Pediatric Dentistry

Contents

Preface: Pediatric Dentistry ix

Joel H. Berg

Early Childhood Caries: Risk-Based Disease Prevention and Management 1

Man Wai Ng and Isabelle Chase
Early childhood caries (ECC), common in preschoolers, can lead to pain
and infection if left untreated. Yet, ECC is largely preventable, and if it is
identified early and the responsible risk factors are addressed, its progres-
sion can be halted or slowed. This article reviews the rationale for a first den-
tal visit by age 1 year, caries risk assessment, and risk-based prevention
and management of ECC and discusses strategies for providers to imple-
ment these contemporary evidence-based concepts into clinical practice.

Periodontal Considerations for Children 17

H. Jung Song
This article reviews periodontal disease and gingival disease and also
explores issues relating to mucogingival defects such as gingival hyperpla-
sia, gingival recession, and exposure of impacted canines.

Overview of Trauma Management for Primary and Young Permanent Teeth 39

Dennis J. McTigue
This overview covers diagnosis and management of the most common
dental injuries in children and identifies those children at greatest risk.
Crown fractures and luxation injuries in both the primary and permanent
dentition are discussed and treatment options based on current interna-
tional guidelines are detailed.

Vital Pulp Therapy 59

Nestor Cohenca, Avina Paranjpe, and Joel Berg
Vital pulp therapy is performed to preserve the health status of the tooth and
its ultimate position in the arch. These procedures are performed routinely
in primary and permanent teeth. This review is divided into 2 parts: the first
aims to illustrate the basic biology of the pulp and the effects on the pulp
due to various procedures; the second focuses on the clinical aspects of
treatment and the use of various dental materials during different vital
pulp therapy procedures performed in the primary and permanent teeth.

Restorative Dentistry for Children 75

Kevin J. Donly
This article discusses contemporary pediatric restorative dentistry. Indica-
tions and contraindications for the choice of different restorative materials
in different clinical situations, including the risk assessment of the patient,
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are presented. The specific use of glass ionomer cement or resin-modified

glass ionomer cement, resin-based composite, and stainless steel crowns
is discussed so that preparation design and restoration placement is
understood.

Pediatric Oral and Maxillofacial Surgery 83

Elizabeth Kutcipal
Pediatric oral and maxillofacial surgery is rarely seen as a separate entity
from adult oral and maxillofacial surgery. Many procedures are similar
on adults and children; however, children have unique behavioral, ana-
tomic, and physiologic considerations. Children also have a propensity
for certain injuries and pathologic lesions. Children born with congenital
anomalies may also have a special subset of needs. This article is a brief
review of oral and maxillofacial surgery on the pediatric population.

Temporomandibular Joint Disorders in Children 99

James A. Howard
A child’s difficulty in verbalizing the precise location and nature of facial
pain and jaw dysfunction often results in a nondefinitive history, increasing
the importance of the dentist’s awareness of the early signs and symptoms
of temporomandibular joint disorders (TMD). A focused examination of the
masticatory musculature, the temporomandibular joints, and associated
capsular and ligamentous structures can reveal if a patient’s symptoms
are TMD in origin. An accurate differential diagnosis enables timely referral
to appropriate health care providers and minimizes the use of diagnostic
imaging.

The Continuum of Behavior Guidance 129

Travis Nelson
Behavior guidance is a continuum of techniques, basic and advanced, fun-
damental to the provision of quality dental care for pediatric patients. This
practice must be individualized, pairing the correct method of behavior
guidance with each child. To select the appropriate technique, the clinician
must have a thorough understanding of each aspect of the continuum and
anticipate parental expectations, child temperament, and the technical
procedures necessary to complete care. By effectively using techniques
within the continuum of behavior guidance, a healing relationship with
the family is maintained while addressing dental disease and empowering
the child to receive dental treatment throughout their lifetime.

The Role of Sedation in Contemporary Pediatric Dentistry 145

Travis Nelson and Gary Nelson
Procedural sedation offers an effective and humane way to deliver dental
care to the young, anxious child and to those with extensive treatment
needs. Delivery of sedation requires thorough understanding of its indica-
tions and contraindications, patient assessment, pharmacology, monitor-
ing, and office protocol. Safe and successful outcomes depend on
a systematic approach to care, and the ability to manage unintended
cardiopulmonary events.
 Contents vii

Providing Dental Treatment for Children in a Hospital Setting 163

Elizabeth Velan and Barbara Sheller
This article discusses aspects of providing dental treatment in hospitals to
patients with complex medical and/or behavioral problems. Practical infor-
mation for patient selection for care in a hospital operating room, obtaining
hospital privileges, and other aspects of dental care in hospitals are
introduced.

Index 175