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Pediatric Dentistry

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What are some dental considerations in managing pediatric patients with leukemia?

Commentary by Dr. Mike Casas, Sickkids Hospital, University of Toronto For children with leukemia, the oral cavity can be a source of bleeding and infection as a consequence of leukemia or the chemotherapy prescribed to treat it. Good oral health can mitigate the risks of leukemia and chemotherapy as well as improve oral comfort during therapy. Kholoud et al. recommend treating all teeth likely to produce complications 10-14 days prior to chemotherapy. Oncology teams are unlikely to wait to start chemotherapy until after the mouth is optimized. Improved outcomes for leukemia have been demonstrated for patients receiving expedited chemotherapy. It ...

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Do I have to treat a discoloured primary tooth?

When a primary tooth discolours and turns grayish, it is usually secondary to a traumatic episode. The discolouration indicates a necrotic pulp or that hemorrhaging has occurred and entered the dentinal tubules and can appear within a month of the original injury. The tooth may exhibit a light gray colour initially but may progressively darken. Occasionally, the tooth may present with a yellowish colour due to calcific degeneration of the pulpal tissues. Treatment of these teeth is not always indicated unless there is evidence of pathology. As such, appropriate examination and follow-up is necessary in these cases. Source: Dental Secrets, ...

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Are diastemas normal and when should I consider diastema closure?

Midline diastemas in the primary dentition are common. They are usually associated with a thick maxillary frenum attachment and do not warrant treatment. However, clinicians should appropriately assess large midline diastemas in the primary dentition to rule out the presence of supernumerary teeth. In the permanent dentition, maxillary central incisors erupt buccal to the primary centrals and their eruption often creates a midline space. However, as the lateral incisors erupt, the space tends to close and complete closure of this space occurs once the permanent canines erupt. If there is any remaining midline space, this can be addressed orthodontically or ...

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Case Conference: How would you deal with a fearful child? Case Resolution

Drs. Christine Chambers and Ross Anderson joined Dr. John O’Keefe to present ideas about how to deal with children who are anxious and fearful of dental treatment.  Dr. Christine Chambers Dr. Christine Chambers is a clinical psychologist and Professor of Pediatrics and Psychology. Her research, based in the Centre for Pediatric Pain Research (IWK Health Centre), examines developmental, psychological, and social influences on children’s pain, with a focus on family factors in pediatric pain and pain measurement in children.     Dr. Ross Anderson Dr. Ross Anderson is Division Head / Assistant Professor in the Department of Dental Clinical Sciences, Division of ...

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Case Conference: How would you deal with a fearful child?

One of CDA Oasis priority topics for 2015 is communication and its role in the success of the dental practice. We are pleased to present a series of made-up scenarios related to various aspects of communication in the dental office. In the first phase of this case conference, we request that you provide your comments and feedback as to how you would handle such situation.  In the second phase of this case conference, Drs. Christine Chambers and Ross Anderson will respond to your comments and feedback and will present important information on how to deal with anxious children in the dental office.    ...

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Embracing the infant first visit – one GP dentist’s experience

By Dr. John O’Keefe When I sat in the waiting room at the office of Dr. Janet Leith of Ottawa for my recall visit recently, the first thing I noticed was the prominently featured CDA poster informing patients that her dental office encourages parents to bring their children for a first dental visit by age one. At the end of my visit, I sat and asked Janet  about when she had incorporated this approach into her practice, what trepidation she had prior to adopting it, how she used it as a practice building strategy and what sort of benefits she ...

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What should be included in an infant dental health program?

This information was adapted from Dental Secrtes, Elsevier, 2015. Download the Animated PowerPoint Presentation Download the PowerPoint Presentation (PDF)   Watch the video presentation Infant Dental Health Program from Canadian Dental Association on Vimeo.  

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What are non-nutritional sucking habits and what are the best interventions?

Non-nutritional sucking habits are learned patterns of muscular contraction. The most common types are: Finger habit Lip wetting or sucking Abnormal swallowing or tongue thrusting Abnormal muscular habits Sucking is the best-developed sensation avenue for an infant. Deprivation may cause an infant to suck on the thumb or finger for additional gratification. If a child stops non-nutritional sucking habits within his or her first 3 years of life, the damage usually is limited to the maxillary anterior segment and presents as an open bite. If the habit continues past 3 years, the damage may be long-lasting and detrimental to the developing dentoalveolar structures. After 4 ...

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