There are many new and exciting things in the world of pediatric dentistry. As
the primary caregivers for children's oral health, pediatric dentists are in various
leadership roles, along with the American Academy of Pediatric Dentistry
(AAPD), in working with various governmental and other entities as the
inevitable changes in health care unfold as a result of the Affordable Care Act.
Although it remains unclear exactly what those changes look like, the leadership
of the AAPD and its members are working hard to make sure that, first and foremost,
more children get access to the best dental care possible, and in particular,
the most vulnerable children.
Other than in the regulatory and political world, there are several changes going
on that are affecting the way dentistry for children is being practiced, bringing
improvements to our ability to treat children in the best possible way. First, in the
diagnosis of dental caries, the most prevalent disease in children, and the largest
unmet need (in terms of its identification and treatment), each day brings new
information regarding early caries lesion detection. We live in a world where treating
all children the same is no longer acceptable. We must do whatever we can to
assess the individual risk of each child and ascertain that the care we provide, as well
as the frequency of encounter for that care be adjusted to meet the demands of the
risk level. Children at the highest risk for early childhood caries (ECC) must be
identified at the earliest possible time in their lives, and aggressive intervention
means that many of these children need to have multiple encounters each year to
avert disease progression. New technologies and tools are evolving each day, and
many are beginning to undergo clinical testing to determine their sensitivity and
specificity in predicting which children have the highest risk for disease as evidenced
by the "microscopic" presence of disease, determined by a validated risk assessment
tool. The cost and devastation of ECC can only be reduced by careful attention to
early education of caregivers and other health-care providers, early identification of
risk and early intervention to avert disease presenting in the form of cavitation.
In the restorative dentistry arena, there are many inventions that are now established
into practice, making practitioners' and patients' lives better. In the anterior
aesthetic dentistry for children, zirconia crowns in pre-fabricated form of varying
sizes are now available for use in primary incisors, canines and molars. Whereas these
durable devices are likely to achieve long-term success in allowing restoration, health
and longevity for decayed primary teeth, practitioners must learn a new technique
that requires some additional skill, at least initially. New cements that are self-adhesive
can also be used to cement these zirconia crowns, allowing a sealed and durable
result. In the case of other restorative care, improvements in glass ionomer materials,
resin composites and other materials continue to make dental practice for children
better and easier while improving the health and well-being of child patients.
Whereas pediatric dentistry is the only specialty that treats a population and not
a specific condition, it is clear that every invention in dentistry has implications on
the practice of dentistry for children. We must only take the time to assess the suitability
of various techniques and products as they are adapted for use in children and
ensure that appropriate testing and other considerations are made.
|