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Pediatric Dentistry for Special Child
Priya Verma Gupta
SECTION 1: BASIC CONCEPTS
CHAPTER 1:
General Considerations
INTRODUCTION
HISTORICAL BACKGROUND
DEFINITIONS
Weddell (McDonald and Avery)
World Health Organization
American Public Health Association
Social Security Disability Insurance Program
Americans Disabilities Act of 1990
American Academy of Pediatric Dentistry (2014-15)
CLASSIFICATIONS
Frank and Winter (1974)
Agerholm (1975)
Intrinsic and Extrinsic
Nowak (1976)
Damle (2000)
PREVALENCE
PERCEPTION
Children
Adults
Family
Sources of Stress
Siblings
DENTISTRY FOR SPECIAL CHILD
Need for Dental Services
Importance of Dental Care
Limited Services
Risk Factors
Diet
Muscular Functions
Oral Hygiene Problems
Sweetened Medication
GENERAL CONSIDERATIONS
Dental Office Access
Patient Screening
Family Involvement
Radiographic Technique
The Lateral Jaw Projection
Anterior Occlusal Projections
Buccal Bitewing Radiograph
FIRST APPRAISAL
Assessing Disable Child
Management Scale (Menius, 1971)
Literature Review for Behavior Modification
Concerns of the Pediatric Dentist
PSYCHOLOGY
Fears
Behavioral Characteristics
Approach to Management
Behavior Modification
Reinforcement
MANAGEMENT
Understanding the Condition
The Assistant
The Examination
Treatment Planning
Drugs
Home Care
Diet and Nutrition
Fluoride Exposure
Preventive Restorations
Regular Professional Supervision
Physical Restraints
Cerebral Palsy Head Support
SUPPORT PROGRAMS
Head Start Program
Supplemental Security Insurance Program
Education of the Handicapped
PREVENTIVE METHODOLOGIES
Expectations and Motivation
Suggested Programs
Positioning
CONCLUSION
SECTION 2: INTELLECTUALLY CHALLENGED
CHAPTER 2:
Mental Retardation
INTRODUCTION
HISTORY
DEFINITIONS
EPIDEMIOLOGY
CLASSIFICATIONS
According to Degrees of Mental Retardation
Mild
Moderate
Severe
Profound
Unspecified Severity
According to Origin
Syndromic or Nonsyndromic MR
ETIOLOGY
Genetic
Epigenetic
ETIOPATHOGENESIS
CLINICAL CONSIDERATIONS
ORAL MANIFESTATIONS
INVESTIGATIONS
Diagnostic Examination
Lab Investigations
Metabolic Studies
Cytogenetics
Karyotyping
FISH Probic
Imaging Studies (Neuroradiological Studies)
Psychological Examination
Electrophysiologic Studies
DIFFERENTIAL DIAGNOSIS
DIAGNOSIS
MULTIDISCIPLINARY APPROACH
PHARMACOLOGICAL APPROACH
DENTAL MANAGEMENT
General Considerations
Patient Assessment
Behavior Management
Desensitization
Restraint
Sedation
General Anesthesia
CLINICAL CONCERNS
Periodontal
Restorative
Traumatic Injuries
Developmental Discrepancies
MANAGEMENT MODIFICATIONS
Periodontal
Restorative
Endodontic
Prosthetic
MAINTENANCE
Education
Financial Considerations
Follow-up Care
CONCLUSION
CHAPTER 3:
Cerebral Palsy
INTRODUCTION
DEFINITIONS
HISTORY
EPIDEMIOLOGY
INCIDENCE
ETIOLOGY
Prenatal
Perinatal
Postnatal
Prematurity
Other Factors
MOTOR IMPAIRMENT
CLASSIFICATIONS
According to Degree of Affected Areas
According to Topography
According to Motor Function
Modified Swedish Classification
Early Signs—Infants
CLINICAL MANIFESTATIONS
Spastic Diplegia
Hemiplegia
Congenital Hemiplegia
Acquired Hemiplegia
Spastic Quadriplegia/Bilateral Hemiplegia
Dyskinetic (Athetoid) CP
ORAL MANIFESTATIONS
SYSTEMIC MANIFESTATIONS
Neurologic Status
Nutrition and Oromotor Control
Gastrointestinal Problems
Genitourinary Problems
Dental Care
Growth Abnormalities
DIAGNOSIS
History
Examination
Neurologic
Musculoskeletal
INVESTIGATIONS
Laboratory Tests
Neuroimaging
PROGNOSIS
MANAGEMENT
Goals of Management
Medical Management
Spasticity
Gait
Dental Management
Role of the Dentist
Home Dental Care for Children with Cerebral Palsy
ORAL HEALTH CONCERNS
REHABILITATION
Physiotherapy
Bracing
Accessory Devices
SPASTICITY MANAGEMENT
Oral Medications
Botulinum Toxin
Intrathecal Baclofen
Selective Dorsal Rhizotomy
Corrective Casting
Orthopedic Surgery
CONCLUSION
CHAPTER 4:
Epilepsy
INTRODUCTION
ETIOLOGY
CLASSIFICATIONS
Epilepsy
According to Etiology
According to the Involvement of Area
According to International League of Epilepsy 1989
Seizure
CLINICAL PRESENTATION
Focal/Partial Seizures
Simple Partial Seizures
Complex Partial Seizure
Generalized Seizures
Absence Seizures
Myoclonic Seizure
Atonic Seizure
Clonic Seizure
Tonic Seizures
Febrile Seizure
Neonatal Seizures
ORAL MANIFESTATIONS
EPILEPTIC SYNDROMES
DIAGNOSIS
History
Clinical Examination
Investigations
EEG
Imaging
STATUS EPILEPTICUS
Etiology
Classification
MANAGEMENT
Pharmacological
Nonpharmacological
Surgical
Epilepsy Associated Syndromes
Sturge-Weber Syndrome
Down Syndrome
Fragile X Syndrome
Rett Syndrome
Autism
Cerebral Palsy
Associated Conditions
Behavioral Problems
Differentiating Epileptic Events and Nonepileptic Events
Classification of Nonepileptic Events
DENTAL MANAGEMENT
CONCLUSION
CHAPTER 5:
Autism
INTRODUCTION
DEFINITIONS
Autism Spectrum Disorder
Autistic Disorder
Rett's Disorder
Childhood Disintegrative Disorder
Asperger's Disorder
Pervasive Development Disorder Not Otherwise Specified
THEORIES
EPIDEMIOLOGY
ETIOLOGY
Genetic
Prenatal
Postnatal
Environmental
DIAGNOSIS
CLINICAL MANIFESTATIONS
Primary Features
Associated Features
ORAL MANIFESTATIONS
Dental Caries
Self-injurious Behaviors
MEDICAL MANAGEMENT
DENTAL MANAGEMENT
Things to Remember
CONCLUSION
SECTION 3: PHYSICALLY CHALLENGED
CHAPTER 6:
Hearing Impairments
INTRODUCTION
HEARING IMPAIRMENT
CLASSIFICATIONS
According to Severity of Condition (WHO)
According to the Type
According to the Age of Onset
According to the Involvement
According to Shape of Air Conduction on Audiogram
ETIOLOGY
Genetic
Age
Disease
Medications
Noise-induced Hearing Loss
Exposure to Ototoxic Chemicals
Trauma
MANIFESTATIONS
Clinical
Oral
COMMUNICATION METHODS
GENERAL CONSIDERATIONS
Assessment
Lip-reading
Before Conversation
During Conversation
Improving Communication
DENTAL CONSIDERATIONS
CONCLUSION
CHAPTER 7:
Visual Impairments
INTRODUCTION
DEFINITIONS
CLASSIFICATION
According to WHO
Low Vision
Blindness
ETIOLOGY
ORAL MANIFESTATIONS
ESTABLISHING COMMUNICATION
DENTAL CONSIDERATIONS
Physical Access
Seating the Patient
DENTAL MANAGEMENT
CONCLUSION
CHAPTER 8:
Speech Impairments
INTRODUCTION
DEFINITIONS
SPEECH CENTER
Sequence of Speech
FEEDBACK MECHANISM
Auditory Feedback Loop
Kinaesthetic Feedback Loop
Tactile Feedback Loop
SPEECH PRODUCTION
MODE OF SPEECH ARTICULATION
Resonators
Articulatory Mechanism
Sounds Based on Articulatory Mechanism
CLASSIFICATION
According to the Area of Phonatory System Involved
ETIOLOGY
THEORIES OF SPEECH DEVELOPMENT
Behavioral Theory
Structuralist Theory
Natural Theory
Prosodic Theory
Discovery Theory
MOTOR CONTROL MECHANISM
Muscular Speech Mechanism
Mechanism of Phonation
Frequency of Vibration
Mechanism of Articulation
DENTAL-ASSOCIATED DEFECTS
SPEECH EVALUATION
INVESTIGATION
Articulation
Language
MANAGEMENT
Goals for Management
DENTAL MANAGEMENT
CONCLUSION
SECTION 4: MEDICALLY CHALLENGED
CHAPTER 9:
Cardiovascular Disorders
INTRODUCTION
CONGENITAL HEART DISEASE
Classifications
According to Cyanosis
American Heart Association Classification
Clinical Manifestations
Oral Manifestations
Dental Management
CONGESTIVE HEART FAILURE
Etiology
Types
Classifications
New York Heart Association (NYHA) Classification
American Heart Association Classification
Clinical Features
Symptoms
Signs
Congestive Heart Failure in Pediatrics
Diagnosis
Management
Medical
Dental
RHEUMATIC FEVER
Etiology
Pathophysiology
Diagnosis
Required Criteria
Major Criteria
Minor Criteria
Preventive Measures
Primary Prevention for Rheumatic Fever
Secondary Prevention for Rheumatic Fever
Management
INFECTIVE ENDOCARDITIS
Etiology
Pathogenesis
Classifications
Acute vs Subacute
Culture-positive vs Culture-negative
Right sided vs Left sided
Nosocomial vs Community Acquired
Native-valve Endocarditis vs Prosthetic-valve
Clinical Features
Investigations
Diagnosis
Major Criteria
Minor Criteria
Management
Pharmacotherapy
Surgical Management
Dental Considerations
Prophylactic Antibiotic Regimen
CONCLUSION
CHAPTER 10:
Respiratory Disorders
BRONCHIAL ASTHMA
Etiology
Triggers
Adults
Pediatric
Pathophysiology
General Symptoms
Classifications
Stage 1: Mild Intermittent Asthma
Stage 2: Mild Persistent Asthma
Stage 3: Moderate Persistent Asthma
Stage 4: Severe Persistent Asthma
Status Asthmaticus
Symptoms and Signs
Management
Oral Manifestations
Dental Management
CYSTIC FIBROSIS
Symptoms and Signs
Etiopathogenesis
Oral Manifestations
Caries
Coronal Discoloration
Diagnosis
Complications
Medical Management
Dental Management
CONCLUSION
CHAPTER 11:
Gastrointestinal Disorders
GASTROESOPHAGEAL REFLUX DISEASE
Etiology
Pathophysiology
Clinical Manifestations
Oral Manifestations
Dental Management
INFLAMMATORY BOWEL DISEASE
Risk Factors
Type
Etiopathogenesis
Classification
Clinical Manifestations
Oral Manifestations
Diagnosis
Ulcerative Colitis
Common Oral Manifestations to Ibd (Crohn's Disease + Ulcerative Colitis)
Dental Management
Medical Management
CONCLUSION
CHAPTER 12:
Renal Disorders
NEPHROTIC SYNDROME
RENAL FAILURE
Acute Renal Failure
Chronic Renal Failure
Etiology
Acute Renal Failure
Chronic Renal Failure
ORAL MANIFESTATIONS
MANAGEMENT
DENTAL MANAGEMENT
CONCLUSION
CHAPTER 13:
Hematological Disorders
ANEMIA
Classifications
Iron Deficiency Anemia
Etiology
Clinical Manifestations
Oral Manifestations
Investigations
Management
Megaloblastic Anemia
Etiology
Pathogenesis
Clinical Features
Oral Manifestations
Investigations
Management
Sickle Cell Anemia
Sickle Cell Trait
Pathogenesis
Clinical Features
Oral Manifestations
Radiographic Features
Oral Health Considerations
Investigations
Management
THALASSEMIA
Pathophysiology
Clinical Features
Oral Manifestations
Dental Management
Dental Considerations
Investigations
Management
Complications
HEMOPHILIA
Hemophilia A
Etiopathogenesis
Clinical Features
Investigations
Management
Hemophilia B
Etiopathogenesis
Clinical Features
Investigations
Management
Oral Manifestations
Dental Considerations
VON WILLEBRAND DISEASE
Classification
Etiopathogenesis
Clinical Features
Oral Manifestations
Investigation
Management
Dental Management
LEUKEMIA
Classification
Acute Lymphoblastic Leukemia
Chronic Lymphocytic Leukemia
Acute Myeloid Leukemia
Chronic Myeloid Leukemia
CHAPTER 14:
Endocrine and Metabolic Disorders
HYPOTHYROIDISM
Clinical Presentation
Symptoms
Signs
Craniofacial Manifestations
Skeletal Manifestations
Oral Manifestations
Dental Management
HYPERTHYROIDISM
Etiology
Clinical Manifestations
Symptoms
Signs
Oral Manifestations
Dental Management
HYPERPARATHYROIDISM
Clinical Manifestations
Symptoms
Signs
Radiographic Manifestations
Oral Manifestations
Dental Management
HYPOPARATHYROIDISM
Etiology
Clinical Manifestations
Oral Manifestations
Dental Management
ADRENAL INSUFFICIENCY
Etiology
Clinical Manifestations
Signs
Mineralocorticoid Deficiency
Oral Manifestations
Dental Management
ADDISONIAN CRISES
Chair Side
Medical Emergency
Dental Management
HYPERCORTICISM/CUSHING SYNDROME
Etiology
Clinical Manifestations
Symptoms
Signs
Oral Manifestations
Dental Management
DIABETES MELLITUS
Types
Etiology
Clinical Manifestations—Type I
Early
Late
Management
Diabetes Type-II
Indication for Screening Type-II DM
Diagnosis
Clinical Presentation
Oral Manifestations
Management
Dental Management
Before Management
During Management
After Management
CONCLUSION
CHAPTER 15:
Liver Disorders and Hepatitis
NEONATAL JAUNDICE
Types
Etiopathogenesis
Assessment
Kramer's Role
Ingram Icterometer
Transcutaneous Bilirubinometer
Management
HEPATITIS
Hepatitis A
Pathogenesis
Clinical Features
Lab Investigations
Management
Prevention
Hepatitis B
Pathogenesis
Transmission
Clinical Features
Laboratory Investigation
Management
Prevention
Hepatitis C
Transmission
Pathogenesis
Clinical Features
Diagnosis
Management
Hepatitis D
Transmission
Pathogenesis
Clinical Features
Lab Investigations
Management and Prevention
Hepatitis E
Transmission
Clinical Features
Diagnosis
Management
Hepatitis G
Transmission
Clinical Features
Lab Investigations
Management
Oral Manifestations
Dental Considerations
INDIAN CHILDHOOD CIRRHOSIS
Epidemiology
Etiology
Pathophysiology
Clinical Features
Investigations
Management
CONCLUSION
CHAPTER 16:
Pediatric HIV Infection
INTRODUCTION
CLASSIFICATIONS
Walter Reed Staging Classification
CDC Classification
Clinical Stage 1
Clinical Stage 2
Clinical Stage 3
Clinical Stage 4
Advantages
Pediatric HIV Immune Category Classification
EPIDEMIOLOGY
IMMUNOPATHOGENESIS
HIV INFECTION IN NEONATES AND INFANTS
THE VIRUS STRUCTURE AND ITS PATHOGENICITY
The Genetic Structure of RNA
Proteins of HIV
Gag
Pol
Env
Regulatory Factors
Inhibitory Factors
Antigens
SUSCEPTIBILITY OF VIRUS TO PHYSICAL AND CHEMICAL AGENTS
THE VIRAL REPLICATIVE CYCLE
BIOLOGIC AND ANTIGENIC VARIATION
SPECIES OF CELL INFECTED BY HIV
FATE OF INFECTED CELL
TRANSMISSION
Mode of HIV Transmission in Children
Vertical Transmission
Mode of Vertical Transmission
Risk Factors for Transmission
VARIABILITY OF CLINICAL DISEASE
CLINICAL MANIFESTATIONS
Central Nervous System
Lung
Cardiac
Blood Vessels
Gastrointestinal Tract
Renal
Hematologic
Endocrine
Dermatologic
ORAL MANIFESTATIONS
Prevalence
Classification
Fungal Infections
Viral Infections
Bacterial Infections
Neoplastic Lesions
Other Oral Lesions
Candidiasis
Oropharyngeal Candidiasis
Herpes Simplex Virus (HSV) Infection
Recurrent Aphthous Stomatitis
Other Ulcerogenic Diseases
Hospitalization Associated with Oral Leisons
Hiv-associated Periodontal Disease
Salivary Gland Dysfunction
Hairy Leukoplakia
Oral Warts
Malignancy
Thrombocytopenia
Saliva and HIV
Gingival and Plaque Indices
Over-retained Primary Teeth and Delayed Euption of Primary and Permanent Teeth
Dental Caries
Oral Health
GUIDING A FAMILY THROUGH THE DISCLOSURES PROCESS
MODIFICATION OF DENTAL CARE
Treatment Planning
Antibiotic Prophylaxis
Modification of Dental Procedures
Local Anesthetics
Preventive Oral Health Care
Periodontal Therapy
Restorative and Prosthetic Procedures
Endodontic Therapy
Oral Surgical Procedures
Hemostasis
Extractions
Extensive Surgical Interventions
INFECTION CONTROL
Cleaning of Instruments
Sterilization
Heat Sterilization
Disinfection
Removal
Cleaning and Disinfection
Seating the Patient and Resetting the Operatory
Covers and Disposables
Central Sterilization Area
Cleaning of Instruments
Instrument Set-ups and Packaging
Methods for Cleaning, Packaging, and Sterilization of Dental Hand Instruments
Wrapping Techniques for Other Articles
LABORATORY INVESTIGATIONS
Screening Tests
ELISA (Enzyme-linked Immunosorbent Assay)
Radioimmunoassays
Slide Agglutination Tests
Confirmatory Assays
Western Blot Assay
Radioimmunoprecipitation Assay
MANAGEMENT
CONCLUSION
SECTION 5: GENETICALLY CHALLENGED
CHAPTER 17:
Down Syndrome
INTRODUCTION
HISTORY
EPIDEMIOLOGY
ETIOLOGY
CLINICAL FEATURES
CRANIOFACIAL MANIFESTATIONS
ORAL MANIFESTATIONS
ORAL HEALTH CONCERNS
Dental Caries
Periodontal Disease
Progression and Distribution
Etiology of Periodontal Disease
MALOCCLUSION
MANAGEMENT
Dental Management
BARRIERS IN DENTAL CARE
Sleep Apnea
Intellectual Subnormality Influencing Dental Care and Behavior Management
Orofacial Features Influencing Dental Care
CONCLUSION
CHAPTER 18:
Marfan Syndrome
INTRODUCTION
INCIDENCE
ETIOLOGY
DIAGNOSTIC CRITERIA
Family History
Major criteria
Skeletal
Major Criteria
Minor criteria
Ocular
Major Criterion
Minor Criteria
Cardiovascular
Major Criteria
Minor Criteria
Pulmonary
Major Criterion
Minor Criteria
Skin and Integument
Major Criterion
Minor Criteria
Dura
Major Criterion
Minor Criteria
Requisites for diagnosis
CLINICAL MANIFESTATIONS
General
Systemic
Skull
Ocular
Cardiovascular
Pulmonary
Skin and Integument
Central Nervous System
CRANIOFACIAL MANIFESTATIONS
DIFFERENTIAL DIAGNOSIS
Homocystinuria
Klinefelter's Syndrome
Stickler Syndrome
Ehlers-danlos Syndrome
Beale's Syndrome
Sotos Syndrome
Constitutional Tall Stature
Other Conditions to Consider
Similar Cardiac Features
Similar Ocular Features
Similar Skeletal Features
MEDICAL MANAGEMENT
DENTAL MANAGEMENT
CONCLUSION
CHAPTER 19:
Pierre Robin Sequence
INTRODUCTION
INCIDENCE
PATHOPHYSIOLOGY
Mechanical Theory
Neurological Maturation Phase
Rhombencephalic Dysneurulation
ETIOLOGY
CLINICAL FEATURES
DIAGNOSIS
NATURAL SEQUELAE
MANAGEMENT
Medical Management
Surgical Management
Tongue-lip Adhesion
Tracheotomy
Mandibular Distraction
Cleft Palate Closure
Hearing
Dental Management
CONCLUSION
CHAPTER 20:
Ectodermal Dysplasia
INTRODUCTION
HISTORY
ETIOLOGY
CLINICAL MANIFESTATIONS
ORAL MANIFESTATIONS
RADIOLOGICAL MANIFESTATIONS
CLASSIFICATIONS
DIAGNOSTICS
MANAGEMENT
CONCLUSION
CHAPTER 21:
Cleidocranial Dysplasia
INTRODUCTION
PREVALENCE
ETIOPATHOGENESIS
ETIOLOGY
CLINICAL MANIFESTATIONS
Shoulder Girdle
Skeletal
ORAL MANIFESTATIONS
RADIOLOGICAL MANIFESTATIONS
Skull and Face
Shoulder
Hands
Spine
Pelvis
Hips
Ankle and Feet
PRENATAL DIAGNOSIS
DIFFERENTIAL DIAGNOSIS
MANAGEMENT
CONCLUSION
CHAPTER 22:
Crouzon Syndrome
INTRODUCTION
GENETICS
PATHOPHYSIOLOGY
CLINICAL PRESENTATION
Craniofacial Features
Skull
Face and Eyes
Nose, Mouth and Ears
Skeletal Features
Skin Involvement
DIFFERENTIAL DIAGNOSIS
DIAGNOSIS
MANAGEMENT
CONCLUSION
CHAPTER 23:
Apert Syndrome
INTRODUCTION
HISTORY
PREVALENCE
GENETICS
SUTURAL DEFECT
CLINICAL MANIFESTATIONS
ORAL MANIFESTATIONS
DIAGNOSIS
Prenatal Diagnosis
Postnatal
Imaging
MANAGEMENT
Medical Management
Sleep Apnea
Ophthalmic
Surgical Management
Cranial Surgery
Facial Surgery
Finger Surgery
Orbital Surgery
Mandibular Surgery
CONCLUSION
CHAPTER 24:
Klinefelter Syndrome
INTRODUCTION
HISTORICAL BACKGROUND
PREVALENCE
PATHOGENESIS
CLINICAL MANIFESTATIONS
ORAL MANIFESTATIONS
DIAGNOSIS
MANAGEMENT
Screening
Medical
Surgical Management
Genetic Counseling
DENTAL MANAGEMENT
CONCLUSION
CHAPTER 25:
Myopathies
INTRODUCTION
GENETIC MYOPATHIES
Muscular Dystrophies
Duchenne Muscular Dystrophy (DMD)
Limb-girdle Muscular Dystrophies
Bethlem Myopathy
Emery-Dreifuss Muscular Dystrophy
Congenital Myopathies
Myotonias
Myotonic Dystrophy
Nondystrophic Myotonias and Periodic Paralysis
Genetic Metabolic Myopathies
King Syndrome
McArdle's Disease
ACQUIRED MYOPATHIES
Inflammatory Myopathies
Metabolic Myopathies
Endocrine Myopathies
Toxic Myopathies
Alcohol Myopathy
Drug-induced Myopathy
ORAL MANIFESTATIONS
DENTAL CONSIDERATIONS
CONCLUSION
CHAPTER 26:
Treacher Collins Syndrome
INTRODUCTION
ETIOLOGY/GENETICS
CLINICAL MANIFESTATIONS
Ocular and Periorbital
Auricular
Zygoma and Malar Region
Maxilla and Mandible
Other Important Features
ORAL MANIFESTATIONS
DIAGNOSIS
MANAGEMENT
Neonatal Management
Surgical Management
Oral Surgery
CONCLUSION
CHAPTER 27:
Hemifacial Microsomia
INTRODUCTION
ETIOLOGY
EMBRYOLOGY
CLASSIFICATIONS
1. Pruzansky's Original Classification
2. OMENS Classification
CLINICAL FEATURES
Additional Clinical Features
DIAGNOSIS AND EVALUATION
MANAGEMENT
CONCLUSION
CHAPTER 28:
Cleft Lip and Palate
INTRODUCTION
INCIDENCE AND PREVALENCE
EMBRYOLOGY
Embryology of Cleft Lip and Palate
Mesodermal Migration
Polarization and Ectodermal Sculpting
Positional Change, Growth and Fusion of Palatal Processes
Anomalies of the Positional Change
Development of the Philtrum
ETIOLOGY
Genetic
Environmental
Other Contributing Factors
DIAGNOSTIC EVALUATION
Prenatal History
Family History
Physical Examination
CLASSIFICATIONS
Morphological Classification
Embryological Classification
Symbolic and Computer-graphic Presentation
Davis and Ritchie Classification (1922)
Fogh Anderson (1942) Classification
Schuchardt and Pfeifer's Symbolic Classification
LAHSHAL Classification
CLINICAL PRESENTATION
ASSOCIATED DEVELOPMENTAL DISTURBANCES OF TEETH
PATHOLOGICAL ANATOMY
The Nose
Nerves
Sensory
Motor
Cleft Palate
Blood Supply in Cleft Palate
Epignathus
Cleft Lip Repair
Cleft Palate Repair
DIAGNOSIS
Ultrasound in Prenatal Diagnosis
Sonographic Diagnosis
Common Techniques
MULTIDISCIPLINARY CLP TEAM
General Responsibilities of Team Members
Dental Specialties
MULTIDISCIPLINARY MANAGEMENT IN CLP
Impression Technique and Obturator Construction
Steps in Obturator Construction
Clinical Management of Initial Obturator Therapy (Birth to 3 Months)
Premaxillary Orthopedics (Birth to 4 or 5 Months)
Airway Obstruction
Cheiloplasty (Surgical Lip Closure)
Maxillary Orthopedics (3–9 Months)
Bone Grafting of Alveolar Cleft Defects
Primary Alveolar Cleft Bone Grafting
Surgical Technique for Primary Alveolar Cleft Bone Grafts
Palatoplasty (Surgical Closure of Palate)
Stage II (Primary Dentition Stage—18 Months To 5 Years Of Age)
Stage III (Late Primary or Mixed Dentition Stage—6 to 10 or 11 Years of Age)
Secondary Alveolar Cleft Bone Graft
PROTOCOL FOR DENTAL CARE
At Birth
3 to 5 Months
12 Months
2 to 6 Years
6 to 7 Years
8 Years
9 Years
10 to 12 Years
12 to 15 Years
SURGICAL MANAGEMENT
Technique of Cleft Lip Repair
Technique of Palate Repair
CONCLUSION
SECTION 6: EMOTIONALLY CHALLENGED
CHAPTER 29:
Child Abuse and Neglect
INTRODUCTION
DEFINITION
TYPES
PREVALENCE OF ORAL INJURIES
SIGNS
The Child
The Parent
The Parent and Child
PHYSICAL ABUSE
Forms of Physical Abuse
If Child/Infant Shows
Suspect Physical Abuse If
SEXUAL ABUSE
Types of Sexual Assault
Forms of Sexual Abuse
Suspect Sexual Abuse When the Child
Suspect Sexual Abuse When the Parent
EMOTIONAL ABUSE
Types of Emotional Abuse
Active
Passive
Signs of Emotional Abuse
Signs of Neglect
MUNCHAUSEN SYNDROME BY PROXY
Causes
Symptoms
Diagnosis
Management
Prognosis
Possible Complications
Seek Medical Attention
Prevention
MATERNAL DEPRIVATION SYNDROME
Causes
Factors
Symptoms
Diagnosis
Management
Prognosis
Complications
When to Contact a Medical Professional
Prevention
SHAKEN BABY SYNDROME
Considerations
Etiology
Symptoms
Differentiating Factors
Investigations
Emergency Management
Steps to be taken if the Child is Vomiting
Avoid
Ask for Medical Care
Prevention
Alternative Names
CLINICAL MANIFESTATIONS OF CHILD ABUSE
Cutaneous Manifestations
Bruises
Bite Marks
Burns
Skeletal Manifestations
Orofacial Manifestations
CHILD NEGLECT
Causes of Child Neglect
Types of Child Neglect
Physical Neglect
Neglect/Emotional
Educational Neglect
Nutritional Neglect
Medical Neglect
Dental Neglect
MANAGeMENT OF DENTAL NEGLECT
In Case of Suspect
MANAGEMENT
Managing Child Abuse
Key Concepts for Sexual Abuse
DENTAL MANAGEMENT FOR THE ABUSED
Examination and Documentation
Obtaining Records
Management with Multidisciplinary Approach
CONCLUSION
SECTION 7: LEARNING DISABILITIES
CHAPTER 30:
Attention Deficit Hyperactivity Disorder
INTRODUCTION
HISTORY
SUBTYPES
Predominantly Hyperactive Impulsive
Predominantly Inattentive
Combined Hyperactive Impulsive and Inattentive
PREVALENCE
ETIOLOGY
CLINICAL FEATURES
Adults
Children
ORAL MANIFESTATIONS
Trauma
Oral Hygiene
DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS
DIAGNOSTIC CRITERIA
MANAGEMENT
ADVERSE OROFACIAL REACTIONS
DENTAL CONSIDERATIONS
DENTAL MANAGEMENT
CONCLUSION
CHAPTER 31:
Dyslexia
INTRODUCTION
HISTORY
DEFINITIONS
EPIDEMIOLOGY
THEORIES
PATHOPHYSIOLOGY
TYPES
SIGNS AND SYMPTOMS
General Appearance
Educational Effects of Dyslexia
Writing Skills
Associated Problems
Social and Emotional Problems
ORAL MANIFESTATIONS
DIAGNOSIS
MANAGEMENT
DENTAL MANAGEMENT
CONCLUSION
SECTION 8: PHARAMACOLOGICAL BEHAVIOR MANAGEMENT
CHAPTER 32:
Premedication
INTRODUCTION
INDICATIONS
AIMS
PREMEDICATION DRUGS
Chloral Hydrate
Excessive Doses of Chloral Hydrate
Barbiturates
Effects on CNS
Route of Administration
Adverse Reactions
Dosage
Meprobamate
Actions
Rare Reactions
Dosage
Diazepam
Adverse Reactions
Dosage
Hydroxyzine
Meperidine
Side Effects
Dosage
Emergency Care
GUIDELINES FOR PREMEDICATION
CONCLUSION
CHAPTER 33:
Nitrous Oxide-Oxygen Inhalation Sedation
INTRODUCTION
HISTORY
PHARMACODYNAMICS
ADVANTAGES OF NOIS WITH SPECIAL CHILDREN
NOIS AND SPECIAL CONDITIONS
RELATIVE CONTRAINDICATIONS
EQUIPMENTS
PATIENT PREPARATION
PROCEDURAL STEPS
MONITORING
ADVERSE EVENTS DURING NOIS
OCCUPATIONAL HAZARDS
OTHER MODALITIES VS NOIS
General Anesthesia
Procedural Sedation
CONCLUSION
CHAPTER 34:
Dental General Anesthesia
INTRODUCTION
GENERAL ANESTHESIA
DRUGS USED IN DGA
DAY SURGERY
DGA Team
Explanation of Potential Risks
Informed Consent
Preanesthetic Evaluation
Preanesthetic Preparation
Nil by Mouth Guidelines
INTUBATION
Oral Tracheal Intubation
Retro-Molar Intubation
Nasal Intubation
Submento-Tracheal Intubation
TECHNIQUE
Drugs Integrations
Dental Treatment
DOCUMENTATION
POSTOPERATIVE INSTRUCTIONS
Follow-up
Repeated DGA
CHECK LIST
CONCLUSION
CHAPTER 35:
Hospital Pediatric Dentistry
INTRODUCTION
INDICATIONS FOR HOSPITAL ADMISSION
PEDIATRIC CONSIDERATIONS
MEDICAL RECORDS
Purpose of the Medical Records
Guidelines for Maintaining
Confidentiality of the Medical Records
Characteristics of an Acceptable Record
Content of the Medical Records
Admission Notes
History
Medical History
Family and Psychosocial History
Review of Systems
Physical Examination
Radiographic Surveys
Impressions
Operative Notes
Preoperative Notes
Postoperative Orders
Postoperative Notes
CLINICAL RECORDS
Importance
Components of Clinical Record
Details Required for Treatment Notes
Contemporaneous Records
Medical History
Correspondence
Consents and Warnings
Drugs and Dosages
Radiographs
Investigations and Reports
Payment and Receipts
Computerized Records
Retaining the Records
Missing Notes
Back Up and Safeguards
Retention of Records
Computerized Records
Manual Records
Who can Apply?
Application
CONSENT, NEGLIGENCE AND EXPERT REPORT WRITING
Consent to Treatment
Non-consensual Treatment
The Legal Justification
Is Consent Always Mandatory
Unconscious Patient
Proxy Consent and Consent of Minors
Consent to Testing for HIV Infection
Negligence Action: Causation Problems
Concept of Informed Consent
ADMISSION TO THE DISCHARGE PROCESS
Admission Process
Inpatient Admissions
Procedures for Admitting Dental Patients
Type of Admission
Admission Protocol
Elective Admissions
Nonelective Admissions
Admitting Orders
The Database
Blood Urea Nitrogen (BUN)
Urine Analysis
Radiology
Microbiology
Electrocardiogram
Pulmonary Function Test
Differential Diagnosis
Treatment Plan
Ambulatory Admissions
Patient Selection for Ambulatory One-Day Services
Criteria to Carry out a Day Surgery
Preoperative Evaluation
Minimal Lab Evaluation
Special Instructions
PREPARATION OF AN OPERATIVE PROCEDURE
Operating Room
Dental Assistant
Operating Room is Usually Divided into Two Areas
Position of the Operating Team
DRAPING OF THE PATIENT
OPERATING ROOM EQUIPMENT
CUSTOMS AND COURTESIES
GOWNING AND GLOVING
DENTAL PROCEDURE
Removing Operating Room Garments
POSTOPERATIVE PERIOD
Bring Operative Role
Orders
DISCHARGE
Discharge Criteria
Discharge Summary
Discharge Orders
Follow-up Calls from Hospital
Instructions
CONCLUSION
INDEX
TOC
Index
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