Pedodontics

Two primary objectives of pediatric dentistry include providing for patients' immediate dental needs and initiating good attitudes towards dental health. The practice of pedodontics is currently undergoing significant change. Much greater emphasis is being placed on the psychological techniques of behavior management. With the decline in dental caries, children and dentists are no longer engaged in a crisis confrontation. Pediatric dentistry now involves more patient education and the establishment of trusting relationships.

The American Academy of Pediatric Dentistry (1990) has recently promulgated specific guidelines for behavior management. These "Standards of Care for Behavior Management" make the following point: "Behavior management is as much an art form as it is a science. It is not an application of individual techniques created to 'deal' with children but rather a comprehensive methodology meant to build a relationship between patient and doctor which ultimately builds trust and allays fear and anxiety (Musselman, 1991, p. 1309)." For a child, the dental visit is an intense, rapidly evolving situation. It typically consists of interaction with two different adults: the parent and the dentist. These various social interrelations form the pedodontic treatment triangle. The child's position is at the apex, with the family and dental team forming the triangle's base. In this model, the child becomes

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This understanding is necessary if the dentist is going to make qualified choices with regard to appropriate management strategy (Wright, p. 38). In recent years, certain changes have occurred in pediatric dentistry. Sedation practices seem to be on the decline. For example, the application of conscious sedation techniques among the American Board of Pediatric Dentistry Diplomates dropped from 86% in 1971 to 77% in 1988. In addition general anesthesia is not universally available either. Various factors responsible for this shift include increasing state regulation, the rising costs of liability insurance, increasing fees for sedation, the expense of equipment now required to monitor sedated children, the rigorous "sedation guidelines," and a lack of third party payers. Concomitant with this decline, there has been a corresponding increase in the application of more conventional behavior management methods (Lawrence et al., 1991, p. 151). In pediatric dentistry, behavior management may be defined as "the means by which the dental health team effectively and efficiently performs treatment for a child and, at the same time, instills a positive dental attitude (Wright, p. 45)." Obviously, the dentist has innumerable option
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Approximate Word count = 4617
Approximate Pages = 18 (250 words per page)