Paediatric Dentistry

Paediatric Dentistry is unlike any other dental specialty in that it covers all aspects of oral health care for children such as restorative care (including endodontic treatment and prosthetics), minor oral surgery procedures, and interceptive orthodontics. Paediatric dentists also work closely with paediatricians, surgeons and anaesthetists as part of a team in the overall care of children with complex medical problems. In addition they may work with other agencies such as health visitors and social workers in managing vulnerable children.

Treatment for children can be carried out under local anaesthetic using a range of behaviour management skills. Sometimes it is necessary, because of medical or behavioural problems, to treat children using conscious sedation or general anaesthesia.

Child neglect has a significant impact on children’s physical and emotional health and development with lifelong consequences. Dental decay can lead to maxillofacial space infections which can have life-threatening complications and may indicate that a child has suffered dental neglect.

Dietary patterns from 6 to 24 months of age are strongly influenced by mothers and other primary caregivers. These patterns such as the Guidelines dietary pattern have been associated with childhood and adolescent intelligent quotient and obesity respectively. The Guidelines dietary pattern corresponds most closely to current established weaning guidelines recommended by the World Health Organization.

The Guidelines dietary pattern is characterized by high consumption of rice porridge, fish and meat, fresh fruit, and vegetables as core food items throughout the 6 to 12 months period17. Dietary patterns, a representation of the overall food intake pattern, may be associated with the risk of developing caries, although there are currently no known studies that have examined the relationship between dietary patterns and examining their impact on early childhood caries (ECC).

Currently, the management of dental caries involves preventive and non-preventive treatment methods. While non-preventive caries management involves stopping or slowing the disease progress by mechanical caries removal and restoration of decayed tooth structure, preventive caries protocols, on the other hand, are implemented to prevent the onset of caries and protect the teeth from the conditions that favor the harmful impacts of oral biofilm. These protocols include nutritional counseling, fluoride use, oral hygiene instructions, topical antimicrobial agents, and the use of sugar alcohol sweeteners such as xylitol. In addressing carious lesions, prevention by routine dental visits, oral hygiene, and nutritional counseling resulted in a reduced number of non-preventive dental visits.

Topical fluorides, such as NaF varnish, are used as preventive reagents because of their remineralization and antimicrobial abilities.

Early diagnosis and successful treatment of developing carious lesions or malocclusions can be beneficial for establishing harmonious occlusion, function and esthetics. If arch integrity is disturbed by the loss of primary teeth, problems like supra-eruption of opposing tooth or mesial/distal tipping or drifting of neighboring tooth can affect the alignment of the permanent dentition. This consequently can result in space loss, blocked out permanent teeth, unattractive appearance, food impaction, altered occlusion , increased caries and periodontal disease in permanent dentition.

Ignored proximal caries can lead to the altered mesiodistal dimension of deciduous teeth again causing mesial/distal tipping of adjacent tooth leading to space loss and malocclusion. Hence, the guidance of eruption, development, and maintenance of primary and mixed dentition is an integral component of comprehensive oral health care which contributes to the development of stable, functional and aesthetically acceptable permanent dentition.

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