Paediatric Dentistry at a Glance Titles in the Dentistry at a Glance Series
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Paediatric Dentistry at a Glance Titles in the dentistry At a Glance series Orthodontics at a Glance Daljit S. Gill 978-1-4051-2788-2 Periodontology at a Glance Valerie Clerehugh, Aradhna Tugnait, Robert J. Genco 978-1-4051-2383-9 Dental Materials at a Glance J. A. von Fraunhofer 978-0-8138-1614-2 Oral Microbiology at a Glance Richard J. Lamont, Howard F. Jenkinson 978-0-8138-2892-3 Implant Dentistry at a Glance Jacques Malet, Francis Mora, Philippe Bouchard 978-1-4443-3744-0 Prosthodontics at a Glance Irfan Ahmad 978-1-4051-7691-0 Paediatric Dentistry at a Glance Monty Duggal, Angus Cameron, Jack Toumba 978-1-4443-3676-4 Paediatric Dentistry at a Glance Monty Duggal BDS, MDS, FDS (Paeds), RCS (Eng), PhD Professor and Head of Paediatric Dentistry Department of Paediatric Dentistry Leeds Dental Institute Leeds UK Angus Cameron BDS, MDSc, FDSRCS (Eng), FRACDS, FICD Head of Department, Paediatric Dentistry and Orthodontics Westmead Hospital and Clinical Associate Professor and Head, Paediatric Dentistry The University of Sydney NSW Australia Jack Toumba BSc (Hons), BChD, MSc, FDS (Paeds), RCS (Eng), PhD Professor of Paediatric and Preventive Dentistry Department of Paediatric Dentistry Leeds Dental Institute Leeds UK A John Wiley & Sons, Ltd., Publication This edition first published 2013 © 2013 by John Wiley & Sons Ltd. 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Library of Congress Cataloging-in-Publication Data Duggal, Monty S. Paediatric dentistry at a glance / Monty Duggal, Angus Cameron, Jack Toumba. â p. ; cm. – (At a glance series) Includes bibliographical references and index. ISBN 978-1-4443-3676-4 (pbk. : alk. paper) I. Cameron, Angus C. II. Toumba, Jack. III. Title. IV. Series: At a glance series (Oxford, England) [DNLM: 1. Dental Care for Children–Handbooks. 2. Child–Handbooks. 3. Tooth Diseases– Handbooks. WU 49] 617.6'45–dc23 2012015790 A catalogue record for this book is available from the British Library. Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books. Cover image: courtesy of the authors Cover design by Meaden Creative Set in 9/11.5 pt Times by Toppan Best-set Premedia Limited 1 2013 Contents Treatment planning, growth and development Dento-alveolar trauma 1 Planning treatment for children 6 27 Assessment of trauma in children 58 2 Growth and development 8 28 Trauma to primary teeth 60 3 Child cognitive and psychological development 10 29 Crown fractures in permanent teeth 62 30 Complicated crown and crown/root fractures 64 Strategies for management of the child patient 31 Non-vital immature teeth 66 4 Behaviour management 12 32 Root fractures 68 5 Aversive conditioning and management of phobia 14 33 Luxations and avulsion 70 6 Local analgesia 16 7 Conscious sedation 18 Paediatric oral medicine and pathology 8 General anaesthesia 20 34 Diagnosis, biopsy and investigation of pathology in children 72 9 Rubber dam 22 35 Differential diagnosis of pathology of the jaws 74 10 Dental radiography 24 36 Management of odontogenic infections in children 76 37 Ulcers and vesiculobullous lesions in children 78 Prevention of caries and erosion 38 Swellings and enlargements of the gingiva 80 11 Preventive care for children 26 39 Oral pathology in the newborn 82 12 Topical fluorides I 28 13 Topical fluorides II 30 Dental and oro-facial anomalies 14 Systemic fluoridation and fluoride toxicity 32 40 Premature loss of primary teeth 84 15 Cariology 34 41 Missing teeth and extra teeth 86 16 Caries risk assessment and detection 36 42 Disorders of tooth shape and size 88 17 Dental erosion 38 43 Enamel disorders 90 44 Disorders of dentine and eruptive defects 92 Restorative management in the primary dentition Management of children with special needs 18 Early childhood caries 40 45 Physical and learning disabilities I 94 19 Strip crowns for primary incisors 42 46 Physical and learning disabilities II 96 20 Plastic restorations in primary molars 44 47 Bleeding disorders 98 21 Pulp therapy 46 48 Thalassaemia and other blood dyscrasias 100 22 Crowns for primary molars 48 49 Children with congenital heart defects 102 23 Management of extensive caries 50 50 Children with cancer 104 51 The diabetic child 106 Management of first permanent molars 52 Kidney and liver disease and organ transplantation 108 24 Preservation of the first permanent molar 52 53 Prescribing drugs for children 110 25 Molar incisor hypomineralisation 54 References 113 Space management Index 115 26 Space maintenance 56 Contents 5 1 Planning treatment for children (a) (a) (a) (b) (b) Figure 1.2 Bitewing radiographs showing extent (b) Figure 1.1 Intra-oral view showing the carious of caries. upper (a) and lower (b) primary molars. Figure 1.3 Intra-oral view showing upper (a) and lower (b) arches at the end of treatment. Table 1.1 Step-by-step plan of the proposed treatment where prevention is carried out alongside restorative care. Visit Treatment Preventative One Examination and treatment Oral hygiene instructions plan Use of adult tooth paste Correspondence with Diet sheet was given (a) (b) paediatrician Figure 1.4 Postoperative radiographs of the treated case. Two Full mouth prophylaxis Reinforce oral hygiene 55 – Fissure sealant instructions 65 – Fissure sealant Collect diet sheet 75 – Fissure sealant Duraphat™ (22 600 ppm F) 85 – Fissure sealant Plaque score Temporisation of 54 and 64 Three 64 – Composite restoration Reinforce oral hygiene measures Diet counselling Duraphat™ (22 600 ppm F) Four 54 – Stainless steel crown Reinforce diet advice Plaque score (a) (b) Duraphat™ (22 600 ppm F) Figure 1.5 Follow-up visit revealed that first permanent molars had erupted Five 74 – Composite restoration Reinforce oral hygiene measures and these were fissure sealed. Paediatric Dentistry at a Glance, First Edition. Monty Duggal, Angus Cameron and Jack Toumba. © 2013 John Wiley & Sons Ltd. Published 2013 by Blackwell Publishing Ltd. 6 Chapter 1 Planning treatment for children General philosophy of the authors Diagnosis should be specific. For example, a diagnosis “dental caries” Dentists who treat children are in a unique position not only to provide in itself is incomplete as it does not specify the reason the child has dental treatment when required, but to influence the future behaviour, dental caries. The root cause of the problem cannot be addressed attitudes to oral health and attitude towards dentistry in general. Chil- unless a specific diagnosis is made. dren deserve the highest quality care and highest quality restorative dentistry should be provided to them, supplemented with rigorous pre- Formulating treatment plan vention. Prevention of dental caries in children should be a priority An example of a treated case and the step-by-step treatment plan is but sadly nearly half of 5-year-olds, even in developed countries, still shown is Figs. 1.1–1.5 and Table 1.1 respectively. When managing develop dental caries. A non-interventionist approach, as has been caries in children this should relate to: advocated in some countries such as the UK, or poor restorative • prognosis of the affected teeth; patchwork dentistry, is doomed to failure and only leads to pain, infec- • child’s behaviour and likely acceptance of the treatment. tion and suffering in children, requiring more invasive interventions. These are traumatic and expensive and negatively influence the child’s Restore or extract future behaviour and attitudes to dentistry. Good restorative and pre- • Extent of caries. Are the teeth restorable? ventive care obviates the need for extraction of primary teeth under • Impact that either option will have not only on developing dentition general anaesthesia, a practice which should have only a small place but child’s long-term well-being. in the dental care of young children. In addition, in a developing child, • When all primary molars are involved, give consideration to restor- the dentist has the task of monitoring the dentition, diagnosis and ing the second and extraction of the first primary molars. management of anomalies as well as having a knowledge of medical Each treatment plan should be tailor-made for the child.