Week 5 PP

Question 1

What is Pediatric Dentistry?

Answer 1

Is the specialized area of dentistry that focuses on providing oral healthcare according to the needs of infants, children, adolescents , and individuals with special needs

• pediatric patients require special adaptations and techniques in the way dental treatment is provided

Question 2

Education Requirments for Pediatric Dentist?

Answer 2

A pediatric dentist will continue his or her education for an additional 2 to 3
years after dental school
◦ The program of study and hands-on experience prepares the specialist to meet the needs of infants, children,
adolescents, and persons with special healthcare needs

Question 3

The Pediatric Dental Assistant

Answer 3

• Pediatric dentistry provides a clinical practice environment where you will have an active role in
  the patient’s dental care
• Many pediatric dental offices employ the certified dental assistant to provide dental procedures (polishing, sealants & impressions)
• Understand behavioral issues
• Must like kids! ☺

Question 4

The Pediatric Dental Office

Answer 4

-Display cheerfulness in a pleasant environment with a non-threatending decor
-treatment areas are designed with an open-bay concept in mind
-some offices have a quiet room which is a closed space
-dental personnel dress in bright, coordinating colours

Question 5

What is Chronological age?

Answer 5

Child’s actual age in terms of years and months

Question 6

What is Mental Age?

Answer 6

Child’s level of intellectual capacity and development

Question 7

What is Emotional Age?

Answer 7

Child’s level of emotional maturity

Question 8

Erickson’s Stages of Development

Answer 8

-Psychiatrist determined that the socialization process consists of stages. These stages were formulated to understand the social and emotional development of children & teens. These stages can be used as guides to determine the anticipated behavior of the child and a certain age

*children who differ widely from these norms may be diagnosed as physically and emotionally challenged

Question 9

Erikson’s Stages of Development: 0-12 months

Answer 9

Learning Basic Trust
- this is the period of infancy through the first year of life
-the child is well handled, nutured, and loved and develops trust and security and basic optimism

Question 10

Erikson’s Stages of Development: 1-2 years old

Answer 10

Learning Autonomy
* During this period, children learn to sit, stand, walk, and run
* Vocally, they progress from babbling to using simple sentences
* Socially, they learn to identify familiar faces and alternate through periods of being friendly and being fearful of strangers
* Around the age of 2 years old, children begin to have basic fears associated with separation from the parent and a related fear of strangers

Question 11

Erikson’s Stages of Development: 3-5 years old

Answer 11

Play Age
* The child needs to be allowed to develop autonomy and initiative
* The child requires control and structure in his or her environment
* The child is able to follow simple instructions
* The child welcomes an active role in the treatment experience

Question 12

Erikson’s Stages of Development: 6-11 years old

Answer 12

School Age
* Social skills are developed, conflict experienced
* Learning rules and guidelines
* Children learn to overcome fears of objects and situations that were once quite frightening to them.

Question 13

Erikson’s Stages of Development: 12-20 years old

Answer 13

Adolescence
* Young person acquires self-certainty
* They experiment with different roles
* Clear sexual identity is established
* The adolescent will seek leadership and gradually develop a set of ideals

Question 14

Behaviour Management

Answer 14

• The initial examination is important for both the child and the dental team
  -Often the first dental experience for the child
  -The rapport developed during the initial examination can establish and attitude toward dental health that will last for a child’s lifetime
  -Many dentists willl follow a behavior scale early in the treatment of pediatric patient

Question 15

Frankl Scale for Behavior

Answer 15

2 - Negative - Relectance to accept treatment; uncooperative; some evidence of negative attitude but not pronounced, that is, no sudden withdrawal

Rating #1 - Definitely Negative - refusal of treatment, crying forcefully, fearful, other evidence of extreme negativism

Question 16

Guidlines for Child Behaviour

Answer 16

-Be honest with the child
-Use Child Languages
-Consider the child’s POV
-Use “tell, show, do” ***
-Give positive reinforcement

Question 17

How to Manage the Challenging Pedo Patient

Answer 17

-Treating an anxious, fearful or uncooperative child can be challenging, and occasionally a child’s behavior requires a “firmer management style”

-Voice Control - speaking calmly but firmly
-Sedation - this is prescribed to calm the patient and put him or her at ease before treatment
-Nitrous oxide-oxygen - this method of mild sedation can help calm a patient for treatmet
-Physical restraint - restraints are used to prevent injury to the child and dental team

Question 18

What is a Papoose Board?

Answer 18

looks like a straight jacket attached to a board - put on dental chair *slide 18

Question 19

Patients with Disabilities

Answer 19

a pediatric dental environment better suits a patient with special needs. Evaluation of a medical/dental history will help to disclose whether modifications to treatment are required. Depending on the severity some patient’s treatment is provided in a hospital setting

Question 20

Intellectual Disability - 4 categories

Answer 20

Characterized by limitations in intelligence and adaptive skills. Patients are typically classified into 4 categories: mild, moderate, severe & profound

Question 21

Mild Intellectual Disability

Answer 21

minimize distractions, use positive reinforcement, use simple short explanations, give verbal praise

Question 22

Moderate Intellectual Disability

Answer 22

usually cannot live alone. Will require special care during dental treatment such as premedication, restraints or general anesthesia

Question 23

Severe Intellectual Disability

Answer 23

ususally have poor motor development and lack communication. will require general anesthesia

Question 24

Profound Intellectual Disability

Answer 24

have minimal capacity for sensorimotor function. Need constant aid and supervision. Require special dental care in an institutional setting

Question 25

Patients with Down Syndrome

Answer 25

Down syndrome patients usually have a mild moderate intellectual disability, reduced muscle tone, heart problems and anomalies in dental development such as: ◦ eruption of teeth may be delayed ◦ teeth can be peg shaped ◦ Malocclusion present ◦ Periodontal problems ◦ Typically mouth breathers ◦ Forward position of the mandible and underdeveloped nasal and maxillary bones do not provide enough space for the tongue

Question 26

What is Autism?

Answer 26

Development disorder that affects how information is processed in the brain by altering how nerve cells and their synapses connect & organize.

Question 27

How Autistic behavioural problems can be managed?

Answer 27

◦ Positive reinforcement ◦ Behavior modification ◦ Desensitization ◦ Sedation, restraint or even general anesthesia may be necessary These patients are usually on psychotropic medications which cause xerostomia

Question 28

What is Cerebral Palsy?

Answer 28

Neural disorders caused by prenatal or postnatal brain damage before the central nervous system has reached maturity. Typically characterized by: ◦ Paralysis ◦ Muscle weakness ◦ Lack of coordination ◦ Disorders of motor function ◦ Seizure disorders ◦ Intellectual disability ◦ Sensory and learning disorders

Question 29

What management is typically required for patient with cerebral palsy?

Answer 29

Premedication is frequently required to help conrol and relax the patient. For some patient's general anesthesia may be necessary

Question 30

When is the 1st dental appointment for a child recommended?

Answer 30

It is recommended that a child's first dental visit is once their first tooth errupts, with regular visits occuring at age 2.

Question 31

Specific information noted on Pediatric Medical History

Answer 31

- past hospitalizations and procedures under general -physician visits and current treatment -medications (daily & in the past) -medication reactions -allergies -birth problems and weight at birth -level of learning

Question 32

Specific information noted on Pediatric Dental History

Answer 32

-Primary concern -satisfaction with appearance of teeth -bleeding gums -finger, thumb, pacifier habbits -fluoride and brushing habbits -inheritied family dental characteristics

Question 33

How often is radiographic imaging recommened for children?

Answer 33

Due to children's mouths growing more rapidly they can be more susceptible to decay. It is recommended that radiographs are taken every 6 months.

Question 34

Tips for taking pediatric xrays

Answer 34

-use words such as camera and taking a picture -use appropriately sized film -expose easiest films first -use show-tell-do technique

Question 35

Instruments and Materials Associated with Pediatric Dentistry

Answer 35

* Smaller size dental frame * Smaller dental chairs * Pedo tofflemire retainer and band * Smaller nitrous mask * Colored fillings * Fold the bib in half to make it smaller * Remove head rest if regular dental chair is used