pediatric dentistry

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  • 1. Pediatric Dentistry Chapter 57 Copyright 2003, Elsevier Science (USA). All rights reserved.No part of this product may be reproduced or transmitted in any form 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

2. Introduction

  • Pediatric dentistryis the specialized area of dentistry that is limited to the care of children from birth through adolescence, with particular focus on providing oral health care to patients with special needs.


  • The office should display cheerfulness, a pleasant environment with a nonthreatening decor.
  • Treatment areas are designed with anopen bay concept .
  • Dental personnel dress in bright coordinating colors.

The Pediatric Dental Office 4.

  • 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 Pediatric Patient 5.

  • Birth to age 2
    • Children learn to sit, stand, walk, and run.
    • Vocally, they progress from babbling to using simple sentences.
    • Can identify familiar faces and progress through periods of being friendly and then fearful of strangers.
    • Too young to be expected to cooperate in dental treatment.

Stages of Childhood 6.

  • Ages 3 to 5 years
    • This child needs to be allowed to developautonomyandinitiative .
    • This child requires control and structure in his or her environment.
    • Able to follow simple instructions.
    • Welcomes an active role in the treatment experience.

Stages of Childhood contd 7.

  • Ages 6 to 11 years
    • Period of socialization.
    • Learning to get along with people.
    • Learning the rules and regulations of society
    • Learned to overcome fears of objects and situations.

Stages of Childhood contd 8.

  • Be honest with a child .
  • Consider the child's point of view.
  • Use tell, show, do.
  • Give positive reinforcement.

Behavior Management 9. The Difficult Patient

  • Premedication
    • Prescribed to calm and ease the patient prior to treatment.
  • Nitrous oxide oxygen
    • Method of mild sedation that can help calm a patient for treatment.
  • Physical restraint
    • Used to prevent a possible injury to the child, dentist and or assistant.


  • Mental retardation
      • Mildmental retardation describes individuals with IQs ranging from 5055 to 70.
      • Moderatemental retardation describes individuals with IQs ranging from 3540 to 5055.
      • Severemental retardation describes individuals with IQs ranging from 2025 to 3540.
      • Profoundmental retardation describes individuals with IQs ranging from below 20 to 25.

Special Patients 11.

  • Down syndrome
    • Also namedtrisomy 21 . These individuals have a chromosomal aberration that usually results in certain abnormal physical characteristics and mental impairment. The mental impairment may range from mild to moderate retardation.

Special Patients contd 12.

  • Cerebral palsyis a nonprogressive neural disorder caused by brain damage that occurred prenatal, during birth, or postnatal before the central nervous system reached maturity. Characterized by paralysis, muscle weakness, lack of coordination, and other disorders of motor function.

Special Patients contd 13.

  • 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 14.

  • Clinical examination
    • Radiographic examination
    • Extraoral examination
    • Intraoral soft tissue examination
    • Clinical examination

Diagnosis and Treatment Planning contd 15.

  • Oral hygiene
    • Geared to improving a child's brushing and flossing technique.
  • Fluorides
    • Children between 6 months and age 16 should take in fluoride daily.
  • Diet
    • Review specific nutrients a child needs to grow.

Preventive Dentistry 16.

  • Sealants
      • Applied to the teeth to help keep them cavity-free.
  • Oral/Facial development
      • To identify malocclusion, crowded or crooked teeth, bite problems, and actively intervene.
  • Sports safety
      • Protective face equipment worn during any recreational sport that might injure the mouth area.

Preventive Dentistry contd 17.

  • Restorative
    • Amalgam
    • Composite
  • Endodontic procedures
    • Pulp capping
    • Pulpotomy
  • Prosthodontic procedures
    • Stainless steel crowns

Operative Procedures 18.

  • Causes of dental injuries to children
    • Automobile accidents
    • Bicycle accidents
    • Sports injuries
    • Child abuse

Traumatic Injuries 19. Fig. 57-16Educating school personnel about traumatic injuries. 20. Types of Injuries

  • Fractured anterior teeth
  • Documentation of the accident includes:
    • Clinical examination
    • Radiographs
    • Vitality testing


  • Traumatic intrusion
    • The tooth is forcibly driven into the alveolus so that only a portion of the crown is visible.

Types of Injuries contd 22.

  • Extrusion and lateral luxation
    • Teeth are actually displaced from their position, causing damage to the periodontal ligaments.
      • Displaced teeth repositioned.
      • Temporary splint placed.

Types of Injuries contd 23.

  • Avulsed teeth
    • The process of a tooth being t orn away, or dislodged completely by force.
      • Recover the tooth immediately.
      • Wrap the tooth in a moistened gauze.
      • Go immediately to the dentist's office.

Types of Injuries contd 24.

  • 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 and neck.
    • Facial bruises, swelling of the facial structures, or black eyes.
    • Bite marks.
    • Injuries not consistent with the explanation presented by the parent.

Child Abuse 25.

  • Required information
    • The name, address, g