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TAILOR APPOINTMENTS FOR CHILDREN
24 OCTOBER 2017 | RDHMAG.COM
The most common issues I face when treating children are
parents who don’t want fluoride to be applied, patients who
have a high caries risk, and the need for sealants.
• Fluoride—When parents come in with their children and
say they don’t want fluoride, what do you do? I have a print-out of facts about topical fluoride and provide it to the parents. Some parents change their minds once they hear it’s
topical and not ingested, and some still refuse the fluoride
treatment. When this happens, I recommend taking detailed
documentation and making sure to note that you provided a
handout and explained the importance of fluoride.
A patient I had about a week ago had a lesion so large that
it was very close to the nerve. The doctor recommended
a liner that had fluoride in it and a temporary filling to see if
they could put off a root canal because of the child’s young
age, but the mother refused because the liner contained
fluoride. When patients’ parents decline fluoride, I like to
recommend Arm & Hammer toothpaste because it isn’t as
abrasive, and it helps neutralize the pH of the saliva, which
will hopefully help minimize decay. I also recommend regular
exams and prophies and sugar-free foods and balanced
• High caries risk—For high-caries-risk patients, I recom-
mend three-month recall visits for fluoride treatments and
regular dental cleanings and exams. I also provide nutrition
and oral health education with demonstrations for parents
and children, and I ask what the child eats and drinks at
home. We provide a caries risk assessment yearly at my
office, and it helps to see how things have changed over
the year. Products I recommend for use at home are ACT
fluoride rinse, flossers, and Colgate PreviDent prescription
• Sealants—Sealants on children can be tricky and sometimes downright impossible without help. When I do sealants, I find it best to show the child everything and try it on
a finger first. This allows them time to process what they are
about to have done. Usually this works well. The only other
issue is getting the child to keep his or her mouth open so
the tooth can stay dry. With some children, bite blocks are
great, but with others, it’s too much in the mouth and causes them to gag. I also use cotton rolls and dry angles, and I
love to use cotton-roll holders when I’m working alone.
As for products, at my office I use Embrace (Pulpdent) or
Clinpro (3M Oral Care). My preference is Embrace because
the tooth doesn’t have to be 100% dry, unlike Clinpro.
Clinpro is great for those patients who are very cooperative.
After the sealant is applied, I review oral health instructions. I
discuss foods that can cause sealants to dislodge, such as
really sticky candies and ice, and I review some home-care
tips for better brushing for parents and children.
The main issues about kids