Pedodontics — 30-Min Notes

1. Growth & Development

• Primary dentition: 20 teeth; eruption: 6 months → 2.5 years.

• Mixed dentition: 6–12 years; critical for occlusion guidance.

• Permanent dentition: 32 teeth; eruption sequence important for space management.

• Tip: Premature loss of primary teeth → risk of crowding; consider space maintainers.

• High-yield: Early childhood growth affects jaw development → interceptive treatments recommended

2. Dental Caries in Children

• Early Childhood Caries (ECC): aggressive, affects maxillary anterior teeth primarily.

• High-risk factors: frequent sugar intake, poor oral hygiene, bottle feeding at night.

• Management: preventive → fluoride varnish, sealants; restorative → composite or SSC (stainless steel crown).

• Tip: Fluoride toothpaste for children should be age-appropriate (1000–1450 ppm).

• High-yield: SSC → best long-term restoration for multi-surface caries in primary molars

3. Pulp Therapy in Primary Teeth

• Pulpotomy: removal of coronal pulp, preserve radicular pulp → Formocresol or MTA commonly used.

• Pulpectomy: removal of entire pulp → calcium hydroxide/iodoform paste filling.

• High-yield: Vital pulp therapy preferred over extraction to maintain arch integrity

• Tip: Indications → caries involving pulp, no periapical pathology.

• SSC after pulp therapy → ensures full coronal coverage and durability.

4. Space Management

• Importance: Maintains arch length and prevents malocclusion.

• Space maintainers: Band-loop, distal shoe, Nance appliance.

• Tip: Use removable or fixed based on cooperation and tooth position.

• High-yield: Premature loss of 2nd primary molar → distal shoe maintains first permanent molar position

• Serial extraction in crowded arches can guide eruption of permanent teeth.

5. Habit Management

• Common habits: thumb sucking, tongue thrusting, lip biting.

• Effects: anterior open bite, posterior crossbite, incisor protrusion.

• High-yield: Stop habits before permanent dentition to prevent skeletal changes

• Management: Behavior modification, habit-breaking appliances (palatal crib, bluegrass appliance).

• Tip: Positive reinforcement and early intervention most effective.

6. Traumatic Injuries

• Common in children: luxation, avulsion, fracture.

• Management: repositioning, splinting (flexible for 2–4 weeks), pulp therapy if needed.

• High-yield: Avulsed permanent tooth → reimplant within 1 hour for best prognosis

• Tip: Store avulsed tooth in milk or HBSS if immediate reimplantation not possible.

• Follow-up: Radiographs at 1, 3, 6, 12 months → check pulp vitality and root development.

7. Behavior Management

• Techniques: Tell-show-do, positive reinforcement, distraction, voice control.

• High-yield: Behavior guidance improves cooperation and treatment success

• Advanced techniques: sedation or general anesthesia for uncooperative or special needs children.

• Tip: Non-pharmacologic methods preferred whenever possible.

8. Preventive Pedodontics

• Fluoride application: topical varnish 2–4 times/year for high-risk children.

• Fissure sealants: primary preventive treatment for pit and fissure caries.

• Oral hygiene: supervised brushing, dietary counseling.

• High-yield: Preventive approach reduces future restorative burden

• Tip: Educate parents → crucial for long-term dental health.

9. High-Yield Repeated Points (NEET MDS)

• Early childhood caries → maxillary anterior teeth, aggressive, high-risk with night bottle feeding

• SSC → best restoration for multi-surface primary molars

• Pulpotomy → vital pulp therapy; MTA preferred over Formocresol

• Premature primary tooth loss → use space maintainers

• Stop habits before permanent dentition → prevents skeletal changes

• Avulsed permanent tooth → reimplant within 1 hour

• Behavior guidance → tell-show-do, positive reinforcement