The document discusses the dental home concept and minimally invasive dental techniques. It defines the dental home as an ongoing relationship between dentist and patient to provide comprehensive and family-centered oral healthcare from age 1. This includes preventive services, risk assessments, anticipatory guidance, and treatment. Minimally invasive techniques aim to preserve tooth structure by reducing bacteria, using preventive measures, and remineralizing early lesions. They involve minimal cavity preparation and surgery using adhesive materials, as well as repairing restorations to prevent further decay.

1. PEDIATRIC DENTISTRY UPDATE
By / DR Ali Abdel Fattah
Pedodontist

2. THE DENTAL HOME
THE DENTAL HOME WAS
ESTABLISHED AS “AAPD POLICY
IN 2003, AND IS BASED ON THE
SAME CONCEPT AS THE
AMERICAN ACADEMY OF
PEDIATRICS POLICY STATEMENT
DEFINING THE MEDICAL HOME IN

3. THE DENTAL HOME
 “The dental home is the ‘ongoing
relationship between the dentist and the
patient, inclusive of all aspects of oral
health care delivered in a comprehensive,
continuously accessible, coordinated,
and family-centered way.
Establishment of a dental home begins
no later than 12 months of age and
includes referral to dental specialists

6. The Dental Home Provides…
a. Comprehensive oral health care including
“acute care” and preventive services
in accordance with AAPD periodicity
schedules.
b. Comprehensive assessment for oral
diseases and conditions.

7. The Dental Home Provides…
c. “Individualized “ preventive
dental health program based upon
a caries-risk assessment and a
periodontal disease risk assessment.
d. Anticipatory guidance about growth
and development issues,
(ie, teething, digit or pacifier habits).

8. The Dental Home Provides…
e. Plan for acute dental trauma.
f. Information about proper care of the
child’s teeth and gingivae.
This would include prevention, diagnosis,
and treatment of disease of the
supporting and surrounding tissues
and the maintenance of health, function,
and esthetics of those structures and
tissues.

10. Why Brush Teeth in” Day Care Centers”?
• Develop good habits
• Children may not
brush at home
• Children learn basic
hygiene principals

13. MINIMALLY INVASIVE TECHNIQUES
Minimally invasive techniques
today utilize microscope ,
imaging systems , lasers,
air abrasion Prevention
protocols can keep the
patient disease free
indefinitely

14. Minimal Intervention Dentistry
- Modern approach to the treatment of
tooth decay
- Based on “Medical Model” of caries
management

15. The Intervention approach Minimal
 A medical model;
 Caries treated as a biological
infection
 Surgical techniques are minor and
stress retention of tooth tissue.

16. Details of the MI approach
- (1) Reduces cariogenic bacteria;
- (2) Uses preventive measures;
- (3) Early lesions remineralised;
- (4) Minimal surgery on cavities;
- (5) Repair of defective restorations.

17. (1) Cariogenic bacteria
• Caries is a bacterial disease;
• Depends on dietary sucrose;
• Driven by frequency of eating;
• Modified by saliva.

19. (2) Preventive measures
• Topical fluoride
• Fissure sealants
• Patient education on oral hygiene

20. (3) Remineralisation
• Requires management by non-intervention;
• Enhanced by fluoride ion in saliva.

21. (4) Minimal surgery
 Requires adhesive materials (glass-ionomers,
adhesive composite systems);
 Possibly without drilling (ART technique).

22. (5) Repair of materials
• To prevent cavity extension;
• Not “botch job”, but appropriate.

23. The challenge for materials
 Adhesion
– Occurs naturally for glass-ionomers; problematic for
composites.
 Fluoride-release;
• Release of other mineralising ions
( PO4, Ca2+ )
 Repairable.

24. Conclusions
• Minimal Intervention dentistry is the future:
– Advocated by FDI;
– Cost effective;
– Less trauma for the patient.
• A biological approach, not a mechanical one.
• Makes significant demands on materials.

26.  I R T UTILIZES SIMILAR TECHINQUES Like
A R T BUT HAS DIFFERENT THERAPEUTIC
GOALS
( ART: REMOVAL OF CARIES USING HAND OR
SLOW SPEED ROTARY INSTRUMENT & THEN
RESTORE THEM WITH AN ADHESIVE
RESTORATIVE MATERIAL e.g G I CEMENT )
THE USE OF ITR HAS BEEN SHOWN to

27. POLISY STATMENT
ITR may be used to restore & prevent
dental caries in young pat ,
uncooperative pat , pat with special
health care needs & situations in which
traditional cavity prep, &/or placement
of traditional dental restorations are

34. AIR ABRASION
This technique uses a stream of
purified aluminium oxide
particles that are forced under
pressure through a fine –focused
nozzle onto the tooth surface

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