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Advancements in material science have contributed greatly towards aesthetic dentistry. However, achieving satisfactory aesthetics for children in the developing dentition poses unique challenges. Challenges include, but are not limited to: (1) patient co-operation; (2) optimum moisture control; (3) continuing gingival maturation and bone growth; and (4) the increased need for minimally invasive and non-irreversible techniques to maintain future treatment options. This article addresses the common paediatric dental aesthetic challenges of uncomplicated crown fractures (ie those confined to enamel and dentine), localized, discrete enamel opacities and intrinsic discolouration of anterior, root canal-treated teeth. Treatment techniques and helpful tips for the general dental practitioner are presented.
CPD/Clinical Relevance: This article focuses on common dental aesthetic challenges that present in the paediatric dental population and suggests methods to manage this effectively in primary and secondary care.
Article
Managing dental trauma, especially in younger patients, can be challenging. Emergency treatment carries additional demands as patients and their parents/carers are likely to be distressed, with limited patient dental treatment experience and need to be accommodated for treatment into a busy clinical schedule. However, immediate and appropriate primary care management of dental trauma is critical for ensuring an optimal dental outcome. Epidemiological data from the 2013 Children Dental Health Survey reported an increased prevalence of enameldentine fractures in maxillary central incisors from 5.9 per thousand to 9.4 per thousand in 15-year-olds from 2003 to 2013.1 In both primary and permanent dentitions, maxillary central incisors are most frequently affected. Uncomplicated enamel-dentine fractures are the most common type of dental injury in the permanent dentition and prevalence in this group varies from 2.4% to 33%.2 Risk factors for dental trauma include increased overjet with proclined teeth, incompetent lips, mouth breathing, participation in high/medium trauma risk sports (eg mountain biking/basketball), and medical conditions such as attention deficit disorder, epilepsy and cerebral palsy.2 Clinicians should therefore advocate the use of mouth guards during contact sports and make an orthodontic referral at the appropriate stage in dental development.
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