Scope Of Paediatric Dentistry Notes

Scope Of Paediatric Dentistry

Paediatric dentistry or dentistry for children is relatively a recent science. The first textbook of pedodontics is ‘Les Maladies sur des Dentes’ meaning ‘the diseases on the teeth’. It was published in 1763 by Joseph Hurlock.

Robert Bunon is considered the father of pedodontics as he emphasised the importance of deciduous dentition in 1764.

Until the mid-1950s, dentists had a popular signboard in their clinics. It was given as a compliment by manufacturers of dental products and dentists readily accepted them. The dentists did not want to entertain children as their patients.

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Treating children was considered special or complex due to their emotional immaturity and poor communicative ability. The treatment had to be planned precisely with the prospected growth of the child.

However, times and attitudes have changed. With increased awareness among the public and the activity of several paediatric dentistry forums, dentistry for children has obtained top priority. The evolution of paediatric dentistry in India is depicted.

There are many organisations across the world which formalise the learning, teaching and practice of paediatric dentistry. They bring out journals which incrementally contribute to the literature of this science of paediatric dentistry. They are mentioned in Table.

Paediatric Dentistry Scope And Challenges

American Academy of Pediatric Dentistry defined paediatric dentistry in 1999 as ‘an age-defied speciality that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence including those with special healthcare needs’.

The scope of paediatric dentistry is expanding. The future is more colourful than its past. This is because there is an increasing awareness among parents about primary teeth and willingness towards paediatric dental care.

Paediatric dentistry has taken over the practice of preventive dentistry. Preventive, interceptive and minor corrective orthodontic procedures are rendered by paediatric dentists. Of late, genetics and forensic sciences have been related to paediatric dentistry.

The expansion of paediatric dental practice is challenged by prevalent misconceptions such as milk teeth do not require treatment and why disturb little children for the sake of dental treatment.

There is a lack of professionals practising paediatric dentistry and less acceptance of hospital-based paediatric dentistry.

Paediatric Dentistry Outline:

The practice of paediatric dentistry is structurally different from adult dentistry. The relationship is linear in adult dentistry. It is between the patient and the dentist.

However, the relationship is triangular in the case of paediatric dentistry. The child (patient), parent and dentist are involved. The relationship is diagrammatically represented by G. Wright (1975) as the endodontic treatment triangle.

The endodontic treatment triangle depicts the following features:

1. The well-being of the child is the key objective of both the doctor and the parent. So, the child is at the apex of the triangle.
2. All three entities (parent, child and doctor) mutually interact with each other as shown by arrow connectors.
3. The arrow connectors parent-child and dentist–child are unidirectional, symbolising the one-way responsibility of the parent/dentist.
4. The arrow connecting the parent–the dentist is bidirectional, symbolising the trust that is required mutually.
5. Recently, the fourth entity, society, has been incorporated into the centre. It means that behaviour management modes should be socially acceptable.

Paediatric Dentistry Objectives

The three objectives of paediatric dentistry are

1. To deliver effective dental care
2. To deliver efficient dental care
3. To instil a positive dental attitude1. Effective Dental Care is rendering quality treatment. Even the highest degree of non-cooperative behaviour of the child should not compromise the quality of treatment. An example of effective dental care is the improper isolation of a prepared cavity in a crying child. Preferring extraction over conservative procedures is also ineffective treatment. Restoration of the tooth may be possible but not attempted as it involves more cooperation of the child and more chair
4. 
5. 2. Efficient Dental Care
   Efficient dental care pertains to the quantity of treatment rendered. The quantity of quality treatment should be proportional to the quantity of time spent treating the patient. Examples of inefficient dental care are excessive talking or mimicking a child’s play during the appointment. The attempt may make the child friendly and happy in the dental atmosphere but the treatment is undone. Postponing dental treatment and allowing the child to get on and off the dental chair is also an example of inefficient dental care. Quality professional time should not be spent without a proportional quantity of quality work being rendered.3. Positive Dental AttitudeOne would never get a second chance to make a first impression. The third objective can be fulfilled by delivering effective and efficient dental care to the patient.

   A positive dental attitude is attained when there is a progressive reduction in the child’s anxiety. The child starts looking forward to attending to further appointments. If the child feels better with each subsequent sitting, it means a positive dental attitude has been instilled.

   Effective and efficient dental care can be delivered when there is a change in the way the paedodontist sees children and the way the children see the paedodontist. This requires refining of attitude and redefining of the workplace, respectively. These are depicted.

   A positive dental attitude can be attained only with efficient and effective dental care. Effective and efficient dental care can be rendered only with a refinement in attitude and a redefinition of the workplace.

   Refining attitude is essential to understand the behaviour of children. Certain strategies such as routine interaction help in the efficient handling of children. Redefining the workplace is making structural changes in the dental operatory so that the children are not disturbed by looking at the gadgets, instruments, etc. These are discussed in the subsequent chapters of this unit.

   

   

Paediatric Dentistry Summary

1. Paediatric dentistry is defined as an age-defined speciality that provides both primary and comprehensive, preventive and therapeutic oral health care for infants and children through adolescence, including those with special care needs.
2. Milestones of paediatric dentistry
   1. The first textbook of pedodontics ‘Les Malaides sur des dentes’ by Joseph Hurlock in 1763.
   2. Robert Bunon is the father of pedodontics.
   3. Dr B. R. Vacher is the father of Indian paediatric dentistry.
   4. The science was first recognised as a speciality in 1950 at Government Dental College, Amritsar.
3. The outline of paediatric dental care is a triangle involving the child, parent and the dentist represented by the endodontic treatment triangle by G. Wright.
4. The objectives of paediatric dental care are as follows:
   1. Providing effective dental care
   2. Providing efficient dental care
   3. Instilling a positive dental attitude
      Attainment of the first two objectives is mandatory for the attainment of the third objective.
5. To attain the first two objectives one needs to
   1. Refine the attitude of the dentist
   2. Redefine workplace