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Developmental defects of the human dentition are not uncommon and can adversely affect the physical and psychological health of children. This paper reviews briefly the most common dental defects that can occur during childhood and discusses in more detail defects of enamel and dentine. Guidelines are provided for clinicians to identify children who deviate from normal dental development in order to provide appropriate interventions or make appropriate referrals.
Children's dentistry can be a challenge for both the patient and the dentist. The way a dentist interacts with the child patient will have a major influence on the success of any clinical or preventive care. In order to deliver high-quality dentistry to a child whilst also developing a positive attitude towards dental health, the dentist should have a good understanding of the factors that might affect the behaviour of children in the dental setting. A working knowledge of strategies to minimize anxiety and make positive behaviour more likely is essential, as is a grasp of how best to deal with anxiety or negative behaviour.
Aesthetic problems in childhood and adolescence can have a significant effect on psychosocial development and interaction with peers. Abnormalities of shape, size, colour and structure of the whole or part of the anterior dentition of children can lead to such problems. This article outlines the most appropriate options for the clinical management of different aetiological categories of aesthetic problems, and develops a hierarchy of intervention that should be pursued in a logical order until a satisfactory cosmetic outcome is achieved. These techniques are readily available to most dental practitioners and there is no reason for a child to have to wait until late adolescence for treatment.
In the fourth article in this series the techniques for carrying out pulp therapy and stainless steel restoration in primary molars are discussed. Early pulp involvement in primary molars means that pulp therapy and the use of appropriate coronal restoration, such as stainless steel crowns, are indispensable if repetitive restoration of primary molars is to be avoided. These techniques themselves are not difficult to carry out once the child's co-operation is established and should be well within the capability of any dentist with an interest in the dental care of children.
Prevention of caries underpins all dental care provided to children. This paper reviews the scientific basis of current techniques for dental prevention. It provides guidelines for the identification of children who are at high and low risk and considers the most appropriate preventive strategies for these children.
For several years it has been recommended that aspirin should be avoided in children under the age of 12 years because of the risk of Reye's Syndrome. In this study we investigated the reported use of analgesics among children who attended the Children's Department of the Dental Hospital in Newcastle upon Tyne. In addition the study also investigated the complaints that led to use of analgesics, the dose and frequency of administration of the analgesic, and past and current contact with medical services. Of 179 children investigated, 129 were under 12 years-old; of these 129 children under 12 years-of-age, 72 (56%) had taken an analgesic within the previous six months, 12 (17%) of whom took aspirin. Three of these children who had taken aspirin were reported to have had a serious illness in their lives, and would therefore have had significant contact with medical services. One-quarter of all children who had taken an analgesic did so for toothache. Inappropriate use of aspirin in children under 12 years-of-age indicates that health education about the possible risks of Reye's Syndrome needs to be improved.
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AIM: The scope of the present study has been the analysis of the main psychological approaches used during a first dental visit of a child to gain the necessary collaboration, focusing on the influence of parental presence during the visit. METHODS: The study was conducted on a group of 200 children divided into two sub-groups. In Group I the child was seen without the parent's presence and in Group II the parent was present throughout the visit. Assessment of behaviour was by a simple 'co-operative' or 'non-cooperative' in achieving a dental examination and prophylaxis. Statistical analysis was made by chi square and Fisher's exact test. RESULTS: In Group I (parent out) 89% of children were fully co-operative compared with 63% in Group II (parent present) which was significantly different (chi square 18.503, p<0.001). In addition 8% of children in Group II failed to return for any further dental care compared with 1% in Group I, which was also significantly different (Fisher's exact test p=0.1231). CONCLUSION: Parental presence affects a child's behaviour on an initial dental visit, which is better when the parent is excluded.
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Aesthetic problems in childhood and adolescence can have a significant effect on psychosocial development and interaction with peers. Abnormalities of shape, size, colour and structure of the whole or part of the anterior dentition of children can lead to such problems. This article outlines the most appropriate options for the clinical management of different aetiological categories of aesthetic problems, and develops a hierarchy of intervention that should be pursued in a logical order until a satisfactory cosmetic outcome is achieved. These techniques are readily available to most dental practitioners and there is no reason for a child to have to wait until late adolescence for treatment. Dent Update 2003; 30: 307-313 CLINICAL RELEVANCE: Aesthetic problems in children and adolescents may be treated by a variety of techniques.
The results from a questionnaire to all specialist clinics (n = 38) in Sweden concerning their activities during 1989 show that 1% of all Swedish children between 0 and 19 years of age were treated at specialist clinics in pedodontics. The decrease in caries prevalence during the last decade has not resulted in a decrease in the number of referrals. The major reason for referral was high caries activity in combination with behaviour management problems. Seventy per cent of the specialists' working-hours are spent in clinical treatment and about 11% in educational activities. In the future the need for specialist treatment will continue to change to other areas than those of today, such as medically compromised and socially handicapped children.
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