Treating Children in Practice

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Carestream Dental’s Cheryl Hayes considers the practicalities of paediatric dentistry

It’s no understatement to say that paediatric dentistry comes with its own set of unique challenges. Those with specialist training will know these trials first-hand, but for others considering branching out into this area, it is worth exploring the challenges in more detail.

Dental anxieties and fears may be common in people of all ages, but for children, they can have further implications. Research suggests that extreme dental anxieties and phobias affect between 5-20% of all children and adolescents [1], and these fears can quickly translate into disruptive or uncooperative behaviour during sessions, making treatment difficult or even impossible. This all stems from the fact that children are not as psychologically developed as adults.

It is generally considered that children exhibit these behaviours because they have difficulties in processing what is happening to them and feel emotions such as fear and uncertainty much more strongly. This is because they have not experienced them as much and therefore find them difficult to compare to actual threatening situations. In light of this, calming children down can prove difficult, which, in turn, may cause rifts between dental professionals and the patients’ parents/guardians.

It’s also worth noting that it is important to address such fears because otherwise they may cause long-term damage. Past bad experiences are one of the core reasons cited by people (61%) when asked to explain their fear of the dentist [2]. If these fears aren’t managed, children are likely to grow up with a poor perception of dental care and do everything in their power to avoid visiting the dentist with resultant ramifications for their oral health.

In light of this it’s very important to think of ways to help make your practice and services more appealing to children. Is there a fun way you can decorate the environment to help them feel at ease? It’s also worth taking the time to converse with children and to use positive language, as this has been proven to build trust between dentists and children and will ultimately encourage them to relax in your presence [3].

Anatomical challenges

One of the biggest differences between treating children and adults is that children are not fully physically developed. As well as still having deciduous teeth, the jawbones of children aren’t fully formed, which can create challenges during treatment.

For example, although deciduous teeth do fall out, their condition can still have a direct impact on the permanent teeth beneath; so endodontic work may be necessary in some cases in order to preserve the quality of the tooth emerging below. And, as the jawbone is still developing, proper planning is essential before any treatments as it can be difficult to predict how any dental changes will affect facial anatomy as they grow.

This also leads to another interesting obstacle – namely that many pieces of dental technology have not been developed to work well in the smaller anatomies of children. Intraoral scanners, in particular, can be difficult to use on younger patients as they are often too big to acquire a comprehensive digital impression of the oral cavity.

The CS 3600 intraoral scanner is an exception. Benefitting from multiple interchangeable tips to help streamline the way dentists provide care, the scanner has a unique side orientated tip which is perfectly suited to children – or adults with smaller oral cavities – meaning you can always offer the best level of care. For more information visit https://www.carestreamdental.com/en-gb/cs-3600-landing-page/

Trends in the patient population

Tooth extractions for young children and adolescents are becoming commonplace, and this has become such an epidemic that people are labelling it as a ‘child tooth decay crisis’ [4]. In 2017-2018 alone there were over 26,000 UK children aged 5 – 9 admitted to hospital due to decay, which was the primary reason people in the age group were admitted to hospital.

If you do decide to enter the paediatric dentistry arena, you’ll need to be comfortable with educating the parents/guardians of these patients, and be willing to set children on the path to better oral health.

Every patient population has its own set of obstacles to overcome, and paediatric dentistry is no different. However, as the old adage states – ‘children are the future’ – and helping them overcome fears and to receive the best care possible is a very worthwhile pursuit.

References:

1] Gao, X., Hamzah, S., Yiu, C., McGrath, C., King, N. Dental Fear and Anxiety in Children and Adolescents: Qualitative Study Using YouTube. J Med Internet Res. 2013 Feb; 15(2): e29.

2] Beaton, L., Freeman, R., Humphris, G. Why Are People Afraid of the Dentist? Observations and Explanations. Med Princ Pract. 2014 Jul; 23(4): 295–301.

3] The American Academy of Paediatric Dentistry. Guideline on Behaviour Guidance for the Paediatric Dental Patient. Link: http://www.aapd.org/media/policies_guidelines/g_behavguide.pdf [Last accessed February 19].

4] The Guardian. Dentists Warn of a Child Tooth Decay Crisis as Extractions Hit New High. Link: https://www.theguardian.com/society/2018/jan/13/dentists-warn-of-child-tooth-decay-crisis-as-extractions-hit-new-high [Last accessed February 19].