Dentist blog from Delta Dental

Tag: pediatric dentistry (Page 1 of 2)

Upcoming continuing education courses

Are you interested in learning about the latest trends and practices in dentistry? Sign up for these upcoming Delta Dental–sponsored continuing education courses!

You can learn new skills while receiving continuing education credits to help you meet your licensure requirements. Even better, as a Delta Dental dentist you’ll get a reduced rate.

What courses will be available?

Here’s a quick look at the courses that will be available. The course list is continuously growing, with new courses coming soon.

DateSchoolCourse titleLocationCredits
Oct 7, 2022University of Pittsburgh | School of Dental MedicineDigital Dentistry: The Engine that Supercharges Practice Growth (PDF)PA6
Oct 14, 2022University of Alabama at Birmingham | School of DentistryIntegrative Dental Medicine: The Next Great Frontier (PDF)AL6
Oct 15, 2022University of California, San Francisco | School of Dentistry2022 Delta Dental Day (PDF)CA7
Oct 29, 2022Nova Southeastern University | College of Dental MedicineUsing Risk Assessment for Treatment Planning In Dentistry (PDF)FL6
Nov 2022Columbia University | College of Dental MedicineManagement of Special Needs Patients and Pediatric Dental TraumaNY6
Nov 4, 2022The Dental College of Georgia at Augusta UniversityGeneral Dentistry & Problem Solving (PDF)GA7

Most courses are planned for in-person sessions. Locations are subject to change.

How can I sign up?

These courses are available to all dental professionals, but as a Delta Dental network dentist, you can enjoy a special discount when you enroll. To sign up for one of the courses, visit the training and events page and visit the registration page or brochure for the course you’re interested in. Seating is limited, so register now and reserve your spot.

Be sure to check the training and events page regularly for the most up-to-date information on course offerings. To stay in the loop, subscribe to FYI for monthly updates in your inbox, attend an upcoming webinar for more info. We’ll also send out targeted emails by state to let you know about the upcoming courses in your area.

Coming soon: Continuing education courses for Delta Dental dentists

Staying up to date on new trends and techniques in dentistry is essential for dental professionals. That’s why we’re partnering with dental schools across the country to offer continuing education courses to Delta Dental dentists at a discount.

You’ll earn continuing education credits that can help you meet licensure requirements, improve your clinical skills and provide optimum care for your patients.

What courses will be available?

Here’s a quick look at the courses that will be available this fall. Our course list is continuously growing, with new courses coming soon.

DateSchoolCourse titleStateCredits
10/7/2022University of Pittsburgh School of Dental MedicineDigital Dentistry: The Engine that Supercharges Practice GrowthPA6
10/14/2022University of Alabama at Birmingham School of DentistryIntegrative Dental Medicine: The Next Great FrontierAL6
10/15/2022University of California San Francisco School of DentistryPeriodontics and Oral MedicineCA6
10/28/2022The Dental College of Georgia at Augusta UniversityGeneral Dentistry & Problem SolvingGA6
10/29/2022Nova Southeastern University College of Dental MedicineUsing Risk Assessment for Treatment Planning in DentistryFL6
Nov. 2022Columbia University, College of Dental MedicineManagement of Special Needs Patients and Pediatric Dental TraumaNY6

While most courses are planned for in-person sessions, this is subject to change depending on the public health situation, and virtual offerings may also be available.

Who’s eligible to sign up?

These courses are available to all dental professionals, but as a Delta Dental network dentist, you can enjoy a special discount when you enroll.

How can I sign up?

Registration will be available through the hosting school. Enrollment isn’t yet open, but details will be coming soon.

To stay in the loop, subscribe to FYI for monthly updates in your inbox, attend an upcoming webinar for more info and bookmark the training and events page, where flyers with more details will be posted over the next few weeks. We’ll also send out targeted emails by state to let you know about the upcoming courses in your area.

Too few kids are getting fluoride treatments: What you can do

Dental fluoride treatments are among the most effective and efficient techniques for hindering tooth decay in children. But despite their proven effectiveness, and despite the fact that such treatments are often covered by insurance, too few children are getting them.

Very few privately insured young children receive recommended dental fluoride treatments at health wellness visits, according to a study published in the Journal of the American Medical Association (JAMA) Network Open. The study’s analysis of more than 328,000 well-child visits for privately insured 2- to 5-year-olds found that fluoride treatment was done in fewer than 5% of visits between 2016 and 2018.

Parental refusal and clinical intervention strategies

One common reason that children aren’t getting fluoride treatments is parental refusal. In a survey, nearly 80% of dentists said they believed fluoride refusal was a problem. In one study, refusal of fluoride was found to be correlated with refusal of vaccines, and as many as 51.5% of parents refused topical fluoride treatments.

“Tooth decay is the number one disease of early childhood, and fluoride plays a critical role in strengthening the enamel and preventing cavities,” said Dr. Jessica Buehler, Director of Dental Affairs at Delta Dental. “Unfortunately, in today’s world of information overload and patients getting their news through social media, there are many families that oppose or do not understand the value and importance of fluoride.” 

Reasons for parental refusal

Parental attitudes and beliefs about health are important determinants of fluoride refusal. Most common is the belief that fluoride is unsafe. Such concerns are often spread and amplified through social networks, the media and the internet. Other factors may include religious beliefs, a desire for autonomy and concerns about the true intent of fluoride treatments.

Clinical interventions

The following clinical strategies can help you improve communication with parents about topical fluoride treatments:

  • Assess parents’ knowledge, beliefs and attitudes early. Screen for possible fluoride hesitancy at the start of preventive visits by asking open-ended, non-judgmental questions, such as “Do you have any questions for me about fluoride?” This can help you assess beliefs and start a conversation.
  • Ensure your team is prepared. Make sure your staff of dental assistants and hygienists understands how fluoride works and why it’s important, as they will likely be the ones applying fluoride treatments. Acknowledge that parental refusal can be a problem and assure your staff that you are there to support them. “Auxiliary staff should not engage in an argument when a parent refuses fluoride,” suggested Dr. Buehler. “They should inform the dentist so that she or he can answer any questions the family may have.”
  • Obtain information about why parents are refusing fluoride. Avoid a pro-fluoride “sales pitch.” Instead, ask questions about what’s motivating a parent’s decision to opt out. Listening is key and can help build trust. Reassure the parent that you respect their health care decisions. Some parents may reconsider their decision after several discussions over time. Document conversations with parents so that future discussions can be framed appropriately.
  • Incorporate specific caries risk factors into discussions. Provide parents with an explanation of why fluoride is important based on the unique risk factors associated with each child. For instance, white spot lesions on the child’s teeth should be pointed out to the parent, with a description on how fluoride helps to prevent white spots from turning into cavities that require fillings.
  • Discuss alternative fluoride sources and behavioral strategies. Parents who refuse fluoride during dental and medical visits may be open to use of at-home fluoride products. Discuss alternative sources of fluoride that could be used at home, like fluoridated toothpastes and fluoride mouthwashes. Remind parents about the benefits and safety of fluoride in water. For parents who refuse all fluoride-containing products and water, emphasize that reducing dietary sugars and acids becomes even more critical in managing caries risk.

Fluoride treatments, your pediatric patients and you

Fluoride varnish is recommended by the U.S. Preventive Task Force and the American Academy of Pediatrics for all infants and children starting at tooth eruption through age five years. All children in this age category should receive fluoride varnish application at least once every six months, according to the recommendation. Most private insurers cover the procedure, and coverage with no cost-share for families is mandatory under the Affordable Care Act.

Most Delta Dental PPO™ and DeltaCare® USA plans cover fluoride treatments for children up to age 12, and many cover such treatments up to age 18, and for adults, as well. The specific codes for fluoride treatments are:

  • D1206 Topical application of fluoride varnish
  • D1208 Topical application of fluoride excluding varnish

Preventive dental care is important at any age, and we encourage you to give regular fluoride treatments to your pediatric patients. Developing a clinical workflow that includes fluoride application can greatly improve the oral health of children within your practice.

A guide to detecting and reporting child abuse for dentists

If you treat children in your practice, your work puts you firmly on the frontlines of early detection and response to child abuse. More than half of all child abuse injuries involve the head, neck and mouth. You also see children at the age during which the majority of child abuse occurs, and your work places you in regular contact with children and their caregivers together, which gives you a unique perspective on both physical condition and family behavior.

Still, refusal to believe that abuse is happening and fear of dealing with angry patients can be powerful barriers to reporting suspected abuse. Prevention begins with knowing what to look for and what to do when you suspect abuse. To mark National Child Abuse Prevention Month, here is a dentist’s guide to detecting and reporting child abuse.

Your responsibilities

As a dentist, you’re required by law in all 50 states to report suspected cases of abuse and neglect to social service or law enforcement agencies.

The American Dental Association also states that you must familiarize yourself with signs of child abuse and report suspected cases to appropriate authorities consistent with state law. The law protects you from liability and civil retribution for reporting suspected abuse, as long as such reports are made with reasonable grounds and without malice.

What to look for

Although many people have preconceived notions of what an abusive family looks like, child abuse can occur in any community and in any neighborhood, regardless of educational level, cultural background or financial well-being. Screening for abuse and neglect should be an integral part of your clinical examination of every child.

Before examination

Even before examination begins, make a routine habit of observing children for unusual behavior and signs of abuse, including:

  • Poor hygiene
  • Outward signs of improper nourishment or poor general health
  • Clothing that’s torn, dirty or inappropriate for the weather
  • Wounds or bruises on the child’s face or body
  • Aggressive, out-of-control or inappropriately angry behavior
  • Sullen, stoic or withdrawn behavior
  • Behavior that is inappropriately adult-like (taking care of other children) or inappropriately infantile (rocking, thumb-sucking, throwing tantrums) for the child’s age
  • Trouble walking or sitting
  • Avoidant behavior towards a caregiver or parent

During extraoral examination

Signs of abuse to watch for include:

  • Asymmetry, swelling or bruising in the head and neck
  • Bruising, hair loss or tenderness in the scalp
  • Scars, tears or other abnormalities on or around the ears
  • Bruises or abrasions of varying colors, which indicate different stages of healing
  • Self-treated injuries
  • Distinctive patterns in bruises or abrasions left by objects such as belts, cords or cigarettes
  • Bilateral bruising around the eyes
  • Petechiae (small red or purple spots) in the sclera of the eye
  • Drooping eyelids or a deviated gaze
  • Bruised nose, deviated septum or blood clot in the nose
  • Bite marks that could not be self-inflicted

During intraoral examination

Signs of abuse to watch out for during examination include:

  • Burns or bruises at the commissures of the mouth
  • Scars or tears on the lips, tongue, palate or lingual frenum
  • Untreated or self-treated bleeding or trauma in the orofacial region
  • Oral manifestations of sexually transmitted diseases
  • Fractured or missing teeth
  • Untreated, rampant and visibly apparent caries

How to distinguish normal childhood injuries from abuse

We all know that occasional bumps, scrapes and falls are a normal part of childhood. How then can you as a dentist distinguish ordinary injuries from signs of abuse?

Most injuries from accidental falls are uniplanar (i.e., located on one surface of the body, usually the front). Typical injuries of physical abuse are multiplanar.

You should also routinely question both child and parent about the cause of any observed injuries. If possible, question each separately and have a staff member present as a witness.

When speaking with parents and children about suspected abuse, listen for:

  • Inconsistent accounts of an injury’s origin
  • Explanations that don’t comport with the type of injury observed
  • Denial about the existence of an injury
  • Inappropriate blame placed on the child for injury
  • Description of the child in negative terms (bad, worthless, irresponsible, troublesome, etc.)

If, at the end of the office visit, you are still in doubt about whether to submit a report, consult with the patient’s physician, a social worker, a local authority or a colleague with experience in dealing with child abuse to discuss what you observed.

When in doubt, it’s better that you make your concerns known than to remain silent and possibly allow a child to remain unprotected. Remember, it’s ultimately the responsibility of the appropriate authorities to determine if abuse has occurred with the information you provide. 

How to document suspected abuse

Documentation of suspected abuse is not required to make a report, but it is nonetheless useful to create the following documentation:

  • Photographs and radiographs of the structures involved
  • A ruler placed beside the injury in photographs to help record its size
  • Detailed written notes in the dental chart with respect to the location, appearance, severity and distribution of injuries

Where to report suspected abuse

Once you decide to report suspected abuse, you may wonder whether to inform the parent about your intentions. Generally, it is recommended that parents should not be informed, as the parent may try to dissuade you, or it’s possible an angry encounter might ensue that could place you, your staff or the child at risk.

To fulfill your legal obligation in reporting suspected abuse:

  • Call 911 to alert the authorities if you believe the child is in imminent danger of immediate harm.
  • Otherwise, you or an employee in your office must report your concerns to your local child protective services agency or police department. For more information about where and how to file a report, call the Childhelp National Child Abuse Hotline (800-4ACHILD) or refer to the following state resource listings about where to call to make a report in your state.

The report should be made immediately over the telephone and should be followed up in writing. The agency will have special forms for this purpose that they will ask you to complete. When you complete the report, be prepared to include the following helpful information about the child’s situation:

  • The names and addresses of the child and the parents
  • The child’s age
  • The types of injuries or signs of abuse you observed
  • Information about other children who are living in the same environment

Your practice and child abuse prevention

Dentists who recognize and report abuse can have a positive impact on their patients’ lives by helping victims move toward safety. Intervention is the key to breaking the cycle of abuse, and as a dentist, you’re uniquely positioned to be among the first (and sometimes only) advocate for victims. By being observant and reporting suspected cases, you can help shield your young patients from violence and neglect.

Dentist spotlight: Dr. Michele Dozier

How do you get adults to stop fearing a visit to the dentist? Easy. Give them a great experience when they’re still kids.

That’s the word from Dr. Michele Dozier, who says that giving children a great experience is the key to ensuring they’re unafraid to see the dentist regularly throughout their lives. And she should know. Dr. Dozier has treated thousands of children around the world as a volunteer and at her practice, nusmiles, in Takoma Park, Maryland.

We recently reached out to Dr. Dozier and talked about the many places she’s served as a pediatric dentist, what her top recommendations are for parents and how she recharges after seeing more than 3,000 patients a year.

How and when did you decide to become a dentist?

There were no dentists around me growing up or anything like that. I’m the first in my family to go to college. It was just that I had a lot of dental problems as a child, and my dentist was great. I was inspired.

After you graduated from dental school, you traveled widely as a general dentist. Can you tell us about some of the places that you’ve practiced?

I did a lot of volunteer work in Guatemala, the Dominican Republic and Jamaica. Then I was in the Indian Health Service, so I went up near the North Pole and to Nevada.

You’ve said that you discovered a passion for pediatric dentistry during your travels. What was it that drew you to the field?

A lot of people say they don’t want to work with kids, because a lot of people don’t know how to deal with kids. I like working with kids, because they make me laugh. They speak the truth.

And if I can get kids to have a great experience when they’re young, they don’t become that timid person when they’re older and it comes time to see the dentist. They always remember going to the dentist as a great experience.

For me, because I had such a good experience with my dentist, I always want to make sure kids have a good experience.

Was there a particular experience you found especially memorable in that regard?

One thing I found really memorable was that Third World children can be very stoic and appreciative of dentistry. In some places, they may not have had the chance to see a dentist in years. People would travel for hours and then wait in line for hours just to be seen. Here in the United States, people may have free dentistry, they may have insurance, but they don’t take advantage of it!

When I was in the Dominican Republic, I was literally extracting teeth with people’s heads in my lap: I’m sitting on a table, they’re in a chair in front of me, they lean back with their head in my lap, and I’m extracting teeth. There’s no suction, nothing. They’re spitting into a bucket. But in that really small town, they were always so happy to see me. When I walked down the street, they’d say, “Here comes the Saca-muelas!” which means “takes-out-teeth.” They were so excited because they didn’t have a dentist. That for me is what makes me go back. You can change someone’s life just by taking care of their dentition.

What’s your top piece of advice to parents when it comes time to bring kids to the dentist?

My No. 1 piece of advice is: Don’t project any of your fears onto your children! Don’t joke and say, “I’m going to tell the dentist to pull your teeth out,” or try to scare them that they’re going to get a shot. That’s not cool, because then I have to unteach that fear when they come in.

Going to the dentist can be a pleasant experience, and if we can keep it that way, kids don’t have to go through any trauma. I’m here to beautify a smile, not to cause any pain. That’s the last thing I want to do. Kids have so much to deal with in life that can be negative. Let’s make one less thing negative.

Why did you decide to base your practice in Takoma Park?

I went to Maryland Dental School in Baltimore, and I did my residency in pediatrics in Las Vegas. I came back to this area right on the border next to D.C. because I’m a city girl. I love the city. I’m originally from Brooklyn, New York, so I just came down the coast. And I love the diversity.

Speaking of diversity, there have been some recent reports highlighting the lack of diversity in dentistry. In your opinion, what is most needed to improve diversity in the field?

Recruitment is important. Schools in the city tend to have more diversity, but when you go out to the Midwest, that’s not the case. When I did my residency, there were probably two black people out of about 350 people.

For me, Temple University had a pre-dentistry summer program. They brought students in who were considering dentistry. If you have programs that actually recruit and bring people in, that can really pique their interest.

What do you like to do in your free time when you’re not practicing dentistry?

I like to travel. Travel and self-care. I work with kids, and I probably see over 3,000 patients a year. I have to become a friend, a counselor, a clown, a negotiator, all these things I have to be with every single child. With that, the biggest key is wellness. I love the spa, and I love to travel. If I don’t have the mental capacity to come in every single day, there’s no point. I think taking care of yourself and keeping yourself balanced is the key.

Congratulations to Dr. Dozier for being our Dental Health Partner of the Month, and a big thank you for taking the time to share her thoughts with us! Be sure to visit Dr. Dozier’s website and Twitter.

5 practical tips for treating children in your office

February is Children’s Dental Health Month, so it’s the perfect time to consider how you and your office interact with children as patients. Kids, just like adults, experience fear and anxiety about visiting the dentist, but they show it in different ways. There’s no magic formula for making things easy when it comes to treating kids, but here are a few practical tips that can help keep you and your child patients smiling.

Encourage parents to bring children in early

As a dentist, you know that an ounce of prevention is worth a pound of cure. This applies especially to children.

If a parent brings a child to the dentist for the first time because of a problem or pain, chances are the visit will involve a lot of anxiety and discomfort. But if the first visit is positive and routine, the child will become familiar with the process and will likely have a better attitude during future visits.

Whenever possible, stress to parents how important it is to begin bringing their children to visit the dentist early, by their first birthday or soon after their first tooth appears. It’s not just about providing great oral health care in the early stages of life but also about acclimating the child to the entire process of visiting the dentist regularly.

Know the territory

Pediatric dentists understand that they often have to know just as much about Ariel and Spider-Man as they do about x-rays and cavities. Communicating with kids is crucial and can make them more comfortable, helping to distract them from dental procedures. Look for topics beyond the dental visit that can spur the child’s interest, such as favorite cartoons, movies, school subjects, hobbies, sports, foods or games.

Whenever possible, sit down or keep low so that you’re at the same level when you’re talking to kids, and maintain good eye contact. It’s natural to want to address the parent-caregiver first and foremost, but establishing a communication link with the patient is key. Ask questions and practice active listening to help establish rapport and trust.

Finding common ground can go a long way in making the experience less stressful for everyone. At the end of an appointment, jot down a few notes about the child’s interests so you’ll have something to ask about during the next visit. Your patients will feel special because you’ve remembered them.

Stay calm

Communication doesn’t happen only through words but also through your body language. A child’s behavior may have you feeling stressed and angry, but it’s important to keep control of the situation by staying calm. Children read facial expressions (even through a mask), so you don’t want to give the impression that you’re frustrated or impatient, which will only cause the child’s anxiety to increase. Even if the child starts to misbehave, try to make the situation light and keep any stress to yourself. Your attitude and body language can be important elements in gaining the trust of the child and shaping a positive dental visit.

Create a child-friendly environment

You and your staff have probably taken great care to ensure that the front desk and waiting area of your practice are calm and friendly spaces, but take another good look through the eyes of a child. Be sure to keep your waiting room stocked with appealing, clean and functional toys, stuffed animals, books and games, and even consider creating a special dedicated child-friendly area of the room.

A waiting area that includes distractions will help keep children occupied while waiting for the dentist. There are some excellent resources along these lines, including activity books, cards and coloring sheets, from the American Dental Association and the American Academy of Pediatric Dentistry. Delta Dental likewise offers resources for kids that teach about dental health:

When the child is in the dental chair, unfamiliar faces can be scary, so only allow necessary dental personnel (such as the dentist and hygienist) and caregivers around the patient. Too many people coming and going, speaking and giving directions in complicated language the child doesn’t understand may only cause more anxiety.

At the end of a visit, reinforce good behavior with praise and little rewards like stickers or other prizes (You can keep rewards relevant to the child’s age and interests by offering the child a choice among various rewards). If your office recognizes and rewards good behavior, the visit can become a pleasant experience, even one the child looks forward to rather than dreads.

Explain, demonstrate and offer choices

Children’s fear and anxiety often come from not understanding what is about to happen. Kids are naturally curious and very hands-on, so always tell a child what you are going to do beforehand.

Use language children can understand. Pediatric dentists have practically developed a whole second language of child-friendly terminology to speak about equipment and procedures. The same child who panics at the mention of the words “drill” or “extraction” may remain much calmer if you speak of a “buzzer” or “wiggling the tooth out” instead.

Making the child feel informed and in control can also go a long way in reducing nervousness around equipment that can otherwise seem loud, scary and strange. For instance, you might explain how a suction tool works and then allow a child to briefly hold it while you demonstrate how it operates, or explain that a face shield protects you when you’re at work the way an astronaut’s helmet protects her when she’s exploring outer space.

Even young children have preferences and like to feel important. Offering children choices in simple matters (for instance, which color dental bib would they like, what angle feels best for the headrest, etc.) can help provide feelings of control and autonomy. When children feel less helpless, they feel less stressed and are easier to treat.

Children and your practice

Treating children presents its own special set of challenges, but your flexibility and ability to communicate can be essential factors for effective dental care. Guiding the child’s behavior through positive interaction and communication can help ensure a smoother and easier dental visit for everyone.

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