- increased overjet: children with an overjet of >9 mm are twice as likely to sustain
dental trauma; - contact sports: active participation in sports, such as rugby, hockey, and martial arts,
carries an increased risk of sustaining orofacial trauma; - previous dental trauma: there is a significant risk of sustaining further trauma!
- motor disabilities: children with poor co-ordination are more at risk of sustaining
trauma; - neurological disabilities: uncontrolled epileptics are high trauma risk candidates;
- age: peak ages for sustaining orofacial trauma are around 1-2 years and 8-10 years;
- gender: boys are more at risk than girls.
3.7 PRINCIPLES OF TREATMENT PLANNING
3.7.0 Introduction
In planning dental care for child patients, the dentist must satisfy two, sometimes
apparently conflicting, objectives. First, it is clearly necessary to ensure that the child
reaches adulthood with the optimum achievable dental health. Second, it is essential
that the child both learns to trust the dental team and develops a positive attitude
towards dental treatment. At any point in time, therefore, the desirability of the 'ideal'
care (whatever this might be) must be carefully balanced against
- the child's potential to cope with the proposed treatment;
- the ability and willingness of the child and parent to attend for care;
- parental preference.
Thus, the dentist may be required to exercise a degree of compromise which those
more used to treating adults may find unfamiliar and even a little uncomfortable.
However, it is important to accept that there will be no winners if, at the outset, a
treatment plan is unrealistic or insufficiently flexible to allow modification, should
this become necessary, as treatment progresses.
From the foregoing comments, it should be evident that it is not possible to take a 'one
size fits all' approach to treatment planning: very different treatment plans may be
drawn up for children who present with very similar problems. However, basic
principles pervade all treatment plans and these are set out in Fig. 3.28. (The reader
should note the emphasis that has been placed on repeated assessment and
discussion.) Several aspects of this approach are worthy of special comment.