Paediatric Dentistry for the General Dental Practitioner (BDJ Clinician’s Guides)

✍ Scribed by Sondos Albadri (editor), Claire L. Stevens (editor)

• Publisher: Springer
• Year: 2021
• Tongue: English
• Leaves: 325
• Category: Library

✦ Synopsis

This book is a practical, comprehensive guide to the management of children and adolescents in general dental practice. A logical, evidence-based approach to oral health is adopted throughout. The commonly encountered oral and dental problems and their diagnosis and treatment are covered in detail, with particular attention to dental caries, dental trauma, developmental anomalies, periodontal problems, and soft tissue conditions. Up-to-date guidance is provided on history taking, dental examination, preventive strategies and advanced behaviour management. In addition the relevance of common medical conditions to dental management is discussed. The book is divided into four sections, each of which focusses on a specific age group, helping the reader to relate clinical issues to the different dental developmental stages. The readily understandable text is supported by many informative colour illustrations and diagrams.

✦ Table of Contents

Contents
Part I: The Early Years
1: Introducing the Paediatric Patient to the Dental Surgery
1.1 History Taking
1.1.1 Introduction to History Taking
1.1.2 Child Friendly Environments and First Impressions
1.1.3 Patient and Family Details
1.1.4 Presenting Complaint
1.1.5 Medical History
1.1.6 Dental History
1.1.7 Family and Social History
1.2 Dental Examination
1.2.1 Extra-Oral Examination
1.2.1.1 General Examination
1.2.1.2 Height, Weight and Body Mass Index
1.2.1.3 Examination of the Facial Tissues
1.2.1.4 Temporomandibular Joint (TMJ)
1.2.1.5 Lymph Nodes and Major Salivary Glands
1.2.1.6 Intraoral Examination
1.2.1.7 Examination of the Oral Mucosa
1.2.1.8 Examination of the Periodontal Tissues
1.2.1.9 Examination of the Teeth
1.2.1.10 Examination of the Occlusion
1.2.1.11 Radiographic Examination
1.2.1.12 Examination of the Young Child Aged 0–3 Years
1.2.1.13 Risk Assessment
1.2.1.14 Dental Check by One
1.3 Management of the Family
1.3.1 What Constitutes Valid Consent?
1.3.2 Consent for a Child and Young Person
1.3.3 Consenting a Child Under the Age of 16
1.3.4 Who Can Consent for a Child?
1.3.5 Who Is Unable to Consent for a Child?
1.3.6 Obtaining Consent for Emergency Treatment
1.3.7 Refusal to Consent
1.3.8 Consent for Research Purposes
1.3.9 Parent In or Out of the Surgery
Further Reading
2: Growth and Development in Relation to Paediatric Dentistry
2.1 General Growth
2.2 Tooth Development
2.3 Cognitive Development
2.4 Clinical Oral Examination
2.5 Developmental Conditions Seen in Young Children
2.6 Summary
3: Prevention and Interventions in Oral Health Care in Children
3.1 Early Childhood Caries
3.1.1 Definition and Aetiology
3.1.2 Detection and Diagnosis
3.1.3 Management: Prevention, Remineralisation and Arrest
3.1.3.1 Dietary Intake
3.1.3.2 Oral Hygiene Practices
3.1.3.3 Access to Fluoride
3.1.3.4 Fissure Sealants
3.1.3.5 Routine Dental Examination
3.1.3.6 Secondary Prevention
3.1.4 Management: Operative Interventions Including Extractions
3.2 Soft Tissue Pathology
3.2.1 Viral
3.2.1.1 Primary Herpetic Gingivostomatitis
3.2.1.2 Mumps
3.2.1.3 Measles
3.2.1.4 Hand Foot and Mouth Disease
3.2.1.5 Papilloma
3.2.2 Bacterial
3.2.3 Fungal
3.2.4 Developmental
3.2.4.1 Bohn’s Nodules and Epstein Pearls
3.2.4.2 Eruption Cysts
3.2.4.3 Congenital Epulis
3.2.4.4 Haemangioma
3.2.4.5 Other Developmental Cysts
3.2.5 Ulcers
3.2.6 Other Soft Tissue Conditions
3.3 Hard Tissue Pathology Mainly Developmental
3.3.1 Tooth Number
3.3.1.1 Hypodontia
3.3.1.2 Supernumerary Teeth
3.3.1.3 Gemination/Fusion
3.3.2 Tooth Structure
3.3.2.1 Developmental Defects of Enamel
3.3.2.2 Developmental Defects of Dentine
3.3.2.3 Abnormal Morphology
3.3.3 Eruption
3.3.3.1 Neonatal and Natal Teeth
3.3.3.2 Delayed Eruption
3.3.3.3 Premature Exfoliation
3.3.4 Bony Pathology
Further Reading
Part II: The Young Child
4: Behaviour Management for Dental Procedures in the Paediatric Patient
4.1 Dental Fear and Anxiety Assessment
4.1.1 Age and Development
4.1.2 Anxiety Levels
4.1.3 Aetiology of Dental Fear and Anxiety
4.1.4 Coping Styles
4.2 Non-pharmacological Behaviour Management
4.2.1 Tell-Show-Do
4.2.2 Enhancing Control
4.2.3 Voice Control
4.2.4 Modelling
4.2.5 Behaviour Shaping and Positive Reinforcement
4.2.6 Distraction
4.2.7 Guided Imagery
4.2.8 Systematic Desensitisation
4.2.9 Negative Reinforcement
4.2.10 Magic Trick
4.2.11 Hypnosis
4.2.12 Motivational Interviewing
4.2.13 Cognitive Behavioural Therapy
4.3 Pharmacological Behaviour Management
4.3.1 Definition of Conscious Sedation
4.3.2 Inhalation Sedation (IHS)
4.3.3 Intravenous Sedation (IVS)
4.3.4 General Anaesthesia
4.3.4.1 Description
4.3.4.2 Indications
4.3.4.3 Contraindications
4.4 Problem Based Scenarios
4.4.1 Mild–Moderate DFA in 9-year-old
4.4.2 Moderate–Severe DFA in a 13-Year-Old
4.4.3 Mild–Moderate DFA in a 6-Year-Old
Further Reading
5: Management of Dental Caries in Primary Teeth
5.1 Risk Assessment and Prevention
5.1.1 Risk Assessment
5.1.1.1 Caries Risk Assessment
5.1.2 Prevention
5.1.2.1 Fluoride
Oral Hygiene Practices
Professionally-Delivered Fluoride Interventions
5.1.3 Dietary Advice
5.1.4 Fissure Sealants
5.2 Treatment Planning and Caries Management for Children in the Primary Dentition
5.2.1 Principles of Treatment Planning
5.2.2 To Restore, or Not to Restore?
5.2.3 Choice of Restorative Material
5.2.4 Preformed Metal Crowns
5.2.4.1 Acceptability of PMCs
5.2.5 Pulp Therapy
5.2.5.1 Indirect Pulp Cap
5.2.5.2 Direct Pulp Cap
5.2.5.3 Pulpotomy
5.2.5.4 Pulpectomy
5.2.6 Extraction of Primary Teeth
Further Reading
6: Dento-Alveolar Trauma in the Primary Dentition
6.1 Incidence and Presentation
6.2 History and Examination
6.2.1 Taking a History: Questions to Ask
6.2.2 Extraoral Examination
6.2.3 Intraoral Examination
6.2.4 Special Investigations
6.2.5 Trauma Chart
6.2.5.1 Medical Concerns
6.3 Fracture Injuries
6.4 Luxation Injuries
6.5 Prognosis
6.5.1 Complications of Traumatic Injury to the Primary Teeth
6.5.2 Prevention and Limitation of Complications Affecting Permanent Successors
6.5.3 Interesting Cases
6.5.3.1 Case 1
6.5.3.2 Case 2
6.5.3.3 Case 3
Further Reading
7: Safeguarding for the Paediatric Patient
7.1 Definitions Within Safeguarding
7.2 General and Dental Neglect
7.2.1 Dental Neglect
7.2.2 Long-Term Effects
7.2.3 Interaction with Rest of ‘My World’
7.3 The Dentists Role in the Management of Dental Neglect
7.4 Aetiology of Child Physical Abuse
7.5 Signs of Child Physical Abuse
7.6 Diagnosis of Child Physical Abuse
7.7 Types of Orofacial Injuries in Physical Child Abuse
7.7.1 Bruising, Abrasions and Lacerations
7.7.2 Burns
7.7.3 Bite-Marks
7.7.4 Dental Trauma and Facial Fractures
7.8 Differential Diagnosis
7.9 The Dentists Role in Safeguarding
7.10 Policy and Procedure
7.10.1 When You Have Concerns About a CYP
7.10.2 Skills Needed in Making the Decision to Refer
7.10.3 How Do I Make a Child Protection Referral?
7.10.3.1 What Happens After You Refer?
7.11 Case Scenarios
7.11.1 Results of an Unmet Treatment Need
7.11.1.1 Learning Points
7.11.2 Family with Well Looked After Baby
7.11.2.1 Learning Points
7.11.2.2 Outcome
7.11.3 Teenager (Expose and Bond)
7.11.3.1 Background/Results of Investigation
7.11.3.2 Learning Points
7.11.3.3 Outcome
7.11.4 Hidden Trauma
7.11.4.1 Learning Points
Further Reading
Part III: Older Children and Young People
8: Medical Conditions in Paediatric Dentistry
8.1 Respiratory Disorders
8.1.1 Asthma
8.1.1.1 Definition
8.1.1.2 Features and Medical Management
8.1.1.3 Dental Implications of Asthma
8.1.1.4 When to Refer
Severely Atopic Child
8.1.2 Cystic Fibrosis
8.1.2.1 Definition
8.1.2.2 Features and Medical Management
8.1.2.3 Dental Implications of Cystic Fibrosis
8.1.2.4 When to Refer
8.2 Cardiovascular Disorders
8.2.1 Introduction
8.2.2 Congenital Heart Disease
8.2.2.1 Prevalence
8.2.2.2 Aetiology
8.2.2.3 Features and Medical Management
8.2.2.4 Dental Implications of CHD
8.2.3 Bacterial Endocarditis
8.2.3.1 Dental Management for Patients with CHD
History Taking
Active Treatment
8.2.3.2 When to Refer
8.3 Bleeding Disorders
8.3.1 Introduction and Classification
8.3.2 Tests and Diagnosis
8.3.3 Coagulation Factor Deficiencies
8.3.4 Preventative Treatment
8.3.5 Haemophilia A
8.3.5.1 Definition
8.3.5.2 Features and Medical Management
8.3.5.3 Signs and Symptoms
8.3.5.4 Medical Management
8.3.6 Haemophilia B
8.3.6.1 Definition
8.3.6.2 Features and Medical Management
8.3.7 von Willebrand’s Disease
8.3.7.1 Definition
8.3.7.2 Signs and Symptoms
8.3.7.3 Features and Medical Management
8.3.8 Platelet Disorders
8.3.8.1 Aetiology
8.3.8.2 Signs and Symptoms
8.3.8.3 Medical Management
8.3.8.4 Challenges and Implications for the Dental Team
8.3.8.5 Dental Implications
8.3.8.6 Dental Management for Patients with Bleeding Disorders
History Taking
Active Dental Treatment
8.3.8.7 When to Refer
8.4 Oncology
8.4.1 Introduction
8.4.2 Leukaemia
8.4.2.1 What Are the Signs and Symptoms of Leukaemia?
8.4.2.2 How Is Leukaemia Treated?
8.4.3 Solid Tumours in Childhood
8.4.3.1 What Are the Signs and Symptoms of Solid Tumours?
8.4.3.2 How Are Solid Tumours Treated?
8.4.3.3 Dental Implications for Children with a Diagnosis of Cancer
8.4.3.4 Implications for the Dental Team
8.4.3.5 Dental Management for Oncology Patients
8.4.3.6 Pretreatment Oral Examination
8.4.3.7 Prevention
8.4.3.8 Active Treatment
8.4.4 Oral Complications Related to Cancer Treatment
8.4.4.1 Oral Mucositis
8.4.4.2 Oral Infections
8.4.4.3 Neuropathic Pain
8.4.4.4 Xerostomia
8.4.4.5 Lip Care
8.4.5 Oral Concerns Related to Stem Cell Transplants
8.4.6 Oral Challenges Faced by Long-Term Cancer Survivors
8.4.7 When to Refer
8.5 Endocrinopathies and Metabolic Disorders
8.5.1 Diabetes Mellitus
8.5.1.1 Definition
8.5.1.2 Features and Medical Management
8.5.1.3 Dental Implications of Diabetes Mellitus
8.5.1.4 When to Refer
8.5.2 Adrenal Disorders
8.5.2.1 Congenital Adrenal Hyperplasia
Definition
Features and Medical Management
Primary Adrenal Insufficiency (Addison’s Disease)
Features and Medical Management
8.5.2.2 Cushing Syndrome
Features and Medical Management
Dental Implications of Adrenal Disorders
8.5.2.3 When to Refer
8.6 Renal Disorders
8.6.1 Nephrotic Syndrome
8.6.1.1 Features and Medical Management of Nephrotic Syndrome
Steroid-Sensitive Nephrotic Syndrome (SSNS)
Steroid-Resistant Nephrotic Syndrome (SRNS)
8.6.2 Henoch–Schonlein Purpura (HSP)
8.6.3 Chronic Kidney Disease (CKD)
8.7 Management of Children with Developmental Disabilities
8.7.1 Introduction
8.7.2 Mental Capabilities
8.7.3 Behavioural Problems (Attention Deficit Hyperactivity Disorder (ADHD) and Autistic Spectrum Disorder (ASD))
8.7.3.1 ADHD
8.7.3.2 Dental Considerations and Management
8.7.3.3 Autistic Spectrum Disorder (ASD)
8.7.3.4 Dental Considerations and Management
8.7.4 Mobility Problems
8.7.5 Neuromuscular Problems (Uncontrolled Body Movements) and Seizures
8.7.5.1 Cerebral Palsy
8.7.5.2 Dental Considerations and Management
8.7.5.3 Epilepsy
8.7.5.4 Dental Considerations and Management
8.7.6 Visual and/or Hearing Problems
8.7.6.1 Oral Health Problems and Strategies for Care
8.8 Cleft Lip and Palate (CLP)
8.8.1 Definition
8.8.2 Features and Medical Management
8.8.3 Dental Implications of Orofacial Clefting
8.8.4 When to Refer
8.9 Summary
Further Reading
Bleeding Disorders
Oncology
Endocrine Disorders
Renal
Disability
Orofacial Clefting Disorders
9: Tooth Eruption and Common Disturbances
9.1 Introduction
9.2 Dental Development and Eruption of Permanent Teeth
9.3 Identifying Abnormal Development
9.3.1 Clinical Examination
9.3.2 Radiographic Examination
9.4 Ectopic Eruption
9.4.1 Eruption of Maxillary Central Incisors
9.4.1.1 Management
9.4.2 Assessment of Ectopic Canines
9.4.2.1 Management
9.4.3 Ectopic Eruption of First Permanent Molars
9.5 Common Occlusal Anomalies
9.5.1 Infraocclusion of Primary Molars
9.5.2 Crossbites
9.6 Summary
Further Reading
10: Management of Dental Caries in the Young Permanent Teeth
10.1 Introduction
10.2 Caries Risk Assessment
10.2.1 Risk Predictors
10.3 Prevention Strategies
10.3.1 Oral Hygiene
10.3.2 Diet
10.3.3 Behaviour Change
10.3.4 Fluoride
10.3.5 Fissure Sealants
10.4 Assessment and Treatment Planning
10.4.1 Staged Approach to Delivery of Treatment
10.5 Restorations Versus Extractions of First Permanent Molars
10.6 Minimal Intervention
10.6.1 Fissure Sealants for Early Occlusal Enamel Lesions
10.6.2 Preventive Resin Restoration
10.6.3 Selective Caries Removal
10.6.4 Stepwise Caries Removal
10.6.5 Endodontic Therapies in Permanent Teeth
10.6.6 Restorative Materials
Further Reading
11: Dentoalveolar Trauma in the Permanent Dentition
11.1 Incidence and Prevention
11.1.1 Prevention
11.2 History and Examination
11.2.1 Overview
11.2.2 History
11.2.2.1 General
11.2.2.2 Dental
11.2.2.3 Medical
11.2.3 Examination
11.2.3.1 Overall Patient Assessment
11.2.3.2 Maxillofacial Assessment
11.2.3.3 Dentoalveolar Assessment
11.2.3.4 Sensibility Testing
Why?
What?
How?
11.2.4 Radiography
11.3 Trauma Management Considerations
11.3.1 Protect the Dentine-Pulp Complex
11.3.2 Vital Pulp Therapy for the Traumatically Exposed Pulp
11.3.3 Reposition or Replant Permanent Teeth
11.4 Management of Fracture Injuries
11.5 Management of Luxation Injuries
11.6 Management of Avulsion Injuries
11.6.1 First-Aid Management for an Avulsion Injury
11.6.2 Antibiotics
11.6.3 Avulsion Management: The Evidence Behind the Guidelines
11.7 Follow-Up and Long-Term Prognosis
11.7.1 Pulpal Necrosis
11.7.2 Resorption
11.7.3 Pulp Canal Obliteration
11.8 Managing Trauma in the ‘New-Normal’ Dental Environment
Further Reading
12: Periodontal Conditions in Children and Young People
12.1 Introduction: Do Children and Young People Develop Periodontal Disease?
12.2 Clinical Health and Gingivitis
12.3 Forms of Periodontitis
12.4 Screening for Periodontal Disease: The Simplified Basic Periodontal Examination (BPE)
12.5 Referring to the Specialist
12.5.1 When to Refer?
12.6 Case Based Discussions
12.7 Summary
Further Reading
13: Dental Anomalies
13.1 Number Anomalies
13.1.1 Hypodontia
13.1.1.1 Ectodermal Dysplasia
13.1.2 Supernumerary Teeth
13.1.2.1 Features
13.2 Shape Anomalies
13.2.1 Dens Evaginatus
13.2.2 Dens Invaginatus
13.2.3 Size
13.2.3.1 Microdontia
13.2.3.2 Macrodontia
13.2.3.3 Double Teeth
13.3 Enamel Abnormalities
13.3.1 Localised and Chronological Enamel Defects
13.3.2 Molar Incisor Hypomineralisation (MIH)
13.3.2.1 Features
13.3.3 Fluorosis
13.3.4 Amelogenesis Imperfecta
13.3.4.1 Features
13.4 Dentine Abnormalities
13.4.1 Dentinogenesis Imperfecta
13.4.2 Dentinal Dysplasia
13.5 Summary
Further Reading
14: Tooth Wear in Children and Young People
14.1 Tooth Wear
14.2 Prevalence
14.3 Aetiology
14.4 Presentation and Diagnosis
14.5 Prevention
14.5.1 Diet
14.5.2 Toothbrushing
14.5.3 Fluoride
14.5.4 Splint for Attrition
14.6 Management
14.6.1 Primary Dentition
14.6.2 Mixed Dentition
14.6.3 Permanent Dentition
14.7 Monitoring
14.8 Summary
Further Reading
15: Common Soft Tissue and Hard Tissue Lesions in Children and Young People
15.1 Surgical Sieve
15.1.1 Pathology of Soft Tissues
15.1.2 Ulcers
15.1.3 Traumatic Ulcers
15.1.4 Recurrent Mouth Ulcers
15.1.5 Recurrent Aphthous Stomatitis (RAS)
15.1.6 Behcet’s Disease
15.1.7 Oral Ulceration Due to Systemic Disease
15.1.8 Orofacial Granulomatosis (OFG)
15.1.9 Erythema Multiforme
15.1.10 Malignancies
15.1.11 Vesiculobullous Disorders
15.1.12 White Lesions
15.1.12.1 White Patches
15.1.13 Geographic Tongue
15.1.14 Pigmentary Disorders
15.1.15 Vascular Lesions
15.1.16 Benign Soft Tissue Enlargements
15.1.17 Infective Lesions
15.1.18 Fungal Infections
15.2 Salivary Gland
15.2.1 Salivary Gland Disease
15.2.1.1 Cysts
15.2.1.2 Mucocele
15.2.1.3 Ranula
15.2.1.4 Plunging Ranula
15.2.1.5 Sialadenitis
15.2.2 Salivary Gland Tumours
15.2.3 Radiographic Pathology
15.2.4 Periapical Radiolucencies
15.2.5 Radiolucencies Associated with Crowns of Teeth
15.2.6 Multiple/Multilocular Radiolucencies
15.2.7 Single Radiolucencies Which Are Not Associated with Teeth
15.2.8 Generalised Bony Rarefactions (Reduction in Density)
15.2.9 Lesions of Mixed Radio-Opacities and Radiolucencies
15.2.10 Radiopacities
Further Reading