Week 5 PP Flashcards
What is Pediatric Dentistry?
Is the specialized area of dentistry that focuses on providing oral healthcare according to the needs of infants, children, adolescents , and individuals with special needs
- pediatric patients require special adaptations and techniques in the way dental treatment is provided
Education Requirments for Pediatric Dentist?
A pediatric dentist will continue his or her education for an additional 2 to 3
years after dental school
◦ The program of study and hands-on experience prepares the specialist to meet the needs of infants, children,
adolescents, and persons with special healthcare needs
The Pediatric Dental Assistant
- Pediatric dentistry provides a clinical practice environment where you will have an active role in
the patient’s dental care - Many pediatric dental offices employ the certified dental assistant to provide dental procedures (polishing, sealants & impressions)
- Understand behavioral issues
- Must like kids! ☺
The Pediatric Dental Office
-Display cheerfulness in a pleasant environment with a non-threatending decor
-treatment areas are designed with an open-bay concept in mind
-some offices have a quiet room which is a closed space
-dental personnel dress in bright, coordinating colours
What is Chronological age?
Child’s actual age in terms of years and months
What is Mental Age?
Child’s level of intellectual capacity and development
What is Emotional Age?
Child’s level of emotional maturity
Erickson’s Stages of Development
-Psychiatrist determined that the socialization process consists of stages. These stages were formulated to understand the social and emotional development of children & teens. These stages can be used as guides to determine the anticipated behavior of the child and a certain age
*children who differ widely from these norms may be diagnosed as physically and emotionally challenged
Erikson’s Stages of Development: 0-12 months
Learning Basic Trust
- this is the period of infancy through the first year of life
-the child is well handled, nutured, and loved and develops trust and security and basic optimism
Erikson’s Stages of Development: 1-2 years old
Learning Autonomy
* During this period, children learn to sit, stand, walk, and run
* Vocally, they progress from babbling to using simple sentences
* Socially, they learn to identify familiar faces and alternate through periods of being friendly and being fearful of strangers
* Around the age of 2 years old, children begin to have basic fears associated with separation from the parent and a related fear of strangers
Erikson’s Stages of Development: 3-5 years old
Play Age
* 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
Erikson’s Stages of Development: 6-11 years old
School Age
* Social skills are developed, conflict experienced
* Learning rules and guidelines
* Children learn to overcome fears of objects and situations that were once quite frightening to them.
Erikson’s Stages of Development: 12-20 years old
Adolescence
* Young person acquires self-certainty
* They experiment with different roles
* Clear sexual identity is established
* The adolescent will seek leadership and gradually develop a set of ideals
Behaviour Management
- The initial examination is important for both the child and the dental team
-Often the first dental experience for the child
-The rapport developed during the initial examination can establish and attitude toward dental health that will last for a child’s lifetime
-Many dentists willl follow a behavior scale early in the treatment of pediatric patient
Frankl Scale for Behavior
2 - Negative - Relectance to accept treatment; uncooperative; some evidence of negative attitude but not pronounced, that is, no sudden withdrawal
Rating #1 - Definitely Negative - refusal of treatment, crying forcefully, fearful, other evidence of extreme negativism
Guidlines for Child Behaviour
-Be honest with the child
-Use Child Languages
-Consider the child’s POV
-Use “tell, show, do” ***
-Give positive reinforcement
How to Manage the Challenging Pedo Patient
-Treating an anxious, fearful or uncooperative child can be challenging, and occasionally a child’s behavior requires a “firmer management style”
-Voice Control - speaking calmly but firmly
-Sedation - this is prescribed to calm the patient and put him or her at ease before treatment
-Nitrous oxide-oxygen - this method of mild sedation can help calm a patient for treatmet
-Physical restraint - restraints are used to prevent injury to the child and dental team
What is a Papoose Board?
looks like a straight jacket attached to a board - put on dental chair *slide 18
Patients with Disabilities
a pediatric dental environment better suits a patient with special needs. Evaluation of a medical/dental history will help to disclose whether modifications to treatment are required. Depending on the severity some patient’s treatment is provided in a hospital setting
Intellectual Disability - 4 categories
Characterized by limitations in intelligence and adaptive skills. Patients are typically classified into 4 categories: mild, moderate, severe & profound
Mild Intellectual Disability
minimize distractions, use positive reinforcement, use simple short explanations, give verbal praise
Moderate Intellectual Disability
usually cannot live alone. Will require special care during dental treatment such as premedication, restraints or general anesthesia
Severe Intellectual Disability
ususally have poor motor development and lack communication. will require general anesthesia
Profound Intellectual Disability
have minimal capacity for sensorimotor function. Need constant aid and supervision. Require special dental care in an institutional setting
Patients with Down Syndrome
Down syndrome patients usually have a mild moderate intellectual disability, reduced muscle tone, heart problems and anomalies in dental development such as:
◦ eruption of teeth may be delayed
◦ teeth can be peg shaped
◦ Malocclusion present
◦ Periodontal problems
◦ Typically mouth breathers
◦ Forward position of the mandible and underdeveloped nasal and maxillary bones do not provide enough space for the tongue
What is Autism?
Development disorder that affects how information is processed in the brain by altering how nerve cells and their synapses connect & organize.
How Autistic behavioural problems can be managed?
◦ Positive reinforcement
◦ Behavior modification
◦ Desensitization
◦ Sedation, restraint or even general anesthesia may be necessary
These patients are usually on psychotropic medications which cause xerostomia
What is Cerebral Palsy?
Neural disorders caused by prenatal or postnatal brain damage before the central nervous system has reached
maturity. Typically characterized by:
◦ Paralysis
◦ Muscle weakness
◦ Lack of coordination
◦ Disorders of motor function
◦ Seizure disorders
◦ Intellectual disability
◦ Sensory and learning disorders
What management is typically required for patient with cerebral palsy?
Premedication is frequently required to help conrol and relax the patient. For some patient’s general anesthesia may be necessary
When is the 1st dental appointment for a child recommended?
It is recommended that a child’s first dental visit is once their first tooth errupts, with regular visits occuring at age 2.
Specific information noted on Pediatric Medical History
- past hospitalizations and procedures under general
-physician visits and current treatment
-medications (daily & in the past)
-medication reactions
-allergies
-birth problems and weight at birth
-level of learning
Specific information noted on Pediatric Dental History
-Primary concern
-satisfaction with appearance of teeth
-bleeding gums
-finger, thumb, pacifier habbits
-fluoride and brushing habbits
-inheritied family dental characteristics
How often is radiographic imaging recommened for children?
Due to children’s mouths growing more rapidly they can be more susceptible to decay. It is recommended that radiographs are taken every 6 months.
Tips for taking pediatric xrays
-use words such as camera and taking a picture
-use appropriately sized film
-expose easiest films first
-use show-tell-do technique
Instruments and Materials Associated with Pediatric Dentistry
- Smaller size dental frame
- Smaller dental chairs
- Pedo tofflemire retainer and band
- Smaller nitrous mask
- Colored fillings
- Fold the bib in half to make it smaller
- Remove head rest if regular dental chair is used
