Pediatric dentistry is a growing subset of dentistry. Children are not little adults and require different tactics than adults when it comes to dentistry. What works for one child may not work for another. It is my job to be reading the mood of the child and create a comfortable environment where the child can have a positive dental experience. Before becoming a pediatric dentist, many of my adult patients were holding onto bad dental experiences they had as a child. It is my goal to prevent negative dental experiences, so every child will continue to seek preventative care for the rest of his or her life.
A pediatric dentist completes four years of dental school and progress to two (sometimes three) years of specialty training to receive our degree. Every pediatric dental residency is required to train its students in eight areas: prevention, trauma, sedation/general anesthesia, growth/development and orthodontics, treating patients with special needs, oral pathology, and behavior management.
Prevention: Dentistry is one of the few professions that is constantly trying to put themselves out of business. Preventing disease is a better form of treatment than fixing the disease once the process has started. That begins with starting good oral hygiene at an early age. At my patients’ first visit, I have a discussion with the parents about their child’s dental home care and give my recommendations on how to prevent their child from getting cavities. This is the first step in setting a child up for a positive dental experience.
Trauma: Accidents happen. Teeth get bumped, bruised, broken, knocked out, knocked in, you name it! I am well-versed in what to do and how to give the tooth the best chance to survive after having an injury. Some teeth respond well and unfortunately some do not, depending on the injury, but all I can do is follow the recommendations for each injury based on the best scientific research we have at our disposal.
Sedation/General anesthesia: Dental sedation is when a patient is prescribed a medication to relieve anxiety or prevent memory so dental treatment that is medically necessary can be completed. General anesthesia is used when the patient’s dental needs are too great to be completed with sedation. These tactics are used with adults as well as children. Sedation of children became more popular when certain behavior management techniques fell out of favor (i.e. physical restraints and voice control). Sedation and general anesthesia are always something to be taken seriously by making sure your provider has the proper training to administer the medication as well as the skills required to rescue a child if they become too sedated.
Growth/Development and Orthodontics: Unless a pediatric dentist is dually trained, he or she is not an orthodontist. With that said, every pediatric dental residency is required to train in orthodontics. Some pediatric dentists feel more comfortable in this realm than others, but all pediatric dentists are specialists in growth and development. At each dental appointment, it is important to monitor for potential issues associated with the growth of the patient and whether there is a potential problem with crowding, spacing, discrepancy in number of teeth, size of teeth, malocclusion (problems with the way the child is biting), etc.
Patients with Special Needs: A pediatric dentist can treat patients of all ages who have special needs. Special needs include physical disabilities such as rheumatoid arthritis, cleft lip and/or palate, or spina bifida. Patients can also have mental disabilities such as Asperger’s, autism, or Down syndrome. Every person with special needs is unique, and it takes a bit of creativity to find a dental health regimen or treatment strategy that is successful for each patient.
Oral Pathology: Because the oral cavity is the gateway to the body, many pathologies have oral presentations. Sometimes the first signs of certain diseases present orally. For example, patients with Crohns disease and other autoimmune diseases can present in the mouth prior to any other presentations. Tobacco use presents in several ways in the mouth and conversations can be had on stopping tobacco use. Bulimia also has oral indications and can be discussed so the patient can receive the help that they need.
Behavior Management: Behavior management is what sets a pediatric dentist apart from a family or general dentist. There are many general dentists who are fantastic when it comes to treating children, but when all you do is see children, managing their behavior is a well-honed skill that only comes with practice. All the aforementioned areas are pillars of what a pediatric dentist knows, but behavior management cannot be taught by books. It is learned through treating countless children, knowing when to use TLC, when to take extra time, when to encourage, when to sing a song, when to distract, or when to recommend dental sedation.