Pediatric Dentistry Chapter 57 Copyright 2009 2006 by Saunders an imprint of Elsevier Inc All rights Chapter 57 Lesson 57 1 Copyright 2009 2006 by Saunders an imprint of Elsevier Inc All rights Learning Objectives Pronounce define and spell the Key Terms Describe the appearance and setting of a pediatric dental office Give the stages of childhood from birth through adolescence Cont d Copyright 2009 2006 by Saunders an imprint of Elsevier Inc All rights Learning Objectives Cont d Discuss the specific behavior techniques that work as positive reinforcement when treating children Describe why children and adults with special needs are treated in a pediatric practice Copyright 2009 2006 by Saunders an imprint of Elsevier Inc All rights Introduction Pediatric Dentistry is the specialized area of dentistry limited to the care of children from birth through adolescence with additional focus in providing oral health care to patients with special needs Copyright 2009 2006 by Saunders an imprint of Elsevier Inc All rights The Pediatric Dental Office Display cheerfulness in a pleasant environment with a nonthreatening d cor Treatment areas are designed with an openbay concept in mind Dental personnel dress in bright coordinating colors Copyright 2009 2006 by Saunders an imprint of Elsevier Inc All rights Fig 57 2 Example of a pleasing patient friendly reception area in a pediatric dental office Copyright 2009 2006 by Saunders an imprint of Elsevier Inc All rights The Pediatric Patient Chronological age Mental age The child s actual age in terms of years and months The child s level of intellectual capacity and development Emotional age The child s level of emotional maturity Copyright 2009 2006 by Saunders an imprint of Elsevier Inc All rights Stages of Childhood Birth to 2 years Children learn to sit stand walk and run Vocally they progress from babbling to using simple sentences Children identify familiar faces then progress through periods of being friendly and then fearful of strangers At this age children are too young to be expected to cooperate in dental treatment Cont d Copyright 2009 2006 by Saunders an imprint of Elsevier Inc All rights Stages of Childhood Cont d Ages 3 to 5 years The child needs to be allowed to develop autonomy and initiative The child requires control and structure in his or her environment The child is able to follow simple instructions The child welcomes an active role in the treatment experience Cont d Copyright 2009 2006 by Saunders an imprint of Elsevier Inc All rights Stages of Childhood Cont d Ages 6 to 12 years This is a period of socialization The child is learning to get along with people The child is learning the rules and regulations of society The child is learned to overcome fears of objects and situations Copyright 2009 2006 by Saunders an imprint of Elsevier Inc All rights Behavior Management Be honest with the child Consider the child s point of view Use tell show do Give positive reinforcement Copyright 2009 2006 by Saunders an imprint of Elsevier Inc All rights The Challenging Patient Premedication Nitrous oxide oxygen This isrescribed to calm the patient and put him or her at ease before treatment This method of mild sedation that can help calm a patient for treatment Physical restraint Restraints are used to prevent injury to the child and dental team Copyright 2009 2006 by Saunders an imprint of Elsevier Inc All rights Patients with Special Needs Mentally challenged Mild IQs ranging from between 50 and 55 to 70 Moderate IQs ranging from between 35 and 40 to 50 or 55 Severe IQs ranging from between 20 and 25 to 35 or 40 Profound IQs below 20 to 25 Copyright 2009 2006 by Saunders an imprint of Elsevier Inc All rights Down Syndrome This disorder is also called trisomy 21 Down syndrome is a chromosomal aberration resulting in certain abnormal physical characteristics and mental impairment Mental impairment may range from mild to moderate retardation A person with Down syndrome is affected by low of muscle strength and weak muscle tone Heart conditions are possible An affected child may exhibit abnormalities in dental development Periodontal problems are possible Copyright 2009 2006 by Saunders an imprint of Elsevier Inc All rights Cerebral Palsy This nonprogressive neural disorder is caused by brain damage that occurred prenatally during birth or postnatally before the central nervous system reaches maturity Characterized by Paralysis Muscle weakness Lack of coordination Other disorders of motor function Poor oral hygiene Copyright 2009 2006 by Saunders an imprint of Elsevier Inc All rights Chapter 57 Lesson 57 2 Copyright 2009 2006 by Saunders an imprint of Elsevier Inc All rights Learning Objectives Describe what is involved in diagnosis and treatment planning in a pediatric patient Discuss the importance of preventive dentistry in pediatrics Give the types of procedures for the pediatric patient compared with the treatment of patients with permanent teeth Cont d Copyright 2009 2006 by Saunders an imprint of Elsevier Inc All rights Learning Objectives Cont d Assist in pulpotomy of a primary tooth Assist in the placement of a stainless steel crown Copyright 2009 2006 by Saunders an imprint of Elsevier Inc All rights Diagnosis and Treatment Planning Medical and dental history Past hospitalizations and surgeries Date of the child s last visit to a physician Medications daily medications Unfavorable reactions 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 and pacifier habits Fluoride and toothbrush habits Inherited family dental characteristics Cont d Copyright 2009 2006 by Saunders an imprint of Elsevier Inc All rights Diagnosis and Treatment Planning Cont d Clinical examination Radiographic examination Extraoral examination Intraoral soft tissue examination Clinical examination Copyright 2009 2006 by Saunders an imprint of Elsevier Inc All rights Fig 57 5 Example of dental report card used for recall appointments Courtesy of Dr John Christensen Copyright 2009 2006 by Saunders an imprint of Elsevier Inc All rights Preventive Dentistry Oral hygiene Fluoride Efforts are geared to improving a child s brushing and flossing technique Children between the ages of 6 months and 16 years should take in fluoride daily Diet Review the specific nutrients a child needs to grow Cont d Copyright 2009 2006 by Saunders an imprint of Elsevier Inc All rights