Advertisement

Unique Challenges in the Pediatric Population

  • Rebecca L. Slayton
  • Elizabeth A. Palmer
Chapter

Abstract

Traumatic dental injuries are a challenge for dentists regardless of the age of the patient. This is because these injuries often happen after-hours and occur relatively infrequently. It is difficult to be prepared for an event that is unpredictable in its severity and timing. Among the pediatric population, there are additional unique challenges that complicate the care plan. Very young children may have difficulty understanding questions or providing information about the injury. They may have an inability or desire to cooperate for evaluation and treatment. In some cases, the adult accompanying the child may not have the legal authority to allow the needed care. Communication issues may be present because of language differences. Emotions are high following a traumatic injury, and the dentist and the dental team may need to spend time gaining trust and explaining the treatment options. Finally, the dental team must determine if the injury matches the description provided or if there is a potential concern for child abuse or maltreatment.

Keywords

Dental trauma Pediatric Behavior guidance Sedation Informed consent Trauma guidelines Child abuse 

References

  1. 1.
    American Academy of Pediatric Dentistry. Behavior guidance for the pediatric dental patient. Pediatr Dent. 2018;40(special issue):254–67.Google Scholar
  2. 2.
    Townsend JA, Wells MH. Behavior guidance of the pediatric dental patient. In: Nowak AJ, Christensen JR, Mabry TR, Townsend JA, Wells MH, editors. Pediatric dentistry infancy through adolescence. Philadelphia: Elsevier; 2019. p. 352–70.Google Scholar
  3. 3.
    Pinkham JR, Patterson JR. Voice control: an old technique reexamined. ASDC J Dent Child. 1985;52:199–202.PubMedGoogle Scholar
  4. 4.
    Allen KD, Loiben T, Allen SJ, Stanley RT. Dentist-implemented contingent escape for management of disruptive child behavior. J Appl Behav Anal. 1992;25:629–36.CrossRefGoogle Scholar
  5. 5.
    Boka V, Arapostathis K, Charitoudis G, Veerkamp J, van Loveren C, Kotsanos N. A study of parental presence/absence technique for child dental behaviour management. Eur Arch Paediatr Dent. 2017;18:405–9.CrossRefGoogle Scholar
  6. 6.
    American Academy of Pediatric Dentistry. Use of nitrous oxide for pediatric dental patients. Pediatr Dent. 2018;40(special issue):281–6.Google Scholar
  7. 7.
    American Academy of Pediatric Dentistry. Monitoring and management of pediatric patients before, during and after sedation for diagnostic and therapeutic procedures: update 2016. Pediatr Dent. 2018;40(special issue):287–316.Google Scholar
  8. 8.
    Clark MS, Brunick AL. N2O and its interaction with the body. In: Handbook of nitrous oxide and oxygen sedation, vol. 2015. 4th ed. St. Louis: Elsevier Mosby. p. 90–8.CrossRefGoogle Scholar
  9. 9.
    Selzer RR, Rosenblatt DS, Laxova R, Hogan K. Adverse effect of nitrous oxide in a child with 5,10-methylenetetrahydrofolate reductase deficiency. N Engl J Med. 2003;349:45–50.CrossRefGoogle Scholar
  10. 10.
    Sanders RDB, Weimann J, Maze M. Biologic effects of nitrous oxide: a mechanistic and toxicologic review. Anesthesiology. 2008;109:707–22.CrossRefGoogle Scholar
  11. 11.
    American Academy of Pediatric Dentistry. Protective stabilization for pediatric dental patients. Pediatr Dent. 2018;40(special issue):268–73.Google Scholar
  12. 12.
    Harper DC, D’Allesandro DM. The child’s voice: understanding the contexts of children and families today. Pediatr Dent. 2004;26:114–20.PubMedGoogle Scholar
  13. 13.
    Mosquera RA, Samuels C, Flores G. Family language barriers and special-needs children. Pediatrics. 2016;138:e20160321.  https://doi.org/10.1542/peds.2016-0321.CrossRefPubMedGoogle Scholar
  14. 14.
    Flores G, Abreu M, Barone CP, Bachur R, Lin H. Errors of medical interpretation and their potential clinical consequences: a comparison of professional versus ad hoc versus no interpreters. Ann Emerg Med. 2012;60:545–53.CrossRefGoogle Scholar
  15. 15.
    Wise PH. The future pediatrician: the challenge of chronic illness. J Pediatr. 2007;151(Suppl 5):S6–S10.CrossRefGoogle Scholar
  16. 16.
    Centers for Disease Control and Prevention. Children and youth with special healthcare needs in emergencies. https://www.cdc.gov/childrenindisasters/children-with-special-healthcare-needs.html. Accessed 1/7/19.
  17. 17.
    American Society for the Positive Care of Children. https://americanspcc.org/child-abuse-statistics/. Accessed 12/28/18.
  18. 18.
    Fisher-Owens SA, Lukefahr JL, Tate AR, American Academy of Pediatrics, Section on Oral Health, Committee on Child Abuse and Neglect, American Academy of Pediatric Dentistry, Council on Clinical affairs, Council on Scientific Affairs, Ad Hoc Work Group on Child Abuse and Neglect. Oral and dental aspects of child abuse and neglect. Pediatr Dent. 2017;39(4):278–83.PubMedGoogle Scholar
  19. 19.
    Teece S, Crawford I. Best evidence topic report. Torn frenulum and non-accidental injury in children. Emerg Med J. 2005;22:125.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Rebecca L. Slayton
    • 1
  • Elizabeth A. Palmer
    • 2
  1. 1.Department of Pediatric DentistryUniversity of Washington School of DentistrySeattleUSA
  2. 2.Department of Pediatric DentistryOregon Health & Science University School of DentistryPortlandUSA

Personalised recommendations