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27 September 2021

Pediatric Dentistry During Lockdown: Mission Possible?


At the very beginning of the pandemic of the novel coronavirus infection, during the period of severe restrictions, the dentist remained one of the most in-demand doctors, especially for pediatric dentists. A team of specialists from Volgograd State Medical University under the leadership of Doctor of Medical Sciences, Professor Irina Valerievna Fomenko analyzed what dental complaints and pathologies they had to face during the lockdown.



IRINA FOMENKO
,
Doctor of Medical Sciences, Professor of VSMU,
Volgograd

AWARE OF THE DANGER

Dentists work in the patient's breathing zone. In many countries, dental clinics have been closed since the outbreak of the pandemic or have provided only emergency and urgent dental care. Recommendations were developed: to limit the use of equipment that generates an aerosol cloud (turbine drill, etc.), not to use intraoral radiographs, to shorten the treatment time for patients (use simple materials, choose tooth extraction instead of treatment), try to finish treatment in one visit.

CARIES COMPLICATIONS COME FIRST

Experts from Volgograd analyzed the reasons for visiting dentists and the treatment carried out for 166 children during the period of stiff anti-covid restrictions. And it turned out that the majority (98.8%) of children went to the dentist because of acute toothache. Most often, children of 4–7 years old complained of acute pain in temporary teeth, patients of 11–14 and 15–17 years old -  in permanent teeth (Fig. 1).

On the whole, complaints on periodontitis in children tool the 1st place, pulpitis took the 2nd place (Fig. 2).

Thus, caries complications were the leading cause of acute pain during lockdown. Perhaps more careful advance dental hygiene and regular preventive visits to the dentist could prevent an emergency visit to the dentist.

WHAT IS THE TREATMENT?

Some children have different behaviors and negative attitudes towards dental procedures. Among children with temporary teeth, 45.2% had negative behavior, with permanent teeth — 16.1%. Older children with permanent teeth, as a rule, were satisfied with verbal persuasion methods. Among young patients with temporary teeth, 6% of children needed additional anesthetic aid.

The treatment was serious in many cases. Depulpation of the teeth was often required, of which approximately every third patient required preliminary tooth denervation. Treatment of periodontitis of deciduous teeth almost always (in 98.9% of cases) required their removal to reduce the duration of treatment and prevent the progression of infectious inflammation in the tissues surrounding the tooth root.

LESSONS FOR THE FUTURE

The COVID-19 pandemic has changed the profile of dental patients and the treatment choices made by dentists. The main problems faced by young patients during the quarantine period were the complications of caries, which indirectly indicates insufficient dental hygiene. Probably, parents should pay more attention to regular and thorough brushing of teeth by children, the nature of the diet, the intake of vitamins and microelements. Prophylactic visits to the dentist prevent serious problems and create a more tolerant attitude towards dental treatment on the part of children.

 


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