Pediatric dentistry lecture


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Pediatric dentistry lecture

  1. 1. Pediatric Dentistry
  2. 2. Pediatric Dentistry <ul><li>A pediatric dentist treats patients from birth to age 18-21. </li></ul><ul><li>Patients with special needs may continue to see a pediatric dentist through adulthood. </li></ul>
  3. 3. Education Requirements <ul><li>A pediatric dentist completes a 2-year residency after graduating from dental school. </li></ul><ul><li>IUSD has a pediatric residency program. </li></ul>
  4. 4. Education Requirements <ul><li>During residency, the student learns: </li></ul><ul><ul><li>Specialized diagnostic and surgical procedures </li></ul></ul><ul><ul><li>Child psychology </li></ul></ul><ul><ul><li>Pediatric pharmacology </li></ul></ul><ul><ul><li>Child development </li></ul></ul><ul><ul><li>Treatment of oral/facial trauma </li></ul></ul><ul><ul><li>Caring for patients with special needs </li></ul></ul><ul><ul><li>Conscious sedation and general anesthesia </li></ul></ul>
  5. 5. Education Requirements <ul><li>At IUSD: </li></ul><ul><ul><li>a maximum of 6 residents are accepted each year. </li></ul></ul><ul><ul><li>The program takes 24 months to complete. </li></ul></ul><ul><ul><li>Hospital-based residency at Riley Hospital </li></ul></ul>
  6. 6. Caring for Primary (baby) teeth <ul><li>Decayed baby teeth can lead to problems with the developing permanent teeth. </li></ul><ul><li>Baby teeth that are lost too soon may affect how the permanent teeth erupt </li></ul><ul><li>Advanced decay can actually cause the permanent tooth underneath to erupt with decay already present! </li></ul>
  7. 7. Baby teeth are important for: <ul><li>Proper chewing </li></ul><ul><li>Speech development </li></ul><ul><li>Holding space for permanent teeth </li></ul><ul><li>Jaw and muscle development </li></ul>
  8. 8. Baby teeth aren’t just for babies…. <ul><li>While the front baby teeth are replaced by permanent teeth around the age of 6-7, baby molars will not be lost until pre-teen years. </li></ul>
  9. 9. Pediatric Patient Care <ul><li>For each patient, the pediatric dentist must: </li></ul><ul><ul><li>Examine </li></ul></ul><ul><ul><li>Diagnose </li></ul></ul><ul><ul><li>Treat </li></ul></ul><ul><ul><li>Prevent </li></ul></ul><ul><ul><li>Educate </li></ul></ul>
  10. 10. Pediatric Dentistry: Examinaiton <ul><li>Includes the use of complete medical and dental histories </li></ul><ul><li>Involves radiographs and a clinical examination of the teeth </li></ul>
  11. 11. Pediatric Dentistry: Diagnosis <ul><li>Problems such as tooth decay, extra teeth, parafunctional habits, malocclusion, and facial trauma and defects are noted. </li></ul><ul><li>Appropriate treatment is planned. </li></ul>
  12. 12. Pediatric Dentistry: Treatment <ul><li>Problems detected in the examination are treated, such as: </li></ul><ul><ul><li>Decay is restored </li></ul></ul><ul><ul><li>Spacing/alignment issues are addressed </li></ul></ul><ul><ul><ul><li>Extract any supernumerary teeth </li></ul></ul></ul><ul><ul><ul><li>Place space maintainers </li></ul></ul></ul><ul><ul><ul><li>Begin orthodontics </li></ul></ul></ul><ul><ul><li>Cleft palates, etc. are surgically corrected </li></ul></ul>
  13. 13. Pediatric Dentistry: Prevention <ul><li>Patients may receive routine exams and cleanings </li></ul><ul><li>Pit and Fissure sealants </li></ul><ul><li>Fluoride treatments </li></ul>
  14. 14. Pediatric Dentistry: Education <ul><li>The pediatric dentist and his team educate the patients and their parents in areas such as: </li></ul><ul><ul><li>Good oral hygiene </li></ul></ul><ul><ul><li>Healthy diet </li></ul></ul><ul><ul><li>Oral habits </li></ul></ul><ul><ul><li>Proper development </li></ul></ul>
  15. 15. Dental issues commonly addressed in pediatric patients <ul><li>Malocclusion </li></ul>
  16. 16. Tight Frenulum Attachment
  17. 17. Supernumerary (extra) teeth
  18. 18. Thumb sucking <ul><li>If thumb sucking does not stop by age three, growth of the mouth and alignment of teeth will be disturbed. </li></ul>
  19. 19. Thumb sucking appliance <ul><li>An appliance can be placed on the child’s palate that will discourage sucking his or her thumb. The appliance may need to be used for several months. </li></ul>
  20. 20. “ Baby Bottle” decay
  21. 21. “ Baby Bottle” decay <ul><li>Parents need to avoid giving their children juice or milk bottles at bedtime. </li></ul><ul><li>Nighttime feedings should stop once baby teeth erupt. </li></ul><ul><li>Juice should only be offered in a cup, never in a bottle. </li></ul><ul><li>If a bottle MUST be given to the child at night, it needs to contain only water. </li></ul><ul><li>Children should be weaned from bottles at 12-14 months of age. </li></ul>
  22. 22. Cleft Lip/Palate <ul><li>Occurs when the two “halves” of the face do not unite properly in the womb. </li></ul><ul><li>May be due to genetics, fetal exposure to drugs, or nutrional deficiencies while in the womb. </li></ul><ul><li>Cleft palate results in an opening between the palate and the nasal cavity. Cleft palates may or may not be accompanied by a cleft lip. </li></ul><ul><li>Clefts interupt speech, eating, and drinking as well as causing emotional/psychological damage. </li></ul><ul><li>Cleft lips and palates can be surgically corrected, often soon after birth. </li></ul>
  23. 23. Cleft Lip/Palate
  24. 24. Caring For a Child’s Teeth <ul><li>A child should have his first dental visit by his first birthday, or when baby teeth have started to erupt. </li></ul><ul><li>Problems such as baby bottle decay can be detected before extensive damage is done. </li></ul><ul><li>Parents can be educated on caring for their child’s teeth. </li></ul>
  25. 25. Caring For a Child’s Teeth <ul><li>Even before baby teeth arrive, children’s gums should be gently cleaned with an infant toothbrush, sponge, or washcloth. </li></ul><ul><li>Once teeth appear, a fluoride-free “training” toothpaste can be used to help loosen plaque. </li></ul>
  26. 26. Caring For a Child’s Teeth <ul><li>Children must use a fluoride-free paste until they are old enough to expectorate (rather than swallow) the past. </li></ul><ul><li>Ingesting fluoride can make a child sick or cause discoloration to developing teeth. Ingesting a large amount (such as eating an entire tube) could be fatal. </li></ul>
  27. 27. Caring For a Child’s Teeth <ul><li>Once toothpastes containing fluoride are introduced (commonly around age 3), only a pea-sized amount should be used. </li></ul><ul><li>Parents need to help their children brush and then allow the children to practice brushing their teeth themselves. </li></ul>
  28. 28. How does fluoride work? <ul><li>Enamel’s strength depends on it’s mineral content. </li></ul><ul><li>Exposure to acid causes minerals to be lost from the enamel, resulting in weak spots. </li></ul><ul><li>Fluoride is a mineral that can bond to weakened enamel, therefore encouraging “remineralization”. Other minerals found in saliva also help. </li></ul><ul><li>If remineralization does not occur, decay will result. </li></ul>
  29. 29. Healthy Snack Choices <ul><li>Save sugary treats for special occasions. They should not be a daily part of a child’s diet! </li></ul><ul><li>Encourage fresh fruits and veggies – their texture actually cleans teeth as the child chews </li></ul>
  30. 30. Healthy Snack Choices <ul><li>Gatorade, Kool-Aid, and other flavored drinks should be avoided or used sparingly. These drinks often more sugar than a Snickers candy bar! </li></ul><ul><li>Pediatricians recommend only one cup of fruit juice (such as apple juice) per day. An 8 oz. cup of apple juice contains 28 grams of sugar, which is as sugar as two Kit Kat bars. </li></ul><ul><li>Soda pop often contains 16 or more teaspoons of sugar PER CAN! Fruit-flavored pop, such as orange Crush, are especially high in sugar. </li></ul><ul><li>Children should be given milk and water to drink. </li></ul>
  31. 31. Healthy Snack Choices <ul><li>Eat more cheese! Not only does cheese provide calcium, it is also a natural cavity fighter! </li></ul><ul><li>Cheese stimulates salivary glands, which washes teeth and provides available minerals. </li></ul><ul><li>Calcium and Phosphorous keep the ph level from decreasing (becoming acidic) and also aid in remineralizing weak spots. </li></ul><ul><li>Enzymes in cheese prevent bacteria from adhering to the tooth surface. </li></ul>
  32. 32. Dental Emergencies <ul><li>Nearly every child will experience a dental emergency at some point. </li></ul><ul><li>Most cuts/lacerations to the tongue will heal themselves. Apply ice to the area, and use firm gentle pressure to stop bleeding. If bleeding cannot be controlled, or if the puncture extends from the top surface through to the underneath surface of the tongue (such as biting completely through), go to the emergency room. </li></ul>
  33. 33. Dental Emergencies: <ul><li>For a knocked-out (avulsed) tooth, avoid touching the root! Pick the tooth up by the crown portion and rinse gently (do not scrub!). If the tooth is not fractured, reinsert the tooth into the socket and have the child keep it stable by biting on gauze. If you cannot reinsert the tooth, place it in a cup of the patient’s saliva or water. If the patient is old enough not to swallow the tooth, you may have the child hold it in his mouth while you seek a dentist immediately. </li></ul><ul><li>The longer a tooth is out of the socket, the lower the chance it will be able to be successfully reinserted. </li></ul>
  34. 34. Mouthgaurds <ul><li>Many childhood dental injuries occur while playing sports. </li></ul><ul><li>Mouthgaurds are flexible plastic appliances that are molded to fit the patient’s teeth. </li></ul><ul><li>They protect the teeth from trauma by acting as a “shock absorber” for teeth, as well as protecting lips and cheeks for patients who are in orthodontics. </li></ul><ul><li>Mouthgaurds should be worn in any sport that may include contact with other players or hard surfaces. </li></ul>
  35. 35. Mouthgaurds <ul><li>Custom made mouthgaurds offer the best protection. These are made in a dental office from molds of the childs teeth. </li></ul><ul><li>Over-the-counter mouth-formed protectors are less expensive than custom made protecors.These protectors are placed into boiling water to soften the material and then the child bites into protector as it molds to her teeth. </li></ul><ul><li>Preshaped stock mouthguards are cheapest, but offer minimal protection due to poor fit. </li></ul><ul><li>*Mouthgaurds need to be cleaned with soap and water after being worn. </li></ul>