How Can We Reduce Dental Fear in Children? The Importance of the First Dental Visit

Dental fear is a common problem amongst children. It can affect children’s psychological well-being, quality of life, and oral and systemic health. The aim of this study was to identify whether the patients’ age at which visits to the paediatric dentist begin as well as the periodicity of these visits are factors that can prevent dental fear. This observational transversal study was conducted on 575 school children (average age 6.85 ± 0.78) and their mother/father/guardian. Parents completed a survey on the characteristics of dental visits and the child completed the index of dental anxiety and fear (IDAF-4C) to assess dental fear. The correlation between dental fear and age at first visit (r = −0.36 p < 0.01) and dental fear and frequency of visit (r = −0.65 p < 0.01) were statistically significant. The regression analysis performed showed that both variables predicted 44.4% of the dental fear in the child. In conclusion, the age of initiation to the paediatric dentist (before 2 years) and the periodic revisions (every 6 months or every year) could protect the child from dental fear.

Crowns for paediatric teeth: Stainless steel crown

Management of the severely destructed primary teeth poses a challenge for the paediatric dentist as three important considerations have to be kept in mind, patient’s behavioural management, preservation of the tooth structure and parental satisfaction. Various crowns have been introduced to the field of dentistry such as stainless-steel crowns and aesthetic crowns. Prefabricated stainless steel crowns (SSC) can be adapted to individual primary teeth and cemented in place to provide a definitive restoration. The SSC is extremely durable, relatively inexpensive, subject to minimal technique sensitivity during placement, and offers the advantage of full coronal coverage. SSC are often used to restore primary and permanent teeth in children and adolescents where intra-coronal restorations would otherwise fail. This article brings the update of this definitive restoration.

Hypohidrotic Ectodermal Dysplasia and Its Manifestations in the Oral Cavity

The Ectodermal Dysplasias generally present orofacial manifestations, such as skeletal discrepancies and dental alterations. Therefore, the role of a paediatric dentist in the detection and recognition of these repercussions can be crucial in early diagnosis of the disease. The oral rehabilitation of paediatric patients with this condition is extremely important, ideally, at a very early stage, yet contributing for the re-establishment of normal chewing, swallowing and phonetics functions, and, naturally, aesthetics increase. The purpose of this narrative review aims to elucidate dentists about their role in the detection, diagnosis, treatment and monitoring of the Ectodermal Dysplasia’ oral manifestations in paediatric patients, through the presentation of general physical and specific craniofacial characteristics.

Role of Paediatric Dentist in Non-Invasive Management of Obstructive Sleep Apnoea in Children

BACKGROUND Obstructive sleep apnoea (OSA) is a chronic disorder in which repetitive episodes of cessation of breathing occurs during sleep due to collapse of upper airway leading to recurrent awakening, sleep fragmentation, and perturbation in ventilatory function. The disorder is much more common than realised and the manifestations in children are different from those in adults. OSAS may present in different ways like cognitive dysfunction, excessive day time somnolence, decreased attention span, drooling of saliva, mood disorders like depression or irritability as well as adverse cardiovascular sequelae like hypertension, heart failure. Polysomnography or overnight sleep studies remain the gold standard for the diagnosis of paediatric obstructive sleep apnoea (POSA) disorder. Therapeutic approaches for POSA include surgical and nonsurgical means. The choice of therapy depends on various factors like aetiology, severity of the POSA and patient’s choice. Although continuous positive airway pressure (CPAP) remains the first line therapy in adults, the introduction of oral appliances provided an attractive alternative and made the role of dentists more prominent in management of this disorder. OSA is often under-diagnosed due to lack of awareness. So, it is essential for dentists to be aware of the various aspects of this disorder as well as its management. KEY WORDS OSA, Paediatric Dentist, Oral Appliances, Non-Invasive Management

Visualise a new career perspective

Dental nurse Danielle Schroven and general and paediatric dentist Makbule Ogretme talk about the power of the photograph

Periradicular Cystic Enucleation and PRF Grafting Following Apicoectomy in Trichotillomania Patient- A Case Report

Diagnosis and treatment planning of untreated traumatised anterior teeth specially in children with psychiatric disorders or special health care needs is a challenge to paediatric dentist, that too in non-pharmacological means is a difficult task. Most of the time when these patients report with such complaint, it is already too late. This could be due to unintentional reasons like lack of parent awareness or patient’s response at the time of insult. All these factors bypass the time of conservative and minimal invasive treatment approaches. Ultimately, delayed treatment of trauma to anterior region exposes pulp and infection progress to periradicular region with cystic changes. Here, in this case report, the non-pharmacological management of periradicular cyst enucleation, followed by apicoectomy and Platelet Rich Fibrin (PRF) grafting was done in a 15-year-old female patient with obsessive compulsive disorder i.e., Trichotillomania (TTM) under local anaesthesia. Symptoms and intraoral swelling was resolved postoperatively in follow-up visits.

Space Regaining Made Easy: The Case of a Severely Infraoccluded Primary Molar

Infraocclusion of deciduous molars is a quite common but challenging clinical situation that a paediatric dentist has to face in his everyday practice. This anomaly can lead to space loss, eruption disturbances of the permanent successor, and deformation of the occlusal plane. A case of a severely infraoccluded primary molar is presented. The treatment was carried out using a compressed NiTi wire applied only to the adjacent teeth. In three months, the space was recovered, and the infraoccluded temporary molar was extracted. After one year, the permanent successor erupted without any complication. The technique presented can be considered minimally invasive, and it involves cost- and time-efficient mechanics.

The paedodontic–orthodontic interface

The long-term management of a child’s developing occlusion often benefits greatly from a good working relationship between the paediatric dentist and the orthodontist. Typical problems range from minimizing damage to the occlusion caused by enforced extraction of poor-quality teeth, through the management of specific local abnormalities such as impacted teeth, to referral for comprehensive treatment of all aspects of the malocclusion. This chapter discusses the principles underlying when to refer to a specialist colleague, and looks at some common clinical situations where collaboration is often needed. From the age of 8 years all children should be screened for the presence of malocclusion when they attend for a routine dental examination. Although orthodontic treatment is usually carried out in the late mixed and early permanent dentition, some conditions benefit from treatment at an earlier stage. The screening need only be a brief clinical assessment, but it should be carried out systematically to ensure that no important findings are overlooked. An outline of a basic orthodontic assessment is given in Table 15.1. With practice this can be carried out quite quickly to give an overall impression of the nature and severity of a malocclusion. In essence, it comprises assessments of the following elements: • the patient’s awareness of their malocclusion (the complaint, if any) • their general level of dental awareness • an extra-oral examination of facial form (skeletal pattern and soft tissues) • general oral condition—oral hygiene, periodontal health, caries risk, and tooth quality • the presence or absence of all teeth • the alignment and form of each arch • the teeth in occlusion. Radiographs are not routinely used when screening for the presence of malocclusion and should only be taken when there is a clinical indication. A panoramic radiograph gives a useful general scan of the dentition and indicates the presence or absence of teeth. Modern digital panoramic radiographs are generally of good enough quality to assess for the presence of any abnormalities or gross caries. Intra-oral views may be indicated if specifically indicated by the history/examination (e.g. dental trauma) or for further investigation of pathology found on a panoramic image. A radiographic assessment must always be made when considering any extractions.