Definition and Overview

Paediatric dentistry is a dental specialty that focuses on the treatment, care and management of dental problems of infants, children and adolescents including those with special needs, such as young people who have health concerns like leukemia or congenital diseases or syndromes.

To specialize in this field, dentists are required to complete additional three-year specialty training on top of their basic dental degree. They also have to complete training courses in child psychology so they'll know how to effectively communicate with children who often feel anxious or even misbehave during a dental consultation.

Who Should Undergo and Expected Results

From infancy through adolescence, the teeth undergo several major changes. Baby teeth are replaced with permanent teeth until those are fully-grown. Throughout this period, the teeth are susceptible to all sorts of problems ranging from tooth decay to malformed teeth or incorrect tooth placement. Teeth can also grow at abnormal angles or even in the wrong direction. Paediatric dentists are trained to manage all of these problems.

Most of these specialists choose to limit their practices to children, to include those with special needs, such as those with autism, attention and development disorders or medical conditions such as heart diseases, diabetes, or blood disorders.

These dentists provide a wide range of dental services, the most common of which are dental cleaning, dental sealant s placement, fluoride treatments, and installation of dental crowns for children with damaged permanent teeth. Many dental offices today make use of modern equipment to hasten the procedures and cause less anxiety to the child. These can include laser equipped machines for teeth polishing and computer-aided equipment in the design and manufacturing of dental crowns, among others.

How Does the Procedure Work?

A paediatric dentist consultation typically consists of a short interview about the overall health of the child and any dental problems being experienced. The interview stage has two purposes: to understand the child’s dental and medical history and learn the best method to communicate with him or her. This is followed by an examination of the teeth and bite to determine any problems. At this point, no special instruments will be used other than a small dental mirror.

After the examination, the dentist will discuss his or her findings. Each problem will be explained thoroughly to ensure that the parent or guardian fully understands the need for the recommended treatment. If cavities are found, these will be removed and the damaged portion of the tooth will be filled with tooth-coloured filling. In some cases, the dentist will need to use anesthesia to help the child relax during the procedure. If the tooth has been severely damaged and cannot be saved even by a root canal procedure, tooth extraction will be recommended.

For children with a healthy set of teeth, the dentist will usually recommend plaque removal and teeth cleaning. Dental sealant would then be applied to protect the teeth from damage and plaque build-up.

The dentist may also opt to discuss other matters, such as dental hygiene or proper dental practices.

If the parent or guardian agrees to the suggested treatment, the dentist may proceed with treatment immediately or schedule another date.

Possible Risks and Complications

Initial paediatric dental consultations usually don’t necessitate a dental procedure unless there is an immediate need for treatment. For instance, if the child has an oral infection due to dental cavities, the dentist may recommend that antibiotic treatment be started immediately.

The risks associated with this procedure are minimal, and are usually limited to the behavior of the child during the consultation. Highly experienced dentists know how to manage the child’s behavior, but every patient is different. There may be set guidelines on how a paediatric dental consultation should proceed, but no guidelines are available on how to manage specific child behaviors. If needed, the dentist may request behavioral experts or other specialists in child psychology to assist in relieving the child’s anxiety.

References

  • Chou R, Cantor A, Zakher B, et al. Preventing dental caries in children <5 years: systematic review updating USPSTF recommendation. Pediatrics. 2013;132(2):332-50. PMID: 23858419 www.ncbi.nlm.nih.gov/pubmed/23858419.

  • Douglass JM. A practical guide to infant oral health. Am Fam Physician. 2004;70:2113-20. PMID: 15606059 www.ncbi.nlm.nih.gov/pubmed/15606059.

  • Ng MW. Early childhood caries: risk-based disease prevention and management. Dent Clin North Am. 2013; 57(1):1-16 PMID: 23174607 www.ncbi.nlm.nih.gov/pubmed/23174607.

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