Pediatric dentistry update

PEDIATRIC DENTISTRY UPDATE

By / DR Ali Abdel Fattah Pedodontist

THE DENTAL HOMETHE DENTAL HOME WAS

ESTABLISHED AS “AAPD POLICY IN 2003, AND IS BASED ON THE SAME CONCEPT AS THE AMERICAN ACADEMY OF PEDIATRICS POLICY STATEMENT DEFINING THE MEDICAL HOME IN 1992.

THE DENTAL HOME “The dental home is the ‘ongoing

relationship between the dentist and the patient, inclusive of all aspects of oral health care delivered in a comprehensive, continuously accessible, coordinated, and family-centered way. Establishment of a dental home begins no later than 12 months of age and includes referral to dental specialists when appropriate (AAPD Definition)

Early Childhood Caries_4.mp4

The Dental Home Provides…

a. Comprehensive oral health care including

“acute care” and preventive services

in accordance with AAPD periodicity

schedules.b. Comprehensive assessment for oral

diseases and conditions.


c. “Individualized “ preventive dental health program based upon a caries-risk assessment and a periodontal disease risk assessment.

d. Anticipatory guidance about growth

and development issues,

(ie, teething, digit or pacifier

habits).


e. Plan for acute dental trauma.f. Information about proper care of the

child’s teeth and gingivae. This would include prevention, diagnosis, and treatment of disease of the supporting and surrounding tissues and the maintenance of health, function, and esthetics of those structures and tissues.

Why Brush Teeth in” Day Care Centers”?

• Develop good habits

• Children may not brush at home

• Children learn basic hygiene principals

MINIMALLY INVASIVE TECHNIQUES

Minimally invasive techniques today utilize microscope , imaging systems , lasers, air abrasion Prevention protocols can keep the patient disease free indefinitely

Minimal Intervention Dentistry

- Modern approach to the treatment

of tooth decay- Based on “Medical Model” of caries management

The Intervention approach Minimal

A medical model; Caries treated as a biological

infection Surgical techniques are minor and

stress retention of tooth tissue.

Details of the MI approach

- (1) Reduces cariogenic bacteria; - (2) Uses preventive measures;- (3) Early lesions remineralised;- (4) Minimal surgery on cavities; - (5) Repair of defective restorations.

(1) Cariogenic bacteria

• Caries is a bacterial disease;

• Depends on dietary sucrose;• Driven by frequency of eating;• Modified by saliva.

(2) Preventive measures

• Topical fluoride

• Fissure sealants• Patient education on oral hygiene

(3) Remineralisation

• Requires management by non-intervention;

• Enhanced by fluoride ion in saliva.

(4) Minimal surgery

Requires adhesive materials (glass-ionomers, adhesive composite systems);

Possibly without drilling (ART technique).

(5) Repair of materials

• To prevent cavity extension;

• Not “botch job”, but appropriate.

The challenge for materials

Adhesion– Occurs naturally for glass-ionomers; problematic for

composites. Fluoride-release;• Release of other mineralising ions

( PO4, Ca2+ ) Repairable.

Conclusions

• Minimal Intervention dentistry is the future:– Advocated by FDI;

– Cost effective;– Less trauma for the patient.

• A biological approach, not a mechanical one.

• Makes significant demands on materials.

I R T I R T UTILIZES SIMILAR TECHINQUES Like A R

T BUT HAS DIFFERENT THERAPEUTIC GOALS ( ART: REMOVAL OF CARIES USING HAND OR SLOW SPEED ROTARY INSTRUMENT & THEN RESTORE THEM

WITH AN ADHESIVE RESTORATIVE MATERIAL e.g G I CEMENT )

THE USE OF ITR HAS BEEN SHOWN to REDUCE THE LEVES OF CARIOGENIC ORAL BACTRIA.

POLISY STATMENTITR may be used to restore &

prevent dental caries in young

pat , uncooperative pat , pat

with special health care needs &

situations in which traditional

cavity prep, &/or placement of

traditional dental restorations are

not feasible .

NuSmile Pediatric Crowns.mp4

Quiet Comfort, also called Air Abrasion. - YouTube.mp4

AIR ABRASIONThis technique uses a stream of purified

aluminium oxide particles that are

forced under pressure through a fine –

focused nozzle onto the tooth surface

Pediatrics Air Abrasion.mp4

Introduction to the Aquacut Quattro(3).mp4

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Health & Medicine

Pediatric dentistry update