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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