Rated R: Reliving the Past, Empowering the Future of Philippine Pedodontics

CAMBRA - caries management by risk assessment - is an evidence-based approach to preventing and managing dental caries at its earliest stages. It takes into consideration the patient's health and lifestyle risk factors and weighs them against protective factors to determine caries risk and formulate a tailored management strategy.

An update to the earlier published CAMBRA assessment tool was made in 2019. This updated CRA tool incorporates evidence from recent implementation studies that served as the basis for risk-based caries management treatment planning. This approach is considered as the standard of care for children's oral health.

This lecture provides a step-by-step guide on how to use the updated caries assessment tool and how it can be of value in our clinical practices. Integrating this assessment tool into our patient management will aid us in preparing an individualized, risk- based treatment plan that combines chemical therapy with the necessary restorative treatment for a minimally invasive successful outcome.

Developmental diagnosis is based on an understanding of basic concepts of typical and atypical developmental progression. Some of the common reported developmental concerns include global developmental delay, intellectual disability, cerebral palsy, delayed speech and language, attention deficits and autism.

The number of children diagnosed with developmental disabilities has significantly increased. However, each professional's awareness of children with developmental, emotional and behavioral difficulties may differ, allowing their special needs to be overlooked at child health checkups until secondary difficulties appear. Therefore, it is necessary to enhance collaborative care in children with such condition.

Diagnosis of developmental disability in children fall largely, and often exclusively, to the primary care clinician but the early recognition of growth or developmental failure when we see children in our clinics, helps for timely intervention in managing a patient's problem.

Invasive dental procedures in young children, especially those with developmental delay usually require treatment under advanced behavior guidance. The operator and the team should know how to recognize and handle dental emergencies.

This is a clinical case on the management of a 4-year-old child diagnosed with developmental delay and asthma who had oral rehabilitation under moderate sedation.

Cleft lip and palate are among the most common congenital deformity which can lead to a number of challenges such as nutritional intake, speech, esthetic and the need to undergo multiple surgeries. Presurgical nasoalveolar molding has been introduced to improve clinical and surgical outcomes. This case presents a patient with Bilateral cleft lip and palate in a patient with Ectrodactyly Ectodermal Dysplasia, Cleft lip and palate sydrome (EEC syndrome) treated with presurgical nasoalveolar molding appliance. This presentation focuses more on the treatment process of nasoalveolar molding, discussing its outcome and advantages.

Within the realm of pediatric dentistry, the management of children with autism and congenital heart disorders, such as Tetralogy of Fallot (TO), presents distinctive challenges. This case report delves into these complexities, providing a detailed analysis of a 3-year-old Filipino child who was diagnosed with both conditions.

The report reviews the patient's medical and dental history, treatment plan, and pre-operative measures. It discusses hemodynamics and the rationale behind pharmacological approaches, dental procedures, local anesthesia, and prophylactic antibiotics. The conclusion provides pre- surgery recommendations for parents and guidelines for dentists handling similar cases, emphasizing the importance of a comprehensive approach in pediatric dentistry.

To improve quality of life in children with early childhood caries, comprehensive dental treatment involving extraction of non-restorable teeth is essential. However, parents are frequently concerned that their child's ability to chew may be compromised after oral rehabilitation.

Thus, this study helps provide insight into the changes in a child's masticatory function and food preferences after extensive dental treatment.

Twenty-five children between 4-6 years old were included in this prospective study.

Masticatory function was assessed with two tests: (1) mixing ability test using duo-coloured chewing gum and (2) the number of chews per gram and time taken to eat six food items. Food preferences was also evaluated. These were done before and 3 months after dental treatment.

The result of the study showed that the number of chews per gram and duration taken to consume certain hard food increased after treatment, and both were significantly associated with more extractions. However, there was no change in mastication function for the other foods, mixing ability score, and child's food preferences after dental treatment.

Objective: To evaluate the amnesic effect of oral midazolam on patients seen at the Pediatric Dentistry Center Philippines 3-5 years of age.

Method: This study was conducted from September 6, 2016 to March 1, 2017.

Convenience sampling was used and included patients seen at the Pediatric Dentistry Center Philippines who were aged 3-5 years old, ASA I, and required at least one oral sedation appointment. Excluded from the study were those who expectorated whole or part of the drug given, and those with intellectual disability and developmental delay. A dose of 0.5-0.75 mg/kg of midazolam was administered. A set of three picture cards of shapes (square, circle, and star) were shown to the patients at 20 minutes, 40 minutes, 60 minutes after drug administration. Prior to discharge, the patients were asked to recall the shapes.

Results: Eight males and seven females for a total of fifteen participants were included in the study. More patients were unable to recall the shape presented 20 minutes after drug administration where 33.33% were able to recall and 66.67% were unable to recall the shape. For the recall of the second shape presented 40 minutes after drug administration, 60% were able to recall and 40% were unable to recall while for the recall of the shape presented 60 minutes after drug adminstration, 80% of the patients were able to recall while only 20% were unable to recall the shape.

Conclusion: This study showed that the amnesic effect of oral midazolam on patients aged 3-5 years old may be time dependent. A greater incidence of inability to recall was observed at 20 minutes, and progressively lessened at 40 minutes and 60 minutes after drug administration. There was weak association between the amnesic effect of oral midazolam and the overall sedation result 20 minutes after drug administration but not with crying and movement. There was no correlation between the amnesic effect and the overall sedation result, crying, and movement 40 and 60 minutes after drug administration.