Professor & Head, Dept. of Pedodontics, SIDS, Guntur, A.P GOOD AFTERNOON Dr. A. J. Sai Sankar M.D.S., Professor & Head, Dept. of Pedodontics, SIDS, Guntur, A.P

PEDODONTIST AND PEDIATRICIAN INTER-LIAISON

INTRODUCTION “Oral health is an integral part of the overall health of children”

METHODOLOGY Questions like- Whether they are aware that a separate branch in dentistry deals with dental problems for children? How often they refer child patients to a Pedodontist ? / and if so at what age? When the teeth formation, eruption, exfoliation and occlusion settles? Knowledge regarding the relationship between diet and dental caries. Cariogenicity of breast milk/bovine milk and milk formulas Timing of child’s first dental visit Role of breast feeding on development of dental arches Appropriate age to remove a NNS habits and its consequences on the dento- facial complex. Importance of early preventive measures for special children Early initiation of Dental Home concept

RESULTS Most of the pediatricians know and acknowledged the importance of pediatric dentistry. (85%) Even though they know the importance of breast feeding, most of them are not aware of its cariogenicity. (70%) Much of them are not sure at what age they should refer a child to Pedodontist nor ill effects of NNS habit on stomatognathic system. (90%) None of them are sure about the caries process, etio-pathogenesis , consequences and preventive aspects for the same.(90%)

DISCUSSION Importance of Pedodontics as a specialty Why Pediatrician do not refer to a Pedodontist? Why is it that timing of child patient referral to a Pedodontist is important? - Importance - AAP / AGP / AAPD guidelines

Understanding caries

Window of infectivity Streptococcus Mutans 19-31 months of age Mode of Transmission Importance

Influences the Growth & Development of the individual Dental Caries Vs Growth & Development Severe Carious lesions ( if untreated) Influences the Growth & Development of the individual Pulpitis Dental abscess affects metabolic pathway Erythropoiesis Malnutrition Suppress Haemoglobin production Anaemia

BREAST FEEDING Emotional, immunological and nutritional benefits. Fulfills Oral drive. Reduced risk of having conditions like Acute Otitis Media; Gastroenteritis ; Diarrhea; Serious Infections and diseases; Leukemia; Asthma; Obesity Helps in Craniofacial growth and development . Higher IQ in breastfed children. Cholesterol and other types of fat in human milk support the growth of nerve tissue. . POSITIVE NEGATIVE Frequent & prolonged BF -> leads to increased exposure of lactose to tooth surface -> increase in cariogenic bacteria Early discontinuation of BF leads to NNS habits

Composition of Human Breast milk 4/12/2013 JC

Early childhood caries On demand breast feeding Bottle feeding during infancy (bedtime) Use of honey dipped pacifiers reasons Leads to Pain & Discomfort Loss of tooth structure Disturbed sleep Space loss Reduced Food intake Loss of Self esteem Effects Glucosteroid production Malnutrition Influences Growth & Development

BOTTLE FEEDING Leads to – Poor oral motor development Respiratory disorders Possibility of developing malocclusion Increased risk of caries

Effect of BOVINE MILK & MILK FORMULA on caries activity Cariogenicity of LIQUID PHARMACEUTICAL PREPERATIONS

NON NUTRITIVE SUCKING HABITS Reasons Consequences Discontinuation problems – stress, hunger, pleasure, sadness, boredom, hyperactivity etc., Timing of treatment

NOT TO FORGET…. Introducing DENTAL HOME concept by 1year ANTICIPATORY GUIDANCE about G &D issues “ healthy habits if introduced early in the life will tend to extend for the whole of the individual” Early referral of the child patient to initiate preventive strategies, particularly for Special children

RECOMENDATIONS Interaction with the Pedodontist will help the Pediatrician to guide the parents to prevent various dental problem early. Emphasizing the timing of child first dental visit Encouraging proper breast feeding technique followed by proper oral hygiene practice Incorporating the information regarding the importance of oral health in medical curriculum

Thank you