem and social interaction NEWGIZA UNIVERSITY Aims and benefits of Pediatric Dentistry For the child For the parent For the dentist For the community NEWGIZA UNIVERSITY Aims and Benefits: For the child: 1)Healthy teeth equals a better mastication and digestion process, leading to better health and growth Any imbalance resulting from caries, pain, lesion or extraction of teeth may affect such process leading to bad habits, troubled stomach and malnutrition Haumschild and Haumschild (2009), highlighted the importance of oral health on the whole body A study done on 417 students aged (6-8 ys) showed that there was an inverse linear relationship between caries status and children’s Height for Age, Weight for age, and BMI for age (Alkarimi et al., 2014). NEWGIZA UNIVERSITY Aims and Benefits: Cont’d 2) Preventing caries in primary teeth leads to less dental problems in adulthood 3) Proper approach to manage children allows for less psychological trauma that may stick to the patient as he grows up NEWGIZA UNIVERSITY Aims and Benefits: Cont’d • For the Parent: Studies have showed the cost effectiveness of visiting the pediatric dentist and prevention of caries and other dental anomalies. Skipping work to accompany children in their dental visits may affect the social and economic status of the parents NEWGIZA UNIVERSITY Aims and Benefits: Cont’d • For the Dentist: Learning new techniques and approaches that are beneficial for the pediatric patient • For the Community: Healthy teeth affect the well-being of the child that will have long term effects towards his education, physique A Survey carried out by Jackson et al., 2011 including 2183 students showed that children with poor oral health status were nearly 3 times more likely than were their counterparts to miss school as a result of dental pain NEWGIZA UNIVERSITY Course Overview • Course aims • Main resources NEWGIZA UNIVERSITY Course aims • Provide students with knowledge about basic principles and how to use this content for successful diagnosis and treatment of the child in the primary, mixed and permanent dentitions • Provides students with experience in proper management, behavior modification and the ability to establish a positive attitude towards dental treatment in young patients • Recognize the difference between primary and permanent teeth regarding management and treatment This will be provided through Lectures, Small groups, self-directed learning and practical sessions NEWGIZA UNIVERSITY Main resources • American Association for Pediatric Dentistry • Dean, J.A., Avery, D.R. and McDonald, R.E., 2010. McDonald and Avery Dentistry for the Child and Adolescent 10th edition, 2010. Elsevier Health Sciences. • European Academy of Paediatric Dentistry • Koch, G., Poulsen, S., Espelid, I. and Haubek, D.. Pediatric dentistry: a clinical approach. 3rd edition, 2017. Wiley Blackwell • Welbury, R., Duggal, M and Hosey, M. Paediatric Dentistry; 5th edition, References: • Alkarimi, H.A., Watt, R.G., Pikhart, H., Sheiham, A. and Tsakos, G., 2014. Dental caries and growth in school-age children. Pediatrics, pp.peds-2013 • American association of Pediatric Dentistry Overview (2018). Accessed online. available through: http://www.aapd.org/media/Policies_Guidelines/I_Overview.pdf • Dean, J.A., Avery, D.R. and McDonald, R.E., 2010. McDonald and Avery Dentistry for the Child and Adolescent 10th edition, 2010. Elsevier Health Sciences. • Dye, B.A., Tan, S., Smith, V., Lewis, B.G., Barker, L.K., Thornton-Evans, G., Eke, P.I., Beltrán-Aguilar, E.D., Horowitz, A.M. and Li, C.H., 2007. Trends in oral health status: United States, 1988-1994 and 1999-2004. Vital and health statistics. Series 11, Data from the national health survey, (248), pp.1-92 • Haumschild, M.S. and Haumschild, R.J., 2009. The importance of oral health in long-term care. Journal of the American Medical Directors Association, 10(9), pp.667-671. • Lee, J.Y., Bouwens, T.J., Savage, M.F. and Vann Jr, W.F., 2006. Examining the cost-effectiveness of early dental visits. Pediatric dentistry, 28(2), pp.102-105 • Jackson, S.L., Vann Jr, W.F., Kotch, J.B., Pahel, B.T. and Lee, J.Y., 2011. Impact of poor oral health on children's school attendance and performance. American journal of public health, 101(10), pp.1900-1906 • Reading material: Students are advised to review any relevant teaching provided in the first year. In addition they are advised to read relevant sections of the following texts: Koch G et al; Pediatric Dentistry - a Clinical Approach; 3rd Edition, Wiley Blackwell • Welbury R et al; Paediatric Dentistry; 5th Edition, Oxford Press • Prevention and Management of Dental Caries in Children, Scottish Dental • Clinical Effectiveness Programme http://www.sdcep.org.uk/published-guidance/caries-in-children/ Aim: The aim of this lecture is to give an overview of the specialty of Pediatric Dentistry and how managing children in the dental chair differs from adult patients Subject Title Goes Here Objectives: • Understand what is Pediatric Dentistry • • • • Understand how pediatric patients differ from adults Describe the type of treatments provided by pediatric dentists Have an awareness of the factors influencing management Recognize the importance of primary teeth and how it affects the patient, parent, dentist and community • Check the main reading resources throughout the course Subject Title Goes Here