Handbook of Pediatric Dentistry

Angus C. Cameron, Richard P. Widmer

• Publisher: Mosby
• Year: 2013
• ISBN:
  9780702054280
• Edition: 4
• Topic: Medicine
• Subtopic: Dentistry

The new edition of this internationally recognised text offers comprehensive guidance on the successful management of the child in the dental setting.

Prepared by authors of international renown, the Handbook of Paediatric Dentistry presents a volume that takes the reader far beyond the technical skills that are needed to treat disorders of the childhood dentition and instead delivers a whole philosophy of integrative patient care.

Richly illustrated and in full colour throughout, the Handbook of Paediatric Dentistry is written in a friendly 'how to' manner and contains useful 'pull out' boxes to act as useful aide-mémoires. Exploring a variety of topics, the book includes discussion of child development, practical communication skills and advice on how to deal with behavioural problems. Clinical topics include the management of caries, fluoridation, restorative dentistry, pulp therapy, trauma management, oral medicine and pathology, dental anomalies, and the treatment of medically compromised children. Chapters also explore the use of orthodontics, the management of cleft lip and palate and speech, language and swallowing.

The Handbook of Paediatric Dentistry has become an essential chairside and bedside companion for all practitioners caring for children and is suitable for undergraduate dental students, general dental practitioners, specialist paediatric dentists, orthodontists and paediatricians.

• • Established as the foremost available comprehensive handbook on paediatric dentistry
  • Prepared in an 'easy-to-digest' fashion – which allows for quick reference and easy reading
  • Contains over 550 full colour line artworks, photographs and tables together with 'Clinical Hints' boxes to act as useful aide-mémoires
  • Sets out the essentials for managing conditions such as clefting disorders, haematological and endocrine disorders, congenital cardiac disease, disorders of metabolism, organ transplantation and cancer in children as well as more familiar presentations such as dental trauma, oral infections and caries
  • Detailed appendices provide the reader with information that is often difficult to find and which may be overlooked
  • Designed specifically to give all practitioners confidence when managing children
  • Convenient handbook size ensures that the book can be easily referred to in the clinical setting
  • Endorsed by the Australasian Academy of Paediatric Dentistry
• ~

• Improved layout and completely new colour illustrations
• Expanded section on sedation and use of nitrous oxide
• Includes details from the most recent international guidelines
• Cases expanded to show 20 year follow-up
• Includes the latest research findings in orthodontics
• Fully updated section on clefting problems

1

The philosophy of paediatric dentistry

Richard P Widmer and Angus C Cameron

What is paediatric dentistry?

Paediatric dentistry is a specialty based not on a particular skill set, but encompassing all of dentistry’s technical skills against a philosophical background of understanding child development in health and disease. This new edition of the handbook emphasizes again the broader picture in treating children. A dental visit is no longer just a dental visit – it should be regarded as a ‘health visit’. We are part of the team of health professionals who contribute to the well-being of children, both in an individual context and at the wider community level. Children often slip through childhood to adolescence in the blink of an eye and family life is more pressured and demanding. Commonly, children spend more time on social media than interacting directly with family and friends and, more than ever, the major influences on their lives, come from outside the family.

The pattern of childhood illness has changed and with it, clinical practice. Children presenting for treatment may have survived cancer, may have a well-managed chronic disease or may have significant behavioural and learning disorders. There are increasing, sometimes unrealistic, expectations, among parents/carers that the care of their children should be easily and readily accessible and pain-free and result in flawless aesthetics.

Caries and dental disease should be seen as reflective of the family’s social condition and the dental team should be part of the community.

Your [patients] don’t have to become your friends, but they are part of your social context and that gives them a unique status in your life. Treat them with respect and take them seriously and your practice will become to feel part of the neighbourhood, part of the community.

(Hugh MacKay, psychologist, social researcher and novelist)

In the evolving dynamics of dental practice, we feel that it is important to change, philosophically, the traditional ‘adversarial nature’ of the dental experience. It is well recognized that for too many, the dental experience has been traumatic. This has resulted in a significant proportion of the adult population accessing dental care only episodically, for the relief of pain. Thus, it is vital to see a community, and consumer, perspective in the provision of paediatric dental services. The successful practice of paediatric dentistry is not merely the completion of any operative procedure but also ensuring a positive dental outcome for the future oral health behaviour of that individual and family. To this end, an understanding of child development – physical, cognitive and psychosocial – is paramount. The clinician must be comfortable and skilled in talking to children, and interpersonal skills are essential. It will not usually be the child’s fault if the clinician cannot work with the child.

Patient assessment

History

A clinical history should be taken in a logical and systematic way for each patient and should be updated regularly. Thorough history-taking is time consuming and requires practice. However, it is an opportunity to get to know the child and family. Furthermore, the history facilitates the diagnosis of many conditions, even before the hands-on examination. Because there are often specific questions pertinent to a child’s medical history that will be relevant to their management, it is desirable that parents be present. The understanding of medical conditions that can compromise treatment is essential.

The purpose of the examination is not merely to check for caries or periodontal disease, as paediatric dentistry encompasses all areas of growth and development. Having the opportunity to see the child regularly, the dentist can often be the first to recognize significant disease and anomalies.

Current complaints

The history of any current problems should be carefully documented. This includes the nature, onset or type of pain if present, relieving and exacerbating factors or lack of eruption of permanent teeth.

Dental history

• Previous treatment – how the child has coped with other forms of treatment.

• Eruption times and dental development.

• What preventive treatment has been undertaken previously.

• Methods of pain control used previously.

Medical history

Medical history should be taken in a systematic fashion, covering all system areas of the body. The major areas include:

• Cardiovascular system (e.g. cardiac lesions, blood pressure, rheumatic fever).

• Central nervous system (e.g. seizures, cognitive delay).

• Endocrine system (e.g. diabetes).

• Gastrointestinal tract (e.g. hepatitis).

• Respiratory tract (e.g. asthma, bronchitis, upper respiratory tract infections).

• Bleeding tendencies (include family history of bleeding problems).

• Urogenital system (renal disease, ureteric reflux).

• Allergies.

• Past operations or hospital admissions.

• Current treatment and medications.

Pregnancy history

• Length of confinement.

• Birth weight.

• Apgar scores.

• Antenatal and perinatal problems, especially during delivery.

• Prematurity and treatment in a special or neonatal intensive care nursery.

Growth and development

In many countries, an infant record book is issued to parents to record postnatal growth and development, childhood illness and visits to health providers. Areas of questioning should include:

• Developmental milestones.

• Speech and language development.

• Motor skills.

• Socialization.

Current medical treatment

• Medications, including complementary medications.

• Current treatments.

• Immunizations.

Family and social history

• Family history of serious illness.

• Family pedi...

Table of contents

• Cover image
• Title page
• Table of Contents
• Copyright
• Contributors
• Contributors to previous editions
• Foreword
• Preface
• Acknowledgements
• 1. The philosophy of paediatric dentistry
• 2. Child development, relationships and behaviour management
• 3. Pharmacological behaviour management
• 4. Dental caries
• 5. Fluoride and dental health
• 6. Restorative paediatric dentistry
• 7. Pulp therapy for primary and immature permanent teeth
• 8. Clinical and surgical techniques
• 9. Trauma management
• 10. Paediatric oral medicine, oral pathology and radiology
• 11. Dental anomalies
• 12. Medically compromised children
• 13. Children with special needs
• 14. Orthodontic diagnosis and treatment in the mixed dentition
• 15. Management of cleft lip and palate
• 16. Speech, language and swallowing
• Appendices
• Index