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FUN AND PROFITABLE PEDIATRIC DENTISTRY

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The dentist and staff must understand that Pediatric Dentistry is in the ' ... Initially affects primary maxillary incisors. Causes. Nursing bottle at sleeptime ... – PowerPoint PPT presentation

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Title: FUN AND PROFITABLE PEDIATRIC DENTISTRY


1
FUN AND PROFITABLEPEDIATRIC DENTISTRY
  • Kaneta R. Lott, DDS
  • Board Certified Pediatric Dentist
  • 404-349-7777

2
The dentist and staff must understand that
Pediatric Dentistry is in the Business of
Education.
3
The dentist and staff must know,Who is in
Control?
  • Have you communicated well with the parent and
    the child?
  • How do you neutralize the effect of the parent on
    the child?
  • Has the doctor been informed of the staffs
    observations?

4
Never say the words hurt, pain, mad, sad,
afraid, scared, stick, needle or shot.
Do say push, tickle, shake, brush, count,
uncomfortable, and pinch.
5
Dental Caries Etiology Transmission
6
EARLY CHILDHOOD CARIES(Baby Bottle Tooth
Decay/Nursing Caries)
  • Initially affects primary maxillary incisors.
  • Causes
  • Nursing bottle at sleeptime
  • Breast feeding (at will) after teeth have erupted
  • Continuous use of the sippy cup
  • Frequent snacking

7
Always smile. Your mood will show.
Only ask those questions that you know will
receive a positive answer.
IF THE PARENT IS AFRAID. THE CHILD WILL ALSO BE
AFRAID.
8
Caries Risk Assessment(Counseling)
  • Fluoride History
  • Dietary Habit
  • Sleeptime Habit
  • Medications
  • Non-Nutritive Sucking Habits
  • Family History
  • Oral Hygiene Habits

9
TOPICAL FLUORIDE
  • 20 TO 40 CARIES REDUCTION
  • PROFESSIONALLY APPLIED
  • FLUORIDE VARNISH, 2.26
  • APF GEL, 1.23
  • OVER-THE-COUNTER RINSES
  • PRESCRIPTION RINSES AND GELS
  • DENTRIFICES
  • DIETARY FLUORIDE SUPPLEMENT

10
FLUORIDE SUPPLEMENTS
  • FORMS
  • Drops
  • Chewable Tablets
  • Tablets
  • In combination with vitamins
  • DOSAGES
  • 0.25 mg
  • 0.5 mg
  • 1.0 mg

11
DIETARY FLUORIDE SUPPLEMENTATION SCHEDULE
  • Less than More than
  • Age 0.3 ppm F 0.3 0.6 ppm F 0.6
    ppm F
  • Birth 6 mos. 0 0 0
  • 6 mos. 3 yrs. 0.25 mg 0 0
  • 3 yrs. 6 yrs. 0.50 mg 0.25 mg 0
  • 6 yrs. Up to 1.00 mg 0.50 mg 0
  • at least 16 yrs.

12
ORAL HABITS
  • Bottles
  • Pacifiers
  • Digits
  • Sippy Cups

13
Follow Seven Basic Rules When Treating Children
  • Introduce yourself to the parent and to the child
    or children in the same formal tone of voice. It
    is important to establish a level of authority at
    this time.
  • Remember that the first impression is the lasting
    impression.
  • Always find something about which you can give a
    compliment.

14
Follow Seven Basic Rules When Treating Children
(Continued)
  • Speak with the parent about the medical history.
  • Now is the time to tell the child with the parent
    listening, all of the things that you will be
    accomplishing at this visit. It is very
    important that the parent remains quiet. Use
    words that are age appropriate.

15
Follow Seven Basic Rules When Treating
Children(Continued)
  • While interviewing the parent it is important to
    remind them that the dental staff will give the
    instructions.
  • If the child is two years old or younger, invite
    only one parent into the treatment area with the
    child.

16
Separation From Parent
  • Separate child from parent at the reception room
    door.
  • Reassure child that the parent will wait right
    there until they return.
  • Hold the childs hand and lead them into the
    clinical area.
  • You may have to pick the child up in order to get
    them into the clinical area.

17
Help The Child Into The Chair
  • This is the first step to good cooperation.
  • Encourage and praise the childs efforts.
  • Help but do not place the child in the chair.
  • Praise, praise, praise.

18
Reclining The Second Test
  • Once the child has gotten into the chair the
    second test comes when you try to recline the
    chair.
  • Keep the chair reclined at all times.
  • Hug and talk while the chair is reclining.
  • Your arms and entire body will have to be
    involved.

19
Evaluate The Body Language
  • Beware of the talkative child.
  • Children that give directions and are overly
    confident find it hard to take directions.
  • Watch for the fidgety child.
  • Look for mood changes.

20
Intraoral Examination
  • Begin by asking to see the childs tongue.
  • The first instrument should be a mirror and a
    tongue blade.
  • Be very discrete with the explorer.
  • Your assistant should pass it from behind the
    childs head.
  • Touch other parts of the mouth and chin before
    you touch the teeth.
  • Count out loud.

21
Infant - Intraoral Exam
  • Parent holds the child in their arms.
  • Knee to knee examination with parent.
  • You hold baby in the feeding position.

22
Your Clinical Staff Can Help
  • Send children to the rest room before allowing
    them to get into the chair.
  • Block the view of other patients.
  • Suggest the use of N2O.
  • Do tooth brush prophy.
  • Give oral hygiene instructions.

23
Your Clinical Staff Can Help (Continued)
  • Practice 6 handed dentistry.
  • Answer questions honestly Not too many details.
  • What are you going to do?
  • Is that blood?
  • Are you going to give me a shot?

24
Restraint May Be Needed
  • Hold the knees, you are less likely to get
    kicked.
  • Hold the wrists, you will not be surprised.
  • Parents are good at doing this job.
  • Children often will restrain themselves. This is
    the goal.
  • A papoose board may be needed with parental
    consent.
  • Older children may need a little encouragement.

25
Radiographs On A Three-Year-Old Child Are
Necessary And Possible
26
DENTAL SEALANTS
  • Non invasive Procedure
  • Preventive
  • Seals Deep, Narrow Grooves

27
INJECTIONS
Only ask those questions that you know will
receive a positive answer. Always smile. Your
mood will show. IF THE PARENT IS AFRAID. THE
CHILD WILL ALSO BE AFRAID.

28
LIP, CHEEK AND TONGUE BITING
  • Anesthetize both sides of the same arch.
  • Limit lip biting by not treating the upper and
    lower on the same side of the face.
  • Protect the lip with a cheek pad between the
    cheek and teeth.

29
LIP, CHEEK AND TONGUE BITING
  • Warn the parent and limit eating for 1 hour after
    treatment.
  • Administer Tylenol or Motrin before the child
    leaves the office.
  • Provide palative treatment, it will heal in 5-7
    days.

30
LIP BITING PREVENTION
  • CHEEK PADS
  • PUT THEM IN THE MOUTH UPON EXITING
  • GIVE EXTRAS TO PARENT
  • TALK WITH THE CHILD

31
OPERATIVE TREATMENT
  • Never Lie.
  • Tell-Show-Do but dont show everything.
  • Use nitrous oxide/oxygen and a mouth prop as a
    routine.
  • Introduce the handpiece as a whistle.
  • Work as quickly as possible.
  • Hug before the child departs.
  • Consider using the Wand for anesthesia.

32
WHEN RUBBER DAMS DONT FIT
  • COTTON ROLLS ARE GOOD
  • CHEEK PADS ARE BETTER
  • CHEEK EXPANDERS HELP
  • MOLT MOUTH PROPS ARE ESSENTIAL

33
PULPOTOMY
  • Indications
  • Coronal tissue is infected.
  • The radicular pulp tissue is vital
  • Objectives
  • Maintain vitality of the radicular pulp
  • No internal or external resorption
  • No pain, sensitivity or swelling

34
STAINLESS STEEL CROWNS
  • WHY DO PEDIATRIC DENTIST DO SO MANY?

35
Indications for Long-Term Provisional Restorations
  • Extensive dental procedure
  • Compromised medical condition
  • Pediatric Considerations
  • Economic considerations
  • Patient age

36
Attributes of Stainless Steel Crowns
  • Maintains Space
  • Creates a good marginal seal
  • Restores function and occlusion
  • Protects remaining tooth structure
  • Maintains good gingival health

37
SPACE MAINTENANCE
  • Retain existing space.
  • Prevent additional loss of space.
  • Provide restorative appliance for missing teeth.
  • Provide esthetic prosthesis.

38
Do say push, tickle, shake, brush, count,
uncomfortable, and pinch. Never say the words
hurt, pain, mad, sad, afraid, scared, stick,
needle or shot
39
  • Children love to hug.
  • Let them.
  • You will have a patient for life.

40
Items That You Should Keep Handy
  • A regular toothbrush
  • A comfortable toy
  • A blanket
  • A molt mouth prop
  • Cheek retractors
  • Cheek pads
  • Love for ALL CHILDREN

41
Rewards Stickers and Toys
  • Give rewards for good behavior, only.
  • Dont give a reward if the unwanted behavior
    continues.
  • Never give a reward during treatment. You lose
    your bargaining power.
  • Exit the patient immediately after the reward is
    given.
  • Brag to the parent about the childs good
    behavior while you show off the reward.
  • Give more than one reward for exceptionally good
    behavior.

42
Exiting The Patient
  • Coach the parent to greet the patient with a
    smile.
  • Coach the child to, Let your mom see your
    teeth.
  • Allow parent to enter the operatory and escort
    the child to the front desk.
  • Stoop down to the childs level and thank them
    for good behavior.

43
OUR CHILDREN ARE WHAT WE HAVE TAUGHT THEM TO BE
LottSeminars EDUCATE INSPIRE LEAD Kaneta R.
Lott, D.D.S. Childrens Dentistry with a Lott
of Love.
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