Pediatric Dentistry: infancy through adolescence

CHAPTER FM1

Pediatric Dentistry

INFANCY THROUGH ADOLESCENCE

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Pediatric Dentistry

INFANCY THROUGH ADOLESCENCE

FIFTH EDITION

Paul S. Casamassimo, DDS, MS

Professor and Chair

Division of Pediatric Dentistry and Community Oral

Health

College of Dentistry

The Ohio State University;

Chief

Department of Dentistry

Nationwide Children’s Hospital

Columbus, Ohio

Henry W. Fields, Jr., DDS, MS, MSD

Professor and Division Chair

Division of Orthodontics

College of Dentistry

The Ohio State University;

Section Chief

Department of Dentistry

Nationwide Children’s Hospital

Columbus, Ohio

Dennis J. McTigue, DDS, MS

Professor

Division of Pediatric Dentistry and Community Oral

Health

College of Dentistry

The Ohio State University;

Member

Department of Dentistry

Nationwide Children’s Hospital

Columbus, Ohio

Arthur J. Nowak, DMD, MA

Professor Emeritus

Departments of Pediatric Dentistry and Pediatrics

Colleges of Dentistry and Medicine

University of Iowa

Iowa City, Iowa;

Afiliate Professor

The Center for Pediatric Dentistry

University of Washington

Seattle, Washington

With 520 illustrations

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PEDIATRIC DENTISTRY: INFANCY THROUGH ADOLESCENCE ISBN: 978-0-323-08546-5

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Library of Congress Cataloging-in-Publication Data

Pediatric dentistry: infancy through adolescence.—5th ed. / [edited by] Paul S. Casamassimo … [et al.].

p. ; cm.

Includes bibliographical references and index.

ISBN 978-0-323-08546-5 (hardcover : alk. paper)

I. Casamassimo, Paul S.

[DNLM: 1. Dental Care for Children. 2. Pediatric Dentistry. WU 480]

617.6′45—dc23

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v

Steven M. Adair, DDS, MS

Senior Vice President

Clinical Quality Initiatives and Education CSHM LLC

Nashville, Tennessee;

Professor Emeritus

College of Dental Medicine

Georgia Health Sciences University

Augusta, Georgia

Homa Amini, DDS, MPH, MS

Section Chief and Program Director, Pediatric Dentistry

Nationwide Children’s Hospital

Associate Professor-Clinical

Division of Pediatric Dentistry and Community Oral Heatlh

College of Dentistry

The Ohio State University

Columbus, Ohio

Paul S. Casamassimo, DDS, MS

Professor and Chair

Division of Pediatric Dentistry and Community Oral Health

College of Dentistry

The Ohio State University;

Chief

Department of Dentistry

Nationwide Children’s Hospital

Columbus, Ohio

John R. Christensen, DDS, MS

Adjunct Associate Professor

School of Dentistry

University of North Carolina at Chapel Hill

Chapel Hill, North Carolina;

Private Practice

Durham, North Carolina

Marcio A. da Fonseca, DDS, MS

Law-Lewis Professor

Director, Pediatric Dentistry Graduate Program

The Center for Pediatric Dentistry

School of Dentistry

University of Washington

Seattle, Washington

Kevin James Donly, DDS, MS

Professor and Chair

Department of Developmental Dentistry

Dental School

University of Texas Health Science Center at San Antonio

San Antonio, Texas

Clifton O. Dummett, Jr., DDS, MSD, MED†

Chair, Department of Pediatric Dentistry, Louisiana State

University School of Dentistry, New Orleans, Louisiana

Henry W. Fields, Jr., DDS, MS, MSD

Professor and Division Chair

Division of Orthodontics

College of Dentistry

The Ohio State University;

Section Chief

Department of Dentistry

Nationwide Children’s Hospital

Columbus, Ohio

Catherine M. Flaitz, DDS, MS

Professor of Oral and Maxillofacial Pathology and

Pediatric Dentistry

Department of Diagnostic Sciences and Pediatric Dentistry

University of Texas Dental Branch at Houston

Dental Staff

Texas Children’s Hospital

Houston, Texas

Anna Blinder Fuks, DDS

Professor Emeritus

Department of Pediatric Dentistry

Hadassah School of Dental Medicine

The Hebrew University

Jerusalem, Israel

Steven I. Ganzberg, DMD, MS

Clinical Professor and Chair

Section of Dental Anesthesiology

UCLA School of Dentistry

Los Angeles, California

Ann L. Griffen, DDS, MS

Professor

Division of Pediatric Dentistry and Community Oral

Health

College of Dentistry

The Ohio State University;

Member of Medical Staff

Nationwide Children’s Hospital

Columbus, Ohio

CONTR IBUTORS

†Deceased.

vi CONTRIBUTORS

Marcio Guelmann, DDS

Associate Professor and Chair

Department of Pediatric Dentistry

College of Dentistry

University of Florida

Gainesville, Florida

Ilana Heling, DMD, MSc

Clinical Associate Professor

Department of Endodontics

Hadassah School of Dental Medicine

The Hebrew University of Jerusalem

Jerusalem, Israel

Gideon Holan, DMD

Clinical Associate Professor

Director of Postgraduate Program

Department of Pediatric Dentistry

Hadassah School of Dental Medicine

The Hebrew University of Jerusalem

Jerusalem, Israel

Ari Kupietzky, DMD, MSc, FAAPD

Clinical Instructor

Hadassah School of Dental Medicine

The Hebrew University

Private practice

Jerusalem, Israel;

Visiting Professor

University of Medicine and Dentistry, New Jersey

Newark, New Jersey

Tad R. Mabry, DDS, MS

Clinical Associate Professor

Department of Pediatric Dentistry

College of Dentistry

The University of Iowa

Iowa City, Iowa

Dennis J. McTigue, DDS, MS

Professor

Division of Pediatric Dentistry and Community Oral

Health

College of Dentistry

The Ohio State University;

Member

Department of Dentistry

Nationwide Children’s Hospital

Columbus, Ohio

Dianne M. McBrien, MD

Clinical Associate Professor of Pediatrics

University of Iowa Children’s Hospital

Iowa City, Iowa

Arthur J. Nowak, DMD, MA

Professor Emeritus

Departments of Pediatric Dentistry and Pediatrics

Colleges of Dentistry and Medicine

University of Iowa

Iowa City, Iowa;

Afiliate Professor

The Center for Pediatric Dentistry

University of Washington

Seattle, Washington

Eyal Nuni, DMD

Clinical Instructor

Department of Endodontics

Hadassah School of Dental Medicine

The Hebrew University of Jerusalem

Jerusalem, Israel

Private Practice

Tel Aviv, Israel

Dennis N. Ranalli, DDS, MDS

Professor Emeritus;

Senior Associate Dean Emeritus

Department of Pediatric Dentistry

School of Dental Medicine

University of Pittsburgh;

Professor, Sports Medicine and Nutrition

School of Health and Rehabilitation Sciences

University of Pittsburgh

Pittsburgh, Pennsylvania

Stephen F. Rosenstiel, BDS, MSD

Professor Emeritus

Division of Restorative and Prosthetic Dentistry

College of Dentistry

The Ohio State University

Columbus, Ohio

Jonathan D. Shenkin, DDS, MPH

Clinical Assistant Professor of Health Policy

Department of Health Services Research and Pediatric

Dentistry

School of Dental Medicine

Boston University

Boston, Massachusetts;

Augusta Pediatric Dentistry, Private Practice

Augusta, Maine

Wendi Slaughter, PharmD, RPh

Pharmacy Manager

University of Iowa Hospitals and Clinics

Iowa City, Iowa

CONTRIBUTORS vii

Rebecca L. Slayton, DDS, PhD

Professor and Chair

Department of Pediatric Dentistry

College of Dentistry

University of Iowa

Iowa City, Iowa

Deborah Studen-Pavlovich, DMD

Professor and Chair

Department of Pediatric Dentistry

School of Dental Medicine

University of Pittsburgh

Pittsburgh, Pennsylvania

Dimitris N. Tatakis, DDS, PhD

Professor and Director

Advanced Education Program in Periodontics

Division of Periodontology

College of Dentistry

The Ohio State University

Columbus, Ohio

Sarat Thikkurissy, DDS, MS

Associate Professor

Division of Pediatric Dentistry and Community Oral

Health

College of Dentistry

The Ohio State University;

Director, In-Patient Dental Services

Nationwide Children’s Hospital

Columbus, Ohio

Janice Alisa Townsend, DDS, MS

Assistant Professor

Department of Pediatric Dentistry

Louisiana State University

New Orleans, Louisiana

Kaaren G. Vargas, DDS, PhD

Private Practice

North Liberty, Iowa

Marcos A. Vargas, DDS, MS

Professor

Department of Family Dentistry

College of Dentistry

University of Iowa

Iowa City, Iowa

William F. Waggoner, DDS, MS

Private Practice, Pediatric Dental Care Associates of Las

Vegas

Las Vegas, Nevada

Karin Weber-Gasparoni, DDS, MS, PhD

Associate Professor

Department of Pediatric Dentistry

College of Dentistry

University of Iowa

Iowa City, Iowa

Martha H. Wells, DMD, MS

Assistant Professor

Department of Pediatric Dentistry

College of Dentistry

The University of Tennessee Health Science Center

Memphis, Tennessee

Stephen Wilson, DMD, MA, PhD

Professor and Chief of Division

Division of Pediatric Dentistry

Department of Pediatrics

Cincinnati Children’s Hospital Medical Center

Cincinnati, Ohio

viii

S

ince the irst edition in 1988, there has been terriic

support of this textbook, Pediatric Dentistry: Infancy

Through Adolescence, from clinicians, residents, students, and

allied health professionals. The novel approach to emphasize

age-appropriate themes instead of disease-oriented themes

has been well received and is continued in this edition.

To date, 57 health professionals have contributed to the

ive editions, some for all ive editions with others added as

new themes were introduced. The text has been translated

into ive languages and is used in educational programs

throughout the world.

Additions for the ifth edition include full-color design to

create an immediate visual impact; responsibilities of non￾dental professionals regarding infant oral health (Chapter

13); update on the effect of dental disease on children

(Chapter 17); revised information on dental sealants

(Chapter 32); advances in tissue engineering, as demon￾strated in a new section on revascularization in treating

necrotic immature teeth (Chapter 34); and the importance

of assisting the pediatric patient to transition to an adult

dental home (Chapter 38).

Where possible, all information is evidence based using

classic or contemporary citations from the health literature

and the latest policies and clinical guidelines of the American

Academy of Pediatric Dentistry and American Academy of

Pediatrics.

Embracing the contemporary electronic delivery of infor￾mation, a digital text is offered as an e-book via the Page￾Burst store (http://pageburst.elsevier.com).

Become familiar with the ifth edition, beginning with

Part 1: The Fundamentals of Pediatric Dentistry. Continue

with the next four parts, beginning with the infant and

ending with the adolescent patient. All four age-related parts

are laid out in a similar format for quick searches and user

friendliness.

Your editors and the contributors hope that this edition

will further enhance your enjoyment and competency in

managing the oral health of pediatric patients. It is through

your dedicated and loving care that they can enjoy life

fully.

The Editors

PREFACE

ix

 PART 1

Fundamentals of Pediatric

Dentistry 1

CHAPTER 1

The Practical Importance of

Pediatric Dentistry 2

Paul S. Casamassimo

CHAPTER 2

Differential Diagnosis of Oral Lesions and

Developmental Anomalies 11

Catherine M. Flaitz

CHAPTER 3

Anomalies of the Developing Dentition 54

Clifton O. Dummett, Jr., Sarat Thikkurissy

CHAPTER 4

Oral and Dental Care of Local and

Systemic Diseases 65

Marcio A. da Fonseca

CHAPTER 5

Topics in Pediatric Physiology 81

Dianne M. McBrien

CHAPTER 6

Nonpharmacologic Issues in Pain Perception

and Control 88

Stephen Wilson

CHAPTER 7

Pain Perception Control 98

Stephen Wilson, Steven I. Ganzberg

CHAPTER 8

Pain Reaction Control: Sedation 105

Stephen Wilson, Steven I. Ganzberg

CHAPTER 9

Antimicrobials in Pediatric Dentistry 118

Wendi Slaughter

CHAPTER 10

Medical Emergencies 126

Steven I. Ganzberg

CHAPTER 11

Dental Public Health Issues in

Pediatric Dentistry 139

Jonathan D. Shenkin, Homa Amini

 PART 2

Conception to Age Three 149

CHAPTER 12

The Dynamics of Change 150

Arthur J. Nowak

CHAPTER 13

Examination, Diagnosis, and Treatment

Planning of the Infant and Toddler 184

Karin Weber-Gasparoni

CHAPTER 14

Prevention of Dental Disease 200

Tad R. Mabry, Arthur J. Nowak

CHAPTER 15

Introduction to Dental Trauma:

Managing Traumatic Injuries in the

Primary Dentition 213

Gideon Holan, Dennis J. McTigue

CHAPTER 16

Congenital Genetic Disorders

and Syndromes 231

Rebecca L. Slayton

 PART 3

The Primary Dentition Years: Three to

Six Years 247

CHAPTER 17

The Dynamics of Change 248

Paul S. Casamassimo, Steven M. Adair

CHAPTER 18

Examination, Diagnosis, and

Treatment Planning 258

Paul S. Casamassimo, John R. Christensen,

Henry W. Fields, Jr.

CHAPTER 19

Prevention of Dental Disease 279

Arthur J. Nowak, Tad R. Mabry

CHAPTER 20

Dental Materials 291

Kevin James Donly

CONTENTS

x CONTENTS

CHAPTER 21

Restorative Dentistry for the

Primary Dentition 304

William F. Waggoner

CHAPTER 22

Pulp Therapy for the Primary Dentition 333

Anna Blinder Fuks, Ari Kupietzki,

Marcio Guelmann

CHAPTER 23

Behavior Guidance of the Pediatric

Dental Patient 352

Janice Alisa Townsend

CHAPTER 24

Periodontal Problems in Children

and Adolescents 371

Ann L. Griffen, Dimitris N. Tatakis

CHAPTER 25

Space Maintenance in the

Primary Dentition 379

John R. Christensen, Henry W. Fields, Jr.

CHAPTER 26

Oral Habits 385

John R. Christensen, Henry W. Fields, Jr.,

Steven M. Adair

CHAPTER 27

Orthodontic Treatment in the

Primary Dentition 393

John R. Christensen, Henry W. Fields, Jr.

CHAPTER 28

Local Anesthesia and Oral Surgery

in Children 398

Stephen Wilson

 PART 4

The Transitional Years: Six to

Twelve Years 411

CHAPTER 29

The Dynamics of Change 412

Henry W. Fields, Jr., Steven M. Adair

CHAPTER 30

Examination, Diagnosis, and

Treatment Planning 423

Paul S. Casamassimo, John R. Christensen,

Henry W. Fields, Jr.

CHAPTER 31

Prevention of Dental Disease 460

Arthur J. Nowak, Tad R. Mabry

CHAPTER 32

Pit and Fissure Sealants: Scientiic and

Clinical Rationale 467

Martha H. Wells

CHAPTER 33

Pulp Therapy for the Young

Permanent Dentition 490

Anna Blinder Fuks, Ilana Heling, Eyal Nuni

CHAPTER 34

Managing Traumatic Injuries in the Young

Permanent Dentition 503

Dennis J. McTigue

CHAPTER 35

Treatment Planning and Management of

Orthodontic Problems 518

John R. Christensen, Henry W. Fields, Jr.

 PART 5

Adolescence 557

CHAPTER 36

The Dynamics of Change 558

Deborah Studen-Pavlovich

CHAPTER 37

Examination, Diagnosis, and Treatment

Planning for General and

Orthodontic Problems 566

Paul S. Casamassimo, John R. Christensen,

Henry W. Fields, Jr., Steven I. Ganzberg

CHAPTER 38

Prevention of Dental Disease 586

Tad R. Mabry, Arthur J. Nowak, Henry W. Fields, Jr.

CHAPTER 39

Aesthetic Restorative Dentistry for

the Adolescent 597

Kaaren G. Vargas, Marcos A. Vargas,

Stephen F. Rosenstiel

CHAPTER 40

Sports Dentistry and Mouth Protection 609

Dennis N. Ranalli

Appendix 618

1

PART ONE

Fundamentals of

Pediatric Dentistry

1 The Practical Importance of Pediatric

Dentistry

2 Differential Diagnosis of Oral Lesions

and Developmental Anomalies

3 Anomalies of the Developing Dentition

4 Oral and Dental Care of Local and

Systemic Diseases

5 Topics in Pediatric Physiology

6 Nonpharmacologic Issues in Pain

Perception and Control

7 Pain Perception Control

8 Pain Reaction Control: Sedation

9 Antimicrobials in Pediatric Dentistry

10 Medical Emergencies

11 Dental Public Health Issues in Pediatric

Dentistry

The first section of this textbook deals with information and themes pertinent

to dentistry for children at all ages. Much of this information is covered in other fields

of dental education, but because of the differences between children and adults,

including their physiology and active growth and development, no textbook on

pediatric dentistry would be complete without a discussion of the topics covered in

this section of the textbook as they relate to children.

2

1

The Practical Importance

of Pediatric Dentistry

Paul S. Casamassimo

P

ediatric dentistry is synonymous with dentistry for

children. Pediatric dentistry exists because children

have dental and orofacial problems. Dentistry for children

unquestionably grew out of the need to manage dental

caries and its sequelae of pulpitis, inlammation, and pain

associated with infected pulpal tissue and suppuration in

alveolar bone.

It was logical that from its extraction-oriented begin￾nings, pediatric dentistry grew to include caries interception

with an emphasis on diagnostic procedures and the mainte￾nance of arch integrity in instances of tooth loss due to decay

or trauma. The malocclusion consequences of unbridled

tooth removal were soon determined to be preventable.

Restorative techniques, pulpal therapy, space maintenance,

and interceptive orthodontics were the main themes of this

era, which sadly is still not over. Because of the lingering

problem of early childhood caries and its recent increase,

these treatment techniques are covered in detail in this book.

Pediatric dentistry today emphasizes prevention of dental

diseases, which is a primary focus of this book, and it is

addressed speciically for each of the four age groups that

relect the organization of this book. Caries risk assessment,

as it relates to individualized prevention, is also featured in

this edition to relect the evolution of evidence-based oral

health care.

Historical Perspective

Until the mid-1950s, in at least one state of the United States,

a major dental supplier gave all new clients opening dental

ofices a very handsome sign that said: No children under age

13 treated in this ofice. Fortunately, such attitudes are now

gone, the result of improved education and science as they

relate to pediatric dentistry. Speciic educational guidelines

for pediatric dentistry are now an integral part of the fabric

of dental education imposed on all dental schools accredited

by the Commission on Dental Accreditation. Graduates of

all accredited dental schools in the United States have both

didactic and clinical education in dentistry for children. Fur￾thermore, through the efforts of organized dentistry and

other advocates of the oral health of children, the notion that

the “baby teeth don’t deserve care because you lose them

anyway” has largely disappeared.

The historical premise that dental care should begin at 3

years of age or later was based on the belief that a child under

3 years was too dificult to treat, except by a specialist and

often using pharmacologic techniques, readily available to

only a few specialists. Though it is true that treatment is

often dificult, the threshold of age 3 years meant that many

children would experience dental caries and enter the dental

ofice with restorative and pain management needs. The

American Academy of Pediatric Dentistry today advocates a

dental visit on or before the irst birthday.1

In May 2003, the

American Academy of Pediatrics (AAP) issued guidance to

its membership of more than 50,000 pediatricians to perform

oral health assessment at 6 months of age during well child

visits along with application of luoride varnish.10 Unques￾tionably, the appropriateness of this recommendation for

earlier attention to dental care by health professionals is

due to the recognition today that early childhood caries

cannot be eliminated through restoration or selected tooth

extraction, and that children aflicted with early childhood

caries are more prone to dental caries in their permanent

dentition.

 OUTLINE

Historical Perspective

Milestones in Dentistry for Children in the

United States

Challenges for Pediatric Dentistry in the 21st

Century

Child Abuse and Neglect

Children of Poverty

Informed Consent and Risk Management

Evidence-Based Dental Practice

Technology and Materials

Health Care Delivery and Payment Strategies

Caries Risk Assessment

Advocacy

CHAPTER 1 The Practical Importance of Pediatric Dentistry 3

Milestones in Dentistry for

Children in the United States

Table 1-1 provides a timeline that depicts the evolution of

dentistry for children. Like the specialty of endodontics,

pediatric dentistry grew out of restorative dentistry, cham￾pioned by general dentists who enjoyed working with

children and had compassion for the suffering they under￾went with unchecked dental caries in the pre-luoride era.

Care of children was at irst simply a dentist’s preference, and

then it was oficially recognized as a specialty midway in the

last century. During its rise to specialty status, pediatric den￾tistry followed a path similar to other dental specialties,

beginning with interest groups of dentists, the formation

and gradual proliferation of a number of pediatric dentistry

training programs, and eventual recognition by organized

dentistry. Pediatric dentistry eventually focused on treat￾ment of infants, children, and adolescents and also became

the group in organized dentistry caring for persons with

special health care needs. In the mid-1990s, the oficial dei￾nition of the specialty focused on children and adolescents,

n TABLE 1-1

Milestones in Dentistry for Children in the United States

1900 Few children are treated in dental ofices. Little or no instruction in the care of “baby teeth” is given in the 50 dental schools in

the United States.

1924 First comprehensive textbook on dentistry for children is published.

1926 The Gies Report on dental education notes that only 5 of the 43 dental schools in the United States have facilities especially

designed for treating children.

1927 After almost a decade of frustration in getting a group organized to promote dentistry for children, the American Society for

the Promotion of Dentistry for Children is established at the meeting of the American Dental Association (ADA) in Detroit.

1932 A report of the College Committee of the American Society for the Promotion of Dentistry for Children states that in 1928, 15

dental schools provided no clinical experience with children, and 22 schools had no didactic information in this area.

1935 Six graduate programs and eight postgraduate programs exist in pedodontics.

1940 The American Society for the Promotion of Dentistry for Children changes its name to the American Society of Dentistry for

Children.

1941 Children’s Dental Health Day is observed in Cleveland, Ohio, and Children’s Dental Health Week is observed in Akron, Ohio.

1942 The effectiveness of topical luoride applications at preventing caries is described. The Council on Dental Education

recommends that all dental schools have pedodontics as part of their curriculum.

1945 First artiicial water luoridation plant is begun at Grand Rapids, Michigan.

1947 The American Academy of Pedodontics is formed. (To a large degree, the start of the Academy was prompted by the need for

a more scientiically focused organization concerned with the dental health of children.)

1948 The American Board of Pedodontics, a group formulated to certify candidates in the practice of dentistry for children, is

formally recognized by the Council on Dental Education of the ADA.

1949 The irst full week of February is designated National Children’s Dental Health Week.

1955 The acid-etch technique is described.

1960 Eighteen graduate programs and 17 postgraduate programs in pedodontics exist.

1964 Crest becomes the irst ADA-approved luoridated toothpaste.

1974 The International Workshop on Fluorides and Dental Caries Reductions recommends that appropriate luoride

supplementation begin as soon after birth as possible. (This recommendation was later modiied by authorities to start at

6 months of age.)

1981 February is designated National Children’s Dental Health Month.

1983 A Consensus Development Conference held at the National Institutes of Dental Health endorses the effectiveness and

usefulness of sealants.

1984 The American Academy of Pedodontics changes its name to the American Academy of Pediatric Dentistry.

1995 A new deinition is adopted for the specialty of pediatric dentistry by the ADA’s House of Delegates: Pediatric dentistry is an

age-deined 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.

2003 The AAP establishes “Policy Statement on Oral Health Risk Assessment Timing and Establishment of a Dental Home,” and

issuance of this policy statement will be manifested in several outcomes, including the need to identify effective means for

rapid screening in pediatricians’ ofices, and the mechanisms for swift referral and intervention for high-risk children.