___________________________________ DCA06DT Dental Treatment of Pediatric and Adolescent Patients
Our contributing faculty members have taken care to ensure that the information and recommendations are accurate and compatible with the standards generally accepted at the time of publication. The publisher disclaims any liability, loss or damage incurred as a consequence, directly or indirectly, of the use and application of any of the contents. Participants are cautioned about the potential risk of using limited knowledge when integrating new techniques into practice. Disclosure Statement It is the policy of NetCE not to accept commercial support. Furthermore, commercial interests are prohibited from distrib- uting or providing access to this activity to learners. HOW TO RECEIVE CREDIT • Read the entire course online or in print. • Depending on your state requirements you will be asked to complete: ‒ A mandatory test (a passing score of 75 percent is required). Test questions link content to learning objectives as a method to enhance individualized learning and material retention. • Provide required personal information and payment information. • A maximum of 8 hours of CE may be granted per day. Please record your completion dates on your Certificate(s) of Completion and retain for your records.
INTRODUCTION The goal of achieving and maintaining optimal oral health is one that should begin during childhood, continue during adolescence, and extend into the adult years. Teeth are essential throughout life for mastication, phonation, cosmetics, and support for the tissues that compose the facial form. Dental treatment of pediatric and adolescent dental patients must take into consideration their unique anatomical, physiologic, psychologic, maturational, and emotional differences and needs. This course will highlight these differences and options for preventive dentistry appropriate for this patient population, including a proactive means by which the risk of early child- hood caries can be reduced. The need to adjust the dosage and/or frequency of administration of medications used in conjunction with dental treatment of pediatric and adolescent patients will be discussed. Oral lesions associated with com- mon childhood diseases will be identified, as local outbreaks of infectious disease such as the measles and chickenpox still occur. The factors that are integral to the restoration of carious teeth and the oral and perioral signs of child abuse/domestic violence are discussed. Clinicians should consider the extent of their training with pediatric and adolescent patients before they are treated. If the complexity of the case, behavioral con- cerns, or patient management is beyond the clinician’s ability, referral to a pedodontist should be made. ERUPTION SEQUENCE The first complete set of teeth to erupt in the oral cavity have been called deciduous, primary, baby, or milk teeth. The eruption of a tooth is a developmental process during which a tooth moves from its position within the alveolar bone through the overlying mucosa into the oral cavity until it achieves a fully erupted position, where it will attain occlusion against an opposing tooth. Most teeth follow this process, although some teeth, most often the third molars (“wisdom teeth”), become impacted as they encounter bony or other anatomical obstructions and never fully erupt. Surgical removal is usu- ally required to relieve pain and to prevent pathology to the adjacent structures. Infants are usually born completely edentulous (without teeth), but there are rare exceptions. Natal teeth are those that are pres- ent at birth, and neonatal teeth erupt within 30 days of birth [1]. These usually occur in the anterior mandible, particularly the early eruption of the mandibular deciduous incisors. Natal and neonatal teeth exhibit minimal root formation and may have a variable range of mobility. This can cause complications during breastfeeding, and sharp edges of the exposed teeth can even traumatize the oral mucosa of the infant. Although these are deciduous teeth, they must be cleaned gently with plain cot- ton gauze or a cotton swab, as they are subject to colonization
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