儿童口腔医学课件

武汉大学口腔医学院 儿 童 口 腔 医 学 Pediatric Dentistry 儿童口腔医学 武汉大学口腔医学院儿童牙科 Pediatric Dentistry School of Stomatology, Wuhan University Introduction Definition Pediatric dentistry is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence including those with special health care needs. Definition Paediatric dentistry is a specialised branch devoted to the comprehensive dental health care of the child, as the oral health is vital to its general well- being. The primary axioms of the field are prevention; interception and treatment of existing dental disease. Main Themes Restorative techniques Pulpal therapy Space maintenance Interceptive orthodontics Minor dental surgery Prevention Pediatric (Paediatric) Dentistry full mouth restorative dentistry, minor dental surgery， TMJ, orthopedics, orthodontics, and prosthetics. Pedodontics (Paedodontics) Dentistry for Children 小儿齿科学 儿童口腔医学 儿童牙医学 儿童牙科学 Denomination 研究对象及内容 15岁以下的婴幼儿至青少年 乳牙和年轻恒牙及其相应时期的牙合 系统、口腔软组织 生长发育异常和疾病的诊断、治疗和 预防 儿童口腔医学的最终目的： 诱导建立正常健康的恒牙牙合系统 儿童时期最重要的特点是不断发展变化 ，我们必需以变化发展的观念来对待之 。 儿童口腔医学的基本任务： 常见口腔病的诊断、治疗和预防 家长和儿童的口腔健康教育 儿童口腔医学临床工作的基本要求： 诊疗环境及条件 医务人员的工作态度和敬业精神 患儿的合作 家长的理解与配合 PD, as a body of knowledge and as a clinical discipline, has borrowed heavily from other aspects of dental schools curricula and from breakthroughs in other specialty areas of dentistry. Preventive dentistry techniques, pulpal therapy, instrumentation and restoration of teeth, dental materials, oral surgery, interceptive (preventive) orthodontics, and principles of prosthetics. A variety of disciplines, techniques, procedures and skills that share a common basis with other specialties Modified and adapted to the special needs of infants, children, adolescents and those with special health care needs Pediatric Medicine History of Pediatric Dentistry Europe Related to school dental care ( 19 Century Later) 1931 Oslo Universityindependent pediatric dentistry 1951 Pediatric Dentistry Association of North Europe History of Pediatric Dentistry American Originating in mid 1900s Related to school dental care and department of endodontics “No children under age 13 treated in this office” Handsome Sign in 1950s 1900 Few children are treated in dental offices 1924 First comprehensive textbook on dentistry for children is published 1927 American Society for the Promotion of Dentistry for Children is established in Detroit (ADA conference) 1940 The ASPDC changes its name to the American Society of Dentistry for Children (ASDC) 1947 The American Academy of Pedodontics is formed 1948 The American Board of Pedodontics, certify candidates in the practice of dentistry for children, is formally recognized by the Council on Dental Education of the ADA 1984 The American Academy of Pedodontics changes its name to the American Academy of Pediatric Dentistry Milestones in Dentistry for Children (USA) Oversea Pediatric (Paediatric) Dentistry full mouth restorative dentistry, minor dental surgery, TMJ, orthopedics, orthodontics, and prosthetics. IAPD International Association of Pediatric Dentistry BSPD British Society of Pediatric Dentistry ASDC American Society of Dentistry for Children AAPD American Academy of Pediatric Dentistry PDAA Pediatric Dentistry Association of Asia Interior 1940s，中国儿童牙科雏形（成都、北京、上 海） 长期以来，中国儿童牙医学的教学、科研和临 床工作属口腔内科学中的一小部分 20世纪80年代以来，儿童口腔医学发展较快 The first Chinese academic meeting of prevention and therapy of oral disease for children is held in 1987, Beijing The Stomotologic Division of Chinese Medical Association establishes the pediatrics group in 1987 The 2nd, 3rd, 4th, 5th, and the 6th academic meeting of Stomatology for Children were held respectively in Shanghai, Xian, Wuhan , Beijing and Haerbin in succession The Pedodontic Division of Chinese Stomatology Association was established in Oct. 1998 and reorganized in 2003, and in 2008 The 2nd Conference of Pediatric Dentistry Association of Asia was held in Nov. 2001, Shanghai 教材的建设 1987 口腔预防医学 1/3 篇幅 1995 合编口腔预防医学及儿童口腔医 学 篇幅 2000 独立的儿童口腔病学 2003 儿童口腔医学 2007 儿童口腔医学新版 第三版 学科分化与发展 除了北京大学、四军大、上二医、四川大学、 武汉大学（五大家族）的口腔医学院以外，首 都医科大学、吉林大学、同济大学等口腔医学 院都是较早成立儿童牙病科（诊）室的地方 临床、教学、科研工作 社会基础及背景 A pediatric dental specialist Completing 24 months in an advanced education program which are designed to provide special knowledge and skills Necessary didactic background Clinical experiences to provide comprehensive primary oral health care The services of a specialist Tips of clinical work Cooperation of children Knowledge for speciality Skill of operation Psycology for children Child dental fear Definition Assessment Behavioral Psycological Physiological Pictorial Corahs Dental Anxiety Scale Venham Picture Test Childrens Fear Survey Schedule-Dental Subscale Childrens Dental Fear Picture Test Dental Fear Survey Fear Thermometer Picture Analogue Scale What are the causes of dental fear in children How to eliminate the fears Is fear of dentistry decreasing as time goes on What role do parents play in your patients dental fears Any advice to parents before they bring in their child for the first visit to a dentist Do you allow parents to stay in the treatment room while you are seeing their child What should a parent do or not do while in the treatment area What new techniques are available to make a childs dental visit easier than in the past At what age do you see children for their first visit What do you think the future will bring to childrens dentistry Special concerns for childrens teeth: Baby Bottle Caries Fluorosis Sealants Space Maintenance / Orthodontics Special Dental tips for small infants and toddlers As your child develops. Vista of the future 由于存在许多临床、科研方面的空 白，发展空间巨大 Clinical Treatment Occlusive guidance Air abrasive Carisolv Laser Oral health care of disable children General anesthesia/N2O inhalation Teaching permanent teeth may erupt late, perhaps in the wrong position. The eruption sequencethe order in which the teeth eruptis more important than the age at which they erupt in the establishment of a normal occlusion. Occlusal Development The primary dentition A continuous process of primary tooth eruption between the ages of 6 and 30 months Features of primary dentition The incisor teeth tend to be spaced The socalled “anthropoid” spaces (primate space) between the upper lateral incisor and the canine and between the lower canine and the first primary molar are particularly common Developmental space occur at age 34 The mesiobuccal cusp of the primary upper second molar occludes in the mesiobuccal groove of the lower second molar The distal surfaces of the upper and lower second molar are in the same vertical plane or mesial step Features of primary dentition The incisor teeth tend to be spaced The socalled “anthropoid” spaces (primate space) between the upper lateral incisor and the canine and between the lower canine and the first primary molar are particularly common Developmental space occur at age 34 The mesiobuccal cusp of the primary upper second molar occludes in the mesiobuccal groove of the lower second molar The distal surfaces of the upper and lower second molar are in the same vertical plane or mesial step The mixed dentition The permanent dentition erupts in two stages as first the incisor teeth and the first permanent molar erupt, then the other teeth in the buccal segments Ugly duckling stage, crowding of the permanent incisor teeth “leeway space”: the primary teeth in buccal segment have a larger combined mesiodistal widths than do the permanent teeth Permanent Dentition The mesiobuccal cusp of the upper 1st molar occludes in the mesiobuccal groove of the lower 1st molar The teeth have a normal labiolingual inclination. The teeth have a normal mesiodistal angulation, with the crown of teeth more mesially positioned than their root No rotated teeth No spacing and crowding teeth Occlusal plane should be flat or a mild curve of Spee Anatomical and physiological characteristics of the primary and the permanent teeth Primary Dentition Primary Dentition 20 deciduous teeth , primary teeth incisor, canine, molar Erupt at age 67 month Complete at age 3036 month Clinical differentiation between primary teeth and permanent teeth extent of wear colour and luster shape size array X-RAY Anatomical and physiological characteristics of primary dental pulp relatively large pulp chamber more prominent pulp horns more cellular components in pulp less fibrous components in pulp abundant blood supply loosen pulp tissue nerves Model of Primary 1st Molar Pulp Morphology NOBODY IN THE WORLD DOES ENDO ON FIRST PRIMARY MOLARS! Mark H. Taylor Characteristics of primary dental enamel and dentin Higher content of organics Active chemical reactivity less extent of calcification, antiwear and hardness Prenatal and postnatal hard tissue Active formation of restorative dentin Root absorption of primary teeth physiological absorption intermittent submerged