Pedodontics

Child's psychology

Due to children's sensitivity, maximum precautions must be taken for the first examination ; bad memories can be remembered during an entire life time, disrupting any ulterior treatments.  

The practioner must be careful when communicating with a child, much more than with adults, especially during the first examinations.  It is advisable to have a pleasant behaviour and a casual expression instead of using technical words that would not be properly understood by children. It is only through mutual trust that a treatment can be conducted in a satisactory way.

A dialogue must be established with the accompanying adult as this relation will be used to start or enrich a dialogue with the child. It is essential to know the child's previous medical and dental experiences in order to avoid repeating traumatizing experiences. The body language will be carefully analyzed so that the level of stress of both the accompanying adult and the child will be noticed.

This subtle observation facilitates the decision-making process about : letting the accompanying adult attend the examination or asking him to stay in the waiting room to avoid an artificial infantilizing of the child ; the communication strategy to implement with the child to build trust and lower stress ; using tricks to facilitate a quick intervention.

This scenario may be either simple or complicated depending on the age and history of the child. For the most difficult cases, and if tranquillizers are avoided, the intervention will be split up in as many sequences as necessary.

Pathologies

Cavities can evolve rapidly. 
Pulpitis are less numerous and can be painless. They mainly occur in adults.
However, dental absesses occur more easily on children than on adults.

The baby bottle syndrom : The baby bottle syndrom consists in a large number of cavities on babies (from 2 year-old), particularly on the vestibular sides of the front teeth. The main factors of these cavities are : extended breast-feeding, baby bottles filled up with a liquid rich in sugar ; bad oral hygiene.

Treatments

  • Conservative odontology

Cavity treatment is similar to permanent teeth's.

  • Endodontics

On the other hand, endodontics treatments differ.

  • Pulpectomy : advocated in case of a total inflammation of the pulp and of necrosis. The endodontics treatment aims to eliminate the inflamed or necrosed pulp parenchyma and to disinfect the canal content. The canal fill-in is made of zinc oxide and eugenol. Indeed, contrary to permanent teeth, the canal fill-in is not done with gutta cones. The gutta cones do not resorb and could block the root resorption.
  • Pulpotomy : advocated when a pulp inflammation is localized in the pulp chamber.