A thorough knowledge of practice management in today’s paediatric dental set up is a very important, more so because the entire outlook has shown a radical shift. From inception as a branch dealing with extraction of baby teeth which were decayed, today’s Pedodontists practice prevention and preservation.

1. PRACTICE MANAGEMENT IN
PAEDIATRIC DENTISTRY
Submitted by: Deepak Chawhan
(BDS Final Year)
Guided by: Dr. Mayur Bhattad

2. PREVIEW
 The child is a pristine form of mankind and this
speciality of Pedodontics gives us privilege to deal
with one of the exceptionally unique creations of
God.
 A thorough knowledge of practice management in
today’s paediatric dental set up is a very important,
more so because the entire outlook has shown a
radical shift. From inception as a branch dealing
with extraction of baby teeth which were decayed,
today’s Pedodontists practice prevention and
preservation.

3. ACKNOWLEDGEMENT
 I would like to express the deepest appreciation to
my guide, Prof. Dr. Mayur Bhattad & Prof. Dr.
Krantikumar who has the attitude and the
substance of a genius: they continually and
convincingly conveyed a spirit of adventure in
regard to research & Scholarship, and an
excitement in regard to teaching. Without there
guidance & persistent help this seminar would not
have been possible.

4. CONTENT
1. Practice Management in dentistry.
2. Practice Management in dentistry.
3. Making the choice & planning the career.
4. Dentist may be employed in
5. Planning The Practice Career.
6. For private practice.
7. Practice Management in Pedodontics.
8. Aspects to be reviewed periodically.
9. Objectives of practice management.
10. Initial communication with parents
11. Dental clinic environment
12. Management of time & appointment
13. Ancillary Personnel
14. Establishing a suitable record system
15. Establishing Professional fees
16. Effective Infection control measures
17. Proper maintenance of clinic
18. Health education room
19. Consultation with the parents
20. Accountability
21. Consent
22. Handling the child in the dental chair
23. Sequence of Procedures

5. PRACTICE MANAGEMENT IN DENTISTRY
 Recognize the basic concepts of quality assurance and
practice management practice management.
 Prioritize workload and manage personal stress in the
frame work of proper performance and management.
 Work in collaboration as a member of an interdisciplinary
team.
 Share information and professional knowledge with both
the patient and other professionals, verbally and in writing,
including being able to negotiate and give and receive
constructive criticism.
 Adopt a creative attitude in an ethical and scientific
approach.
 Self evaluate professional abilities, performance, and
progress.
 Use contemporary information technology for
communication, management of information and
applications related to health care.

6. SUCCESSFUL DENTIST
1. Establish a practice in a desirable conditions.
2. Good relationship with the patients.
3. A happy practice team.
4. Reasonable income to maintain reasonable living
standard.
5. Abilities & facilities to keep abreast of modern
dentistry, both educationally & in equipment.
6. Technically Skilful in dental procedures.
7. Respect time.
8. Three A’s are important in making a successful dentist
Availability, Affability and Ability.
* Devote his time to caring of patient as a human being
without the pressure of thinking every minute without
the drill in his hand is lost income.

7. MAKING THE CHOICE & PLANNING THE
CAREER
 It is important to love & enjoy the pattern of work.
 Typical dentist works at the dental chairside,
operate on patients restoring teeth, fillings etc.
 Students must be asked if they good with their
hands.
 All dentist must be able to do adequate
treatment at final examination level.
 There are different areas of dentistry we can gain
experiences in, and we decide which would be
suitable to our temperament.

8. DENTIST MAY BE EMPLOYED IN
 Academic ( full time or part-time)
1. Teaching
2. Research
 Hospital (full time or part-time)
 General dental practice
 Specialist dental practice
 Participant in commercial promotion
 Writing (journalism)
 Organizations & management ( WHO)
 Public relation
 Armed services
 Technique of part-time option to aid in decision making.
 The option of military services is almost a one-way option.
 Possible ladder of promotion depending on further training.

9. PLANNING THE PRACTICE CAREER
 There are two kinds of doctors; those who are
primarily interested in disease and those who are
primarily interested in people.
 There are two kinds of dentists; those who are
primarily interested in the mechanics of
treatment and those who are interested in people.

10. FOR PRIVATE PRACTICE
CHOOSING A PLACE DEPENDS ON:
 Age
 Race
 Social class
 Custom
 Town or Country
* Remember, you can practice at home !
 The question of how far away the place of work will be
from home is important in term of travelling time and
emergencies that necessitate attendance even at
weekends.
 Malpractice cover is sought, especially as a
beginner.
 Payment issues ( fixed salary, percentage basis)

11. PRACTICE MANAGEMENT IN PEDODONTICS
 The child is a pristine form of mankind and this
speciality of Pedodontics gives us privilege to deal
with one of the exceptionally unique creations of
God.
 A thorough knowledge of practice management in
today’s paediatric dental set up is a very important,
more so because the entire outlook has shown a
radical shift.

12.  From inception as a branch dealing with extraction
of baby teeth which were decayed, today’s
Pedodontists practice prevention and preservation.

13. ASPECTS TO BE REVIEWED PERIODICALLY
 To realize this goals the special developmental
characteristics and the important relationship of
paediatric patients with their parents, practitioners
and staff members call for a unique environment
and establishment.

14. OBJECTIVES OF PRACTICE MANAGEMENT
 The clinical practice management of paediatric children is a
mixture of
1. Initial communication with parents
2. Dental clinic environment
3. Management of time & appointment
4. Ancillary Personnel
5. Establishing a suitable record system
6. Establishing Professional fees
7. Effective Infection control measures
8. Proper maintenance of clinic
9. Health education room
10. Consultation with the parents
11. Accountability
12. Consent
13. Handling the child in the dental chair
14. Sequence of Procedures

15. INITIAL COMMUNICATION WITH PARENTS
 At the time the parents make an initial contact by
telephone, the receptionist should project the dental
office staff true interest in the child patient.
 The conversation by receptionist should be –
1. By offering correct information in a friendly manner.
2. The receptionist should speak clearly in a natural &
well modulated tone.
3. The receptionist should converse in an efficient but,
unhurried manner.
 Duties of Receptionist –
The patient’s full name and nick name both the parent’s
names, address and telephone numbers should be
recorded by the receptionist.

17. DENTAL CLINIC ENVIRONMENT
 The ideal office/clinic should be –
1. Easy to approach for self, staff & patients with ample car parking.
2. An attractive and comfortable environment should be designed for both children
and parents.
3. Decor of the reception and dental clinic require careful planning.
4. Natural colours such as beige or light shades of green or blue for the wall decor
promote a tranquil feeling and permit the use of attractive coloured accessories.
5. Decoration depicting definite settings such as Circus, outer space or nursery
rhyme add to the warmth and fantasy of the office and tend to dispel fear.
6. An Aquarium can be placed, which acts as a source of entertainment.
7. Soothing, muffled music in the reception room has comforting effect on both the
parent and the patient.
8. Objects of interest for all ages of children.
9. Children are attracted to toys and comic books.
10. If Adults are accompanying children to the dental office reading material should
be available for them.
11. Certain dental drawing used in conjunction with the different procedures
undertaken in the clinic can also be included and this has shown to anxiety, or
fear of child parents.

20. MANAGEMENT OF TIME AND APPOINTMENT
 To guide the parents in choosing the most desirable hour for
their child’s appointment the receptionist must be prepared
with information to justify the scheduling.
 Morning appointments are preferable in a young patient
because the child will be fresh and active, the length of the
appointment should be as short as possible (preferably less
than 30 minutes).
 Children should not be made to wait too long in the reception
area before the dental procedure, as this will make them
restless.
 An appointment book should be well planned and effectively
designed with the layout for entire week.
 Long appointments should be interspersed with the shorter
once so that it is comfortable for the patient.
 A definite schedule should be set for starting and completing
the appointments.

21. ANCILLARY PERSONNEL
 The efficient utilization of chair side assistants is
extremely important in pedodontic practice
because:
1. It decreases the length of the dental appointment,
thus aiding in child management.
2. The dentist practices more efficiently and more
rapidly, thereby becoming more productive.
3. Help from assistant decreases the number of
steps and movements necessary resulting in less
fatigue to the dentist.
4. The assistant/ individual should be a warm, caring
person who must genuinely portray a friendly
attitude to the child (Stewart 1982).

23. ESTABLISHING A SUITABLE RECORD SYSTEM
 The record system must include –
1. Medical History
2. Chief complaint
3. Investigations advised and carried out
4. Diagnosis & Treatment plan
5. Appointment schedule
6. Fee charged & recovered.
 Computers and Good software can be used to
maintain these records.
 It is legally mandatory to maintain these records
for a dentist.

24. ESTABLISHING PROFESSIONAL FEES
 The fees must be revised time to time.
 A rationale method for determining the fee and
payment system should be followed with a few
important factors in mind such as the patient
workload, annual production hours, working days
per year and the average monthly forecast per year.

25. EFFECTIVE INFECTION CONTROL
 Infection control is the term used to determine the prevention
of disease transmission from the patients and from one patient
to another.
 There are various modes by which infection may spread in a
dental clinic, hence proper infection control guidelines should
be followed for the reasons stated below:
1. All the infected child cannot be identified by Medical history,
physical examination or lab test, Centre for Disease Control
recommends that blood and body fluid precautions be used
consistently for all patients; these are termed as universal
precautions.
2. Common microorganisms affecting dentists and dental
patients are –
* Staphylococci, Streptococci, Hepatitis B & C, Herpes
Simplex 1 & 2, HIV, Mycobacterium tuberculosis, etc.

26. Infection Control For the Dental team
 On employment, checks should be made to ensure
the dental health staff is adequately immunized.
 To prevent contact with the spatter, foreign bodies
(like amalgam fragment) and aerosols, dental
health care workers should position patients
properly, Use of rubber dam, high velocity
evacuators and protective barriers
 Hand Hygiene, Decontamination of the dental
equipments and instruments, Sharp instrument
management, Clinical Waste Management,
Infection Control for patients.

27. Hand Hygiene
Personal Protective Barrier
Decontamination of Dental Equipments

28. Infection Control

29. Bio- Medical Waste Management
Sharp Instrument Handling

30. PROPER MAINTENANCE OF CLINIC
 The flooring, walls, ceilings and all the surface
equipments and cabinets must be made of such
material that can be very easily disinfected.

31. HEALTH EDUCATION ROOM
 Space should be allocated in the dental office
where the child & the parent can be given proper
instruction for preventive procedure.
 Instruction in oral hygiene procedures should be
explained completely and participation by the child
should be reinforced until tooth brushing & flossing
become an established habit pattern.
 Dietary counselling can also be given here.
 The Dentist should keep in touch with the current
developments and participate in the activities of
profession al bodies.

32. CONSULTATION WITH THE PARENTS
 During the consultation the may review the major
diagnosis or may elaborate on specific details such
as the type of infection, severity of dental caries,
reason for pain, nature of oral defects, objectives of
guiding the developing occlusion, etc.
 Consultation should be conducted efficiently to
achieve effective communication with the parent

33. ACCOUNTABILITY
 Dental profession is morally, ethically & legally
accountable to the patient in particular & the society
in general.
 In no way can we get out of the obligation.
 This aspect has to be kept in mind every time we
treat a patient.

34. CONSENT
 Consent before any complicated diagnostic or invasive
procedure is must except in rare circumstances life threatening
and medical emergencies & on an court order.
 The consent should be in local language & signed by the parent
or guardians.
*Never Do It
1. Never operate a patient without a consent.
2. Never lose your temper even on provocation.
3. Don’t neglect updating your knowledge through training
courses/ conferences, etc., and keep proof of it.
4. Never experiment on patient.
5. Never forget your limitations.
6. Never hesitate to refer your case if it cannot be managed by
you.
7. Never give general anaesthesia without anaesthetist.
8. Never use outdated medications.
9. Never resort to UNETHICAL practices.

35. HANDLING THE CHILD IN THE DENTAL CHAIR
 The patient rests in supine position with his body parallel
to the floor and the feet slightly elevated.
 The assistants arm is held slightly above the child’s
chest, which afford a comfortable feeling of security to
him.
 The dentist operates in sitting position comfortable on a
stool.
 All the equipments arranged close to the dentist and
assistant.
 Everything needed should easily accessible without
leaving the dental chair.
 All instruments are handed to and removed by the
dentist’s hand by the assistant.
 The concept of Four- Handed Dentistry implies the
Assistant’s hands.

36. SEQUENCE OF PROCEDURES
Step-1
 Emergency procedure dealt immediately.
Step- 2
 A preventive plaque control program should be introduced.
The emphasis on prevention should be reinforced at every
future appointment.
Step- 3
 Restorative therapy done at the third visit.
Step- 4
 Following the completion of the restortative phase of
treatment, orthodontic and prosthodontic care may be
rendered.
Step- 5
 No treatment plan is made until provision is made to provide
a recall appointment for evaluation and necessary follow up
care.