The children's dental specialty chain and the pediatric health management center are relatively hot oral segmentation industries in recent years, but the children are faced with the challenge of anaesthetic risk and good product loss when they are in the dental chair. Trouble, so try to avoid the traditional oral chair thinking of adult oral.

Jensen Gould, Ph.D., Head of Clinical Affairs at Premier Dental Products Company, said: "Dental surgery can be very simple and quick when children are obedient and relaxed. But if not, the surgery will It will be an extraordinary challenge."

So how to simplify the process of children's teeth, what good products should the dental clinic have, and the dentist needs to have a behavior management theory? The arterial network compiles the views of foreign dental industry experts and shares the challenges and solutions they face when operating a children's dental clinic.

Frequently Asked Questions When Treating Children: Behavior and Fear Management

The most common problem faced by dental professionals in dealing with children is behavioral and fear management. Children who sit in a chair may have an adverse effect on surgical practice if they do not cooperate.

Katrina Sanders, a dentist health educator and international speaker, said: "When you are working in the clinic, there is a screaming child, everyone can hear it. This will definitely affect the work mood of everyone in the clinic. ."

Dr. Jeffrey Limery is a private practice dentist and training specialist in Mooresville, North Carolina, who agrees that uncooperative children can affect the activities of other patients.

Dr. Jeffrey Limberry said: "If you try to give a pediatric patient an operation, but at the same time the child has a behavior management problem, the speed of the operation will be slower, your surgery will be backward, and it will change. Slowly there is a snowball effect."

The undeniable status quo is that children's dentistry is at high risk. The American Academy of pediatric dentistry (AAPD) recommends that all children develop correct dental habits before the age of one. At this age, children are notoriously difficult to manage. When these early childhood experiences are negative and negative, it will have an impact on the child's teeth after growing up.

Dr. Nathaniel Lawson is the head of the Department of Biomaterials at UAB Dental College. He no longer treats children because he sees poor dental experience in adult patients and has a negative impact.

Dr. Lawson said: "I can see some adults have a bad experience in their early years, which brings different degrees of anxiety to their teeth. Sometimes they delay treatment; some even postpone the need for root canal treatment. Degree, because they don't want to go to the dentist.” Dr. Jeffrey Limberry said that delaying the treatment to the point of serious problems can only exacerbate the cycle of fear.

Dr. Jeffrey Limberry explained: “When adults delay treatment and cause problems, we have to do more challenging, more difficult and more expensive surgery because we either try to save the teeth or need to replace them. tooth."

Several products and methods for streamlining the treatment of pediatric teeth

Tina Clarke is the Academic Program Director of the Oregon Technical Oral Hygiene Program and teaches her students at the Chimekta Community College to focus on the children's hands and feet and get used to contact with dental professionals.

Many dentists focus on the mouth, head and chest around the 18- to 4-year-old patient. Clark suggested focusing on the hands and feet when talking to them for the first time. For example, she likes to pay attention to the patient's shoes to distract anxiety and give the patient time to warm up before surgery.

"When you meet a dog, you don't scratch your ears or bury your head in your face. You must let them smell your hand and let them know that you are fine. Then you can play with them," Clark explained, "For the children, to be with them, let them familiarize themselves with the space of contact and ensure that it is safe and not dangerous.

Dr. Lawson suggested rethinking the materials of the teeth. Because time is of the utmost importance to pediatric patients, a simpler, faster method of performing similar procedures can help increase efficiency. When Dr. Lawson used to treat pediatric patients during his work at the Dental Service (DSO), he wanted to be able to use more flowable composites.

Dr. Lawson explained: “Flowable composites (also known as flowable composite resins, the main material for dental restorations) were slammed in the 1990s, but now they are not much different from packageable composites.” Flow compounding Materials are a good choice for repairing deciduous teeth faster and preparing for good fit through small cavities. ”

He also said that he would use more glass ionomers instead of composite restorations because glass ionomers are more resistant to moisture, release fluoride and reduce the risk of dental caries.

Dr. Janet McLean, a private practice pediatric dentist in the Glendale area of ​​Arizona, and an international lecturer in minimally invasive dentistry, agree that glass ion sealants and restorative materials are very useful in pediatric dentistry. The use of GC Fuji TRIAGE glass ionomer sealant was incredible for her clinic because it allowed her to apply sealants to children who had previously been unable to apply.

“This material is hydrophilic, so it needs moisture to fix it. You can apply the sealant on a wet surface instead of the traditional corrosive 37% phosphoric acid. Use a milder 20% polyacrylic acid adjustment. Agents for oral and dental caries," Dr. McLean said. "The most important thing is that the glass ionomer sealant releases fluoride to form a more anti-caries enamel surface."

Dr. Lawson also recommends the use of TheraCal LC indirect and direct pulping for photocuring the pulp material, a photocurable, resin modified, calcium silicate-based core protectant and backing material for direct and indirect use. Cover the pulp, or the underlying protective substrate for resins, amalgam, cement, and other substrate materials. It is faster than traditional calcium hydroxide and glass ionomer methods. In addition, he will reconsider permanent repair of some deep caries lesions.

Biodentine is a calcium silicate-based lining and temporary material that forms repaired dentin next to the pulp and can be used as a temporary material for up to six months.

Dr. Lawson said: "If a child has a deep hole in his teeth and you don't know if they need root canal treatment, how to respond correctly without permanent repair, Biodentine will measure it. ."

Another method of treating dental caries recommended by Dr. Lawson is silver fluoride (SDF). Silver fluoride prevents dental caries until a more permanent repair is possible, or until the first tooth falls off.

Dr. McLean also likes to use silver fluoride to treat caries in young patients, especially when you build a first contact of trust because it is fast, simple and painless. In addition, it is also a desensitizing agent. Dr. McLean said that the combination of silver fluoride and glass ionomer cement has opened up a “new world” that enables minimally invasive treatment without the need for local anesthetics.

Dr. McLean said: "We now have more tools and materials than ever before. Therefore, we can take care of more patients and provide more comfortable, easier and faster treatment."

Sanders is an international lecturer providing local anesthesia. She realized that people's fear of injection is very common. She said: "Even for adults, syringes are terrible. Importantly, as dental professionals, we need to be aware of the fear that children may experience after seeing dental equipment in the clinic."

That's why he likes Kovanaze, a nasal spray on the market that can replace injections and can provide anesthesia for the entire upper jaw, including the ankle.

Saunders said: "Any dentist knows that they are never going to give pediatric patients an ankle. Kovanaze's intranasal administration is very useful for non-injection anesthesia techniques."

Another challenge faced by hygienists is to floss the orthosis. Hormonal changes and common malnutrition problems in adolescents are common, and their inflamed gums make flossing difficult, however, the Platypus Ortho Flosser simplifies the Sanders problem. She said: "Recommended products such as the platypus orthodontic floss for orthodontic patients, making them more receptive to their home care advice."

Kim Miller said another area of ​​challenge for dental professionals is to keep the patient's mouth open. She likes to use different types of occlusion inducers and jaws. Miller said: "They hang it on the lower front teeth, which supports the downward movement of the lower jaw to help the patient keep the chin open."

Children have never seen similar equipment in the dental clinic. Miller has been working for 36 years since 1992 and has been trained. Miller believes that children should be introduced to the tools in advance, and even let them touch them.

Miller said: "I always spend a lot of time showing the children what the tools are. So when I pick them up and start to talk face-to-face with the kids, if you can eliminate the unknown, the fear will disappear."

When Eliza Abel worked at the school and community health center, she also held a sealant syringe and poked the blunt tip of the sealant/etching syringe onto her glove to indicate that it was not a needle and would not Poke through her gloves.

"I affectionately call it a small spray gun, about the size of a tooth," Aberle explained. "It's always helpful to get something unknown from this situation."

Dr. Gould is a general practitioner, but he has treated many children and is good at showing children the tools to win their trust, especially for dental handpieces and dental instruments, but not for needles. He said: "Never show the needle to the child."

Dr. Jennifer Sanders is a private practice general dentist in the Montana countryside who provides home treatment for approximately 10% of children. The challenge for her pediatric patients stems from fear of the unknown. Dr. Sanders uses many methods to control their anxiety, including telling, performing, and doing tricks. However, if this doesn't work, she will try to distract them by talking.

Many operators have TVs that can play children's programs. However, distraction is not necessarily fancy or high-tech.

Dr. Sanders said: "Although I want to have a TV in our room, we don't. So we talk to them and try to get them toe or focus on other things."

Dr. Gould said that the significant difference between children's dentistry and adult dentistry is that there is no significant amount of quiet treatment time.

“Adults can sit quietly and open their mouths to work with you,” he said. “But for children, this is not always the case. Sometimes you have to work according to their schedule. If they can be in a section Keep quiet during the time, then you'd better complete the surgery as soon as possible. It is very helpful to minimize the buffer time."

A child-friendly office that makes the children feel comfortable and sets the tone for the next meeting. Saunders works every day at a train station-themed pediatric clinic. “We have attracted a lot of children.” A child-themed office not only looks interesting but also threatening, giving children peace of mind. .

Dr. McLean is the mother of two children who share her own private paediatric clinic with another female dentist and mother. Together they established a team of assistants and hygienists who love children.

“We have a movie theme in our office. When you walk in, there is a placard that says welcome new patients and details the name of each new patient,” Dr. McLean said. “When children see They will be very excited when their names are, and their parents tell us that the children are really happy to come here because the environment has become very friendly to the children."

Distribute your child's attention in an environmentally friendly clinic

Dr. McLean's office has bright colors, toys, books, game areas and matches the visual level of children. The clinic has a lot of TVs and even a video game room. For a child, a sterile, hospital-like, icy, bright clinic can cause a little anxiety.

Clark said that one way to be child-friendly is to let dental professionals speak their language and keep up with the current way children think. She said: "This creates a connection where you can feel with your child. Conversation with things of interest."

As a dentist, you are responsible for managing your child's behavior in a chair. Dr. McLean believes that good behavior management skills are the primary method for making dental care easier for children.

Dr. McLean pointed out that over the past decade, due to changes in parenting practices and child dental training programs, special emphasis has been placed on the use of sedatives by more and more people.

A tranquilizer is a drug that inhibits the cerebral cortex. It reduces the activity of certain organs or tissues and inhibits the central nervous system from acting as a sedative. Sedatives help relieve depression and anxiety. The right amount of sedative does not affect normal brain activity. Of course, if it is used excessively or for a long time, it will bring certain side effects, such as lethargy and unconsciousness. Such as central nervous system depression symptoms.

“Anyone can work for an unconscious child,” Dr. McLean said. “The specialties of children’s dentists are their training in child development and psychology, and their ability to build trust in children and their families. We need Working with these kids, sometimes I feel that behavior management is an art form."

Dr. McLean believes that working with children requires patience. When you communicate with them, distract them and let them obey. “I like to tell interesting stories and even sing them to create a comfortable and enjoyable medical experience,” she explained.

To show your child a tooth, you need to build trust and dispel your concerns.

Dr. McLean said: "When you have patience and are willing to spend more time building trust, you will give your child and parents a good experience. There is nothing better than a happy customer telling all his friends. 'My children like to go. See the dentist's better word of mouth and free advertising."

Aberle said that a reasonable schedule makes treatment easier. Regardless of who arranges, you should work with your parents to find the best time to promote collaboration with your child.

She said: "Parents are more aware than anyone else. For the children they know best, what is the best time of the day, or at least when they are not hungry, not tired, and there is nothing new in their heads? ."

Sometimes, even if you do your best, it may not work. Some patients need an expert who can give them a sedative, such as an anesthesiologist, so that treatment will not be so traumatic. Recognize when patients should be referred to a reliable pediatric clinic, and the clinic is well equipped to handle some of these challenges and improve patient outcomes. Saunders said that all dental professionals need to know how to refer to their clinic.

Saunders said: "Talk to your parents and tell them that you don't want your child to panic every time you hear a dental drill or see a dentist's chair. It shouldn't be like this."

Clark agrees with this and emphasizes the importance of early positive experience to prevent adverse effects in the future. For some young patients who are afraid, sedatives are the best choice.

Clarke said: "Don't be afraid to use nitrous oxide because it can play a calming function." He said: "A positive experience gained by a person in a dental clinic can reduce any negative effects. If we can start with a positive experience as soon as possible. That will have a huge impact."

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