Pediatric Dental Update
Stephen Shusterman DMD1
1 Dentist-in-Chief, Children's Hospital, Boston, MA.
Introduction
Pediatricians are in an ideal position to influence the oral health of their young patients, from the first prenatal interview with prospective parents and the initial newborn examination through the duration of their general pediatric care. Teeth begin calcification between 14 and 16 weeks of embryonic life, and most of the crowns of the primary teeth, as well as the occlusal edges of some permanent teeth, are calcified by birth. Early plaque removal from gum pads and erupting teeth, the use of fluoride as a dietary supplement in nonfluoridated communities, and timely visits to the dentist all will help to assure a caries-free dentition and healthy oral environment for the child of the 21st century.
Dentistry has emerged from its position as a little understood and poorly tolerated sideline of the itinerant surgeon to its status of partner in supporting total bodily health. Such gains as local anesthesia and the means to administer it painlessly, high-speed instrumentation to remove caries comfortably (albeit mechanically), bonded resins (eg, pit and fissure sealants, composite resin restorative materials) to prevent caries and esthetically restore broken or deformed teeth, and implants to replace missing teeth and to restore function and appearance have highlighted its recent evolution.
