Pediatric Dentistry Dentistry for Special People Dr. Zuhair Sayany Dr. Jeffrey Podowitz Dr. Jennifer Cully Dr. Julia Endrizzi *No use or reproduction without permission of DFSP, 2013, Jean Rath, RDH, BS
Our Mission Dentistry for Special People is committed to the prevention of Early Childhood Caries through community outreach, collaborative care with pediatricians and the promotion of establishing a Dental Home by age 1. Dentistry for Special People is a Leader in bringing the message of the American Academy of Pediatric Dentistry s campaign Get it Done in Year One to medical and public communities. 2
Your Speaker Jean Rath, RDH, BS Registered Dental Hygienist: NJ, PA, DE Public Health Dental Hygiene Practitioner, PA Council of Public Health Issues NJDHA Clinician: Dentistry for Special People Educator: Burlington County College Dental Hygiene Program Pre-Clinic, Freshman / Senior Clinic, Dental Radiology and Medical Emergencies Public Speaker American Dental Hygienist s Association: SNJDHA: Past President, Past Vice-President, Council of Public Health Issues and current editor. 3
Why a Pediatric Dentist? What is the difference between a pediatric dentist and a family dentist? Pediatric dentists are the pediatricians of dentistry. A pediatric dentist has two to three years specialty training following dental school and limits his/her practice to treating children only. Pediatric dentists are primary and specialty oral care providers for infants and children through adolescence (age 1-19), including those with special health needs. 4
The Dental Home The American Academy of Pediatric Dentistry recommends that a dental home be established for infants by the age of 1 year. The dental home is the ongoing relationship between the dentist and the patient, inclusive of all aspects of oral health care delivered in a comprehensive, continuously accessible, coordinated, and family-centered way. Establishment of a dental home begins no later than 12 months of age and includes referral to dental specialists when appropriate. (AAPD Definition) Complete policy available on-line at: http://www.aapd.org/media/policies_guidelines/p_dentalhome.pdf 5
The Dental Home Traditionally children have received first visits around age 3. *By this age all 20 primary teeth have erupted and oral disease and decay may already be present. Establishing a dental home by age 1 promotes oral health and prevents early childhood caries. Enhances the dental professional s ability to assist children and their parents/care givers in the quest for optimum oral health care, beginning with the age 1 visit for successful preventive care and treatment as part of an overall oral health care foundation. Insurance code: D0145 Covers diagnostic and preventative services performed for a child under the age of 3. (Private and Medicaid) 6
AAPD Campaign Get it Done in Year One American Academy of Pediatric Dentistry (AAPD) American Dental Association American Dental Hygienists Association American Academy of Pediatrics All recommend an oral health risk assessment and evaluation by age 6 months and a Dental Home by age 1. A scientific paper published in the journal Pediatric Dentistry revealed that children who wait to have their first dental visit until age 2 or 3 are more likely to require restorative and emergency visits. Examining the Cost-effectiveness of Early Dental Visits, Pediatric Dentistry 28.2 (2006): 102-105. 7
Get it Done in Year One Dental Care is Crucial During the First Year of Life Baby teeth are vulnerable to decay from their very first appearance, on average between the ages of 6 and 12 months. Proper care for baby teeth is imperative as they serve several critical functions, including: Fostering good nutrition by permitting proper chewing Aiding speech development Helping proper development of permanent teeth by saving space for them 8
Get it Done in Year One Undetected and untreated tooth decay can lead to: Infection Loss of teeth Expensive and mostly preventable emergency and restorative visits Establishing anxiety associated with dental care and check ups Anxiety that can lead to a life long apprehension of dental care The associative pain of tooth decay can prevent a child from eating correctly, impacting overall health and development 9
Get It Done in Year One Benefits of the Year One Dental Visit 1 + 1 = ZERO ONE dental visit when there s one tooth can = ZERO cavities Visiting a pediatric dentist by the time the first tooth appears enables the child to begin a lifelong preventative dental care program to minimize tooth decay. Pediatric dentist can detect early tooth decay, provide parents with information on proper oral and facial development, determine fluoride needs and MUCH more. 10
Get It Done in Year One How can Pediatricians make a difference? By incorporating the age one visit / infant oral health exam into your practice referral, you will help prevent early childhood caries and go a long way toward assuring optimal oral health care for a lifetime. Parents may not take young children to the dentist for a variety of reasons and yet an October 2004 study in the journal Pediatrics showed that the dental costs for children who have their first dental visit before age one are 40 percent lower in the first five years than for those who do not see a dentist before their first birthday. Early Preventive Dental Visits: Effects on Subsequent Utilization and Costs. Pediatrics 114: 4 (2004) e418 e423 11
The First Appointment Pediatric Dentist are prepared to see children as early as the first tooth eruption. The 1 st appointment provides: Age Appropriate Anticipatory Guidelines Review of oral and physical health history Evaluation of caries susceptibility Development of an appropriate preventive oral health regimen Communications with and counseling of the child s parent / caregiver 12
The First Appointment Discussion: the first part of the dental appt. Medical Hx: parental issues, infant illnesses, and meds. Meds that contain syrup formulas / sugar flavoring Nebulizer treatments and effects on the oral cavity Systemic fluoride intake: Primary water source Supplements Benefits http://www.aapd.org/media/policies_guidelines/g_fluoridetherapy.pdf 13
The First Appointment Discussion: Provide Parents and Caregivers with Information: Oral developmental stages. Eruption and exfoliation patterns Maternal health: relation between MOH and BOH Vertical transmission: parent / caregiver transmission of carries bacteria to child Nonnutritive sucking Numbing agents Injury prevention: trauma and fluoride ingestion 14
The First Appointment Discussion: Oral hygiene homecare Instructions Roll of Nutrition: Juice intake Nighttime feeding Extended nursing or bottle feeding Teething biscuits: highly cariogenic Snacks Preliminary Caries Risk Assessment derived from obtained information 15
The First Appointment Oral Examination and Cleaning Caries Risk Assessment: Caries lesions: white and dark spots Demineralization Assess for oral malformations Look for visible biofilm plaque formation Prophylaxis Apply fluoride for moderate to high risk Home care instructions and regimen 16
The First Appointment The Lap Exam 17
National Statistics and Facts 31% of American children preschool age & younger experience early childhood caries (ECC) 40% by Kindergarten 1 in 10 school children have at one point experienced oral pain due to ECC 25 50% of general dentist due not treat children 3 and under Iowa Study: 340 parents Findings Taking their child to see dentist by age 1 2% Taking their child to see dentist by age 2 11% Taking their child to see dentist by age 3 31% Amount unseen before age three 56% Expanding the Reach of Early Childhood Caries Prevention. Dimensions of Dental Hygiene 12.1 (2014): 59-63. 18
Statistics and Facts DFSP Statistics 2012 Findings Number of caries 3 and under 1047 / 79 pt = 13.25 % Hospitalizations 3 & under Caries treated 3-5 79 pt 312 pt Hospitalizations 3 5 118 pt 38% NP emergencies 3-5 on average 1 pt a day 19
Case Study 1 Dark Spots 20
Case Study 2 White Spots Not easily seen by Pediatrician s in-office exam Seen by dentist in reclined exam with magnification 21
White Spots White Spots = Demineralization of enamel = Damage already in progress Indicative of early decay and weekend enamel. Early intervention can sometimes reverse the damage. Topical fluoride, homecare / proper plaque removal, dietary changes Many times restorative is needed. Not easy to detect by just a visual exam in doctor office. Preventative education of parents and caregivers by age one is best prognosis. 22
Case Study 3 23
Restorative Porcelain fused to metal Stainless steel crowns Space maintainer 24
About Our Office Dentistry for Special People: OUR MISSION: We offer a unique dental experience that is fun, affordable, interactive and effective. Combining the right mix of personal care, high technology and continuing education, we maintain a commitment to our patients in every facet of our practice. 25
What We Do The child is the superstar here at our practice. When they come into our office we address the child first and make them the center of attention. Dr. Sayany We believe in interacting with children on a level they are comfortable with, which makes them easy to manage and makes us seem not so scary We welcome parents back into the operatory and truly believe in involving the whole family in the process. www.dentistryforspecialpeople.com 26
What We Do Dentistry For Special People: We have completed training which allows us to provide optimal dental care for children of all ages, including those with special needs. Our patients include infants, toddlers, children, adolescents, teenagers, children with special healthcare needs, children with behavior disorders, children with mental disabilities and children with physical handicaps. www.dentistryforspecialpeople.com 27
What We Do Dentistry For Special People: General Sedation in Hospital Hospital Privileges: Virtua, Kennedy, Summit Surgical Center, Cooper, Children s Hospital of Philadelphia, St. Christopher Hospital (2014) Only practice in state of NJ that sees medically complex pts. at CHOP. Voorhees Pediatric Facility Fox Rehabilitation Kids Partners in Pediatrics PRACTICE that other PEDIATRIC DENTIST refer to. 28
Community Outreach What DFSP is doing in the community? - A Lot! Autism Speaks Boy Scouts of America School and Community Education 29
What Can You Do? Educate Refer Spread the word Learn more Get involved 30
Questions How can DFSP help? Cherry Hill Office 1910 Marlton Pike E., Suite 9 Cherry Hill, NJ 08003 Phone: (856) 424-5955 Lectures Professional Associations Continuing education Health fairs Mommy classes Wellness centers Turnersville Office 188 Fries Mill Rd., Suite K-1 Turnersville, NJ 08012 Phone: (856) 629-0222 31
Reference Resources American Academy of Pediatric Dentistry. www.aapd.org. Rainchuso, Lori RDH, MS; ABC s of Infant Oral Health. Dimensions of Dental Hygiene 10.10 (2012): 59-63. Lee JY, DDS, MPH, PhD, Bouwens TJ,DDS, Savage, DDS, MS Vann WF Jr., DMD, PhD; Examining the Cost-effectiveness of Early Dental Visits. Pediatric Dentistry 28.2 (2006): 102-105. Lee JY, DDS, MPH, PhD, Kotch JB, MD, MPH, Savage MF, DDS, MS, Vann WF Jr., DMD, PhD; Early Preventive Dental Visits: Effects on Subsequent Utilization and Costs. Pediatrics. 114.4 (2004): e418 e423. Microsoft PowerPoint for Mac 2011, Microsoft Corporation 2010. < http://www.microsoft.com/mac >. University of North Carolina: Baby Oral Health Program. www.bohp.unc.edu. Uhl, Nicole, RDH EFDA, MSA; Expanding the Reach of Early Childhood Caries Prevention. Dimensions of Dental Hygiene 12.1 (2014): 59-63. No use or reproduction without permission of DFSP, 2013 Jean Rath, RDH, BS 32
Reference Resources American Academy of Pediatric Dentistry. Baby Mouth. Photograph, n.d. Download. Infant Oral Care Handout. 6 Sept. 2013. < http://www.aapd.org/advocacy/points_of_light/ >. Blend. Hispanic Boy Brushing teeth. Photography, n.d. Online image. Fotosearch. 8 Oct. 2013. < http://www.fotosearch.com/photos images/hispanic-boy-brushing.html#comp. asp?recid=2721715&xtra >. Brebca. Laughing Baby. Photograph, n.d. Online image. Can Stock Photo Inc. 8 Oct. 2013. < http://www.canstockphoto.com/laughing-baby-0703008.html >. Glasbergen, Randy. Dental9. Cartoon, 2000. Online image. Todays Cartoon. 1 Sept. 2013. < http://www.glasbergen.com/diet-health-fitness-medical/?album=2&gallery=141 >. Microsoft PowerPoint for Mac 2011, Toddler Girl Smiling. Photograph, n.d. Microsoft Corporation 2010. 18 Aug. 2013. < http://www.microsoft.com/mac >. Picturepartners. Baby Boy Is Brushing His Teeth With Toothbrush. Photograph, n.d. Online image. Can Stock Photo Inc. 8 Oct. 2013. < http://www.canstockphoto.com/baby-boy-is-brushing-his-teeth-with-a-2376935 >. No use or reproduction without permission of DFSP, 2013 Jean Rath, RDH, BS 33