Pediatric Restorative Dentistry by Soraya Coelho Leal, Eliana Mitsue Takeshita
Pediatric Restorative Dentistry describes and discusses the different restorative options for managing carious lesions in children with primary and mixed dentition. The aim is to provide practitioners with thorough, up-to-date information that will improve their clinical practice.
According to the principles of Minimal Intervention Dentistry (MID), patients should be empowered through information in developing skills and be motivated to take care of their own oral health . In the case of children, this task is delegated to parents/caregivers, who play an important role not only in the decision-making process but also in maintaining the oral health status of the child after treatment is concluded.
As decisions related to the health of children are usually made by parents, it is mandatory that dental professionals do their very best to understand the family beliefs and the possible impact of the socioeconomic background and the parents’ level of education on the oral health of the child prior to focusing on the child’s dental needs. A successful treatment is related to a broader diagnosis, which includes the context in which the child lives.
In this way, the child’s first dental appointment, except in case of emergency, is focused on collecting information about the child’s and his/her family profile, medical/dental history, and relevant data about oral hygiene and diet habits. This information and that collected during the clinical oral examination allows the dental professional to determine the child’s needs and to develop the best dental care plan.
Undoubtedly, dental caries is the most prevalent chronic disease during childhood, affecting hundreds of thousands of children all over the world . Although a decline of caries experience in children has been observed in the last decades in a number of countries, significant variations between and within countries exist . A systematic review that aimed at assessing the evidence for the association between socioeconomic position—defined by own or parental educational or occupational background, or income—and caries prevalence, experience, or incidence concluded that a low socioeconomic position was associated with a greater chance of having carious lesions or caries experience . Similar findings were reported by a systematic review of caries epidemiological studies carried out in Brazil between 1999 and 2010 that showed higher percentages of dental caries among the poorest and least educated people .
Another important aspect in the discussion about dental caries in children is the parent’s level of education. The literature shows that caregivers with a higher education level, determined by having completed high school, were directly associated with a lower number of untreated decayed teeth among their children compared to caregivers who did not complete high school . However, the number of years of parents at school required for influencing children’s oral health is not
well established. For developing countries, there is evidence that mothers who had studied for less than 8 years are more likely to have children with higher levels of dental caries [7, 8].
Additionally, the way families are structured seems to play an important role in childhood dental caries. A study conducted in the Netherlands concluded that family organization was associated to the occurrence of dental caries, indicating that the establishment of routines; the assignment of roles, abiding to rules; and the family’s ability to resolve problems are important variables to be considered when establishing a dental care plan for the child . Moreover, there is indication that children from one-parent families have a higher chance to develop carious lesions than those from two-parent families .