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PAEDIATRIC DENTISTRY - 3rd Ed. (2005) Front matter Title page Paediatric Dentistry - Third Edition Edited by Richard Welbury Professor of Paediatric Dentistry University of Glasgow Monty Duggal Professor of Child Dental Health Leeds Dental Institute and Department of Child Dental Care University of Glasgow Copyright page OXFORD UNIVERSITY PRESS Great Clarendon Street, Oxford OX2 6DP Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide in Oxford New York Auckland Cape Town Dar es Salaam Hong Kong Karachi Kuala Lumpur Madrid Melbourne Mexico City Nairobi New Delhi Shanghai Taipei Toronto With offices in Argentina Austria Brazil Chile Czech Republic France Greece Guatemala Hungary Italy Japan Poland Portugal Singapore South Korea Switzerland Thailand Turkey Ukraine Vietnam Oxford is a registered trade mark of Oxford University Press in the UK and in certain other countries Published in the United States by Oxford University Press Inc., New York © Oxford University Press, 2005 The moral rights of the author have been asserted Database right Oxford University Press (maker) First edition published 1997 Reprinted 1999 Second edition published 2001 Reprinted 2003, 2004 Third edition published 2005 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without the prior permission in writing of Oxford University Press, or as expressly permitted by law, or under terms agreed with the appropriate reprographics rights organization. Enquiries concerning reproduction outside the scope of the above should be sent to the Rights Department, Oxford University Press, at the address above You must not circulate this book in any other binding or cover and you must impose the same condition on any acquirer British Library Cataloguing in Publication Data Data available Library of Congress Cataloging in Publication Data Data available Typeset by Newgen Imaging Systems (P) Ltd., Chennai, India Printed in Italy on acid-free paper by Grafiche Industriali ISBN 0 19 8565836 (pbk) EAN code 978 0 19 856583 3 1 3 5 7 9 10 8 6 4 2 Contents List of contributors vii Preface to the third edition ix Abbreviations xi 1 Craniofacial growth and development 1 P. H. Gordon 2 Introduction to the dental surgery 17 A. S. Blinkhorn 3 History, examination, risk assessment, and treatment planning 39 M. L. Hunter and H. D. Rodd 4 Pharmacological management of pain and anxiety 63 G. J. Roberts and M. T. Hosey 5 Local anaesthesia for children 89 J. G. Meechan 6 Diagnosis and prevention of dental caries 107 C. Deery and K. J. Toumba 7 Treatment of dental caries in the preschool child 131 S. A. Fayle 8 Operative treatment of dental caries in the primary dentition 147 M. S. Duggal and P. F. Day 9 Operative treatment of dental caries in the young permanent dentition 175 J. A. Smallridge and B. Williams 10 Advanced restorative dentistry 203 N. M. Kilpatrick and R. R. Welbury 11 Periodontal disease in children 231 P. A. Heasman and P. J. Waterhouse 12 Traumatic injuries to the teeth 257 R. R. Welbury and J. M. Whitworth 13 Anomalies of tooth formation and eruption 295 P. J. M. Crawford and M. J. Aldred 14 The paedodontic/orthodontic interface 319 N. E. Carter 15 Oral pathology and oral surgery 355 J. G. Meechan 16 Medical disability 385 M. T. Hosey and R. R. Welbury 17 Childhood impairment and disability 411 J. H. Nunn Index 435 Contributors M. J. Aldred Department of Dentistry Royal Childrens' Hospital Melbourne A. S. Blinkhorn Professor of Oral Health University of Manchester N. E. Carter Department of Child Dental Health Dental Hospital, Newcastle upon Tyne P. J. M. Crawford Department of Child Dental Health University of Bristol P. F. Day Department of Child Dental Health Leeds Dental Institute C. Deery Department of Paediatric Dentistry Edinburgh Dental Institute M. S. Duggal Professor of Child Dental Health Leeds Dental Institute S. A. Fayle Department of Child Dental Health Leeds Dental Institute P. H. Gordon Department of Child Dental Health University of Newcastle upon Tyne N. M. Kilpatrick Department of Dentistry Royal Children's Hospital Melbourne P. A. Heasman Department of Restorative Dentistry University of Newcastle upon Tyne M. T. Hosey Department of Child Dental Care University of Glasgow M. L. Hunter Department of Child Dental Health University of Cardiff J. G. Meechan Department of Oral Surgery University of Newcastle upon Tyne J. H. Nunn Professor of Special Needs Dentistry Trinity College Dublin G. J. Roberts Department of Children's Dentistry Eastman Dental Institute London H. D. Rodd Department of Child Dental Health University of Sheffield J. A. Smallridge Department of Child Dental Health Guys and St Thomas' Trust London K. J. Toumba Professor of Preventive and Paediatric Dentistry Leeds Dental Institute P. J. Waterhouse Department of Child Dental Health University of Newcastle upon Tyne R. R. Welbury Professor of Paediatric Dentistry University of Glasgow J. M. Whitworth Department of Restorative Dentistry University of Newcastle upon Tyne B. Williams General Dental Practitioner Ipswich, Suffolk Preface to the third edition I was very pleased when my younger colleagues and Monty Duggal accepted my offer to join me in editing this third edition. Our book has now sold four and a half thousand copies since its launch in 1997 and it is essential that we maintain a contemporary outlook and publish changes in techniques and philosophies as soon as they have an evidence base. Since 2001 and the second edition, there have been a significant number of changes of authorship, as well as a change of chapters for some existing authors. Gerry Winter died in December 2002. He was a wise colleague and friend who was a mentor to many of us. I continue to miss his expertise and availability for consultation, by post or telephone, which he freely gave even after his retirement. John Murray, Andrew Rugg-Gunn, and Linda Shaw have now retired from clinical practice. I am indebted to them all for their support, both in my own personal career and in the production of out textbook. I am grateful to them for allowing the new chapter authors to use their texts and figures. The restorative section of the book has been remodelled. The endodontics chapter in the previous editions has now been incorporated into either chapters 8 or 12, and there are separate chapters relating to the operative care of the primary and the permanent dentitions. Without the help and friendship of Jim Page the original 'Operative care of dental caries' chapter would not have been possible. I am grateful to Jim for allowing us to continue to use his original illustrations from that chapter. Although designed for the undergraduate we hope the new edition will continue to be used by undergraduate, postgraduate, and general dental practitioner alike, and that their practice of paediatric dentistry will be both fulfilling and enjoyable. R. R. W Glasgow January 2005 Copyright © 2005 Oxford University Press, 2005. All rights reserved. (+/-) Show / Hide Bibliography 2. Introduction to the dental surgery - A. S. Blinkhorn 2.1 INTRODUCTION It is a common belief among many individuals that being 'good with people' is an inborn art and owes little to science or training. It is true that some individuals have a more open disposition and can relate well to others ( Fig. 2.1). However, there is no logical reason why all of us shouldn't be able to put young patients at their ease and show that we are interested in their problems. It is particularly important for dentists to learn how to help people relax, as failure to empathize and communicate will result in disappointed patients and an unsuccessful practising career. Communicating effectively with children is of great value, as 'being good with younger patients' is a practice-builder and can reduce the stress involved when offering clinical care. All undergraduate and postgraduate dental training should include a thorough understanding of how children relate to an adult world, how the dental visit should be structured, and what strategies are available to help children cope with their apprehension about dental procedures. This chapter will consider these items, beginning with a discussion on the theories of psychological development, and following this up with sections on: parents and their influence on dental treatment; dentist-patient relationships; anxious and uncooperative children, and helping anxious patients to cope with dental care. Fig. 2.1 Being good with patients is not necessarily an inborn art! (With thanks to David Myers and kind permission of Eden Bianchi Press.) 2.2 PSYCHOLOGY OF CHILD DEVELOPMENT 2.2.0 Introduction At one time the psychological development of children was split into a series of well- defined phases, but more recently this division has been criticized and development should now be seen as a continuum. The phases of development may well differ from child to child, so a rigidly applied definition will be artificial. Nevertheless, for the sake of clarity when describing a child's psychological development from infancy into adulthood, certain developmental milestones should be considered. The academic considerations about psychological development have been dom-inated by a number of internationally known authorities who have, for the most part, concentrated on different aspects of the systematic progression from child to adult. However, the most important theoretical perspective now influencing thinking about child development is that of attachment theory⎯a theory developed by the psychoanalyst John Bowlby. In a series of writings over three decades, Bowlby developed his theory that child development could best be understood within the framework of patterns of interaction between the infant and the primary caregiver. If there were problems in this interaction, then the child was likely to develop insecure and/or anxious patterns that would affect the ability to form stable relationships with others, to develop a sense of self-worth, and to move towards independence. The other important concept to note is that development is a lifelong process, we do not switch off at 18, nor is development an even process. Development is uneven, influenced by periods of rapid bodily change. The psychological literature contains many accounts of the changes accompanying development; therefore, this section will present a general outline of the major 'psychological signposts' of which the dental team should be aware. As the newborn child is not a 'common' visitor to the dental surgery no specific description of newborn behaviour will be offered, instead general accounts of motor, cognitive, perceptual, and social development from birth to adolescence will be included. It is important to understand that the thinking about child development has become less certain and simplistic in its approach; hence, dentists who make hard and fast rules about the way they offer care to children will cause stress to both their patients and themselves. 2.2.1 Motor development A newborn child does not have an extensive range of movements, but these develop rapidly and by the age of 2 years the majority of children are capable of walking on their own. The 'motor milestones' occur in a predictable order and many of the tests used by paediatricians assess normal development in infancy in terms of motor skills. The predictability of early motor development suggests that it must be genetically programmed. Although this is true to some extent, there is evidence that the environment can influence motor development. This has led to a greater interest in the early diagnosis of motor problems so that remedial intervention can be offered. A good example of intervention is the help offered to Down syndrome babies, who have slow motor development. Specific programmes, which focus on practising sensory- motor tasks, can greatly accelerate motor development to almost normal levels. Motor development is really completed in infancy, the changes which follow the walking milestone are refinements rather than the development of new skills. Eye- hand co-ordination gradually becomes more precise and elaborate with increasing experience. The dominance of one hand emerges at an early age and is usually linked to hemisphere dominance for language processing. The left hemisphere controls the right hand and the right hemisphere controls the left. The majority of right-handed people appear to be strongly left-hemisphere dominant for language processing, as are