Rohini Dua

Para gerir o medo, a ansiedade e a fobia dent ria em crian as necess rio, em primeiro lugar, reconhecer onde a crian a se situa no continuum - desde a apreens o normal at fobia grave e incapacitante. Os factores que contribuem para isso podem incluir o temperamento da crian a, experi ncias dent rias dolorosas passadas, ansiedade dos pais e o ambiente dent rio em geral. A interven o segue uma abordagem faseada, come ando com t cnicas n o farmacol gicas de orienta o comportamental, tais como Tell-Show-Do, refor o positivo, distra o, modelagem, comunica o eficaz e dessensibiliza o gradual. Quando necess rio, podem ser utilizados m todos psicol gicos como a terapia cognitivo-comportamental, o treino de relaxamento, a hipnose ou ferramentas de base tecnol gica. Em casos mais dif ceis, o apoio farmacol gico - como o xido nitroso ou outras op es sedativas - pode ser cuidadosamente introduzido. Os objectivos gerais s o assegurar cuidados dent rios seguros e eficazes, evitar experi ncias traum ticas e promover atitudes positivas em rela o medicina dent ria que encorajem a frequ ncia regular durante toda a inf ncia e at mais tarde na vida.

Zarządzanie strachem, lękiem i fobią stomatologiczną u dzieci wymaga najpierw rozpoznania, gdzie dziecko znajduje się na kontinuum - od normalnego lęku do poważnej, upośledzającej fobii. Czynniki przyczyniające się do tego mogą obejmowac temperament dziecka, bolesne doświadczenia stomatologiczne w przeszlości, niepok j rodzic w i og lne otoczenie stomatologiczne. Interwencja przebiega stopniowo, zaczynając od niefarmakologicznych technik kierowania zachowaniem, takich jak Tell-Show-Do, pozytywne wzmocnienie, odwracanie uwagi, modelowanie, skuteczna komunikacja i stopniowa desensytyzacja. W razie potrzeby można zastosowac metody psychologiczne, takie jak terapia poznawczo-behawioralna, trening relaksacyjny, hipnoza lub narzędzia oparte na technologii. W trudniejszych przypadkach można ostrożnie wprowadzic wsparcie farmakologiczne - takie jak podtlenek azotu lub inne środki uspokajające. Nadrzędnym celem jest zapewnienie bezpiecznej i skutecznej opieki stomatologicznej, unikanie traumatycznych doświadczeń i promowanie pozytywnego nastawienia do stomatologii, kt re zachęca do regularnego uczęszczania na wizyty w dzieciństwie i w p źniejszym życiu.

Per gestire la paura, l'ansia e la fobia odontoiatrica nei bambini necessario innanzitutto riconoscere la posizione del bambino nel continuum, dalla normale apprensione alla fobia grave e invalidante. I fattori che contribuiscono possono essere il temperamento del bambino, le esperienze dentistiche dolorose del passato, l'ansia dei genitori e l'ambiente dentale in generale. L'intervento segue un approccio graduale, iniziando con tecniche di guida comportamentale non farmacologiche come il "Tell-Show-Do", il rinforzo positivo, la distrazione, il modeling, la comunicazione efficace e la desensibilizzazione graduale. Se necessario, si possono utilizzare metodi psicologici come la terapia cognitivo-comportamentale, il training di rilassamento, l'ipnosi o strumenti tecnologici. Nei casi pi difficili, si pu introdurre con cautela un supporto farmacologico, come il protossido di azoto o altre opzioni sedative. L'obiettivo generale quello di garantire un'assistenza odontoiatrica sicura ed efficace, evitare esperienze traumatiche e promuovere un atteggiamento positivo nei confronti dell'odontoiatria che incoraggi la frequenza regolare durante l'infanzia e in et avanzata.

Pour g rer la peur, l'anxi t et la phobie dentaires chez les enfants, il faut d'abord savoir o se situe l'enfant sur le continuum, de l'appr hension normale la phobie grave et invalidante. Les facteurs contributifs peuvent tre le temp rament de l'enfant, les exp riences dentaires douloureuses pass es, l'anxi t des parents et l'environnement dentaire dans son ensemble. L'intervention se fait par tapes, en commen ant par des techniques non pharmacologiques d'orientation du comportement, telles que la m thode Tell-Show-Do, le renforcement positif, la distraction, la mod lisation, la communication efficace et la d sensibilisation progressive. Si n cessaire, des m thodes psychologiques telles que la th rapie cognitivo-comportementale, l'entra nement la relaxation, l'hypnose ou des outils technologiques peuvent tre utilis s. Dans les cas les plus difficiles, un soutien pharmacologique, tel que l'oxyde nitreux ou d'autres options s datives, peut tre introduit avec pr caution. Les objectifs principaux sont de garantir des soins dentaires s rs et efficaces, d' viter les exp riences traumatisantes et de promouvoir des attitudes positives l' gard de la dentisterie qui encouragent une fr quentation r guli re tout au long de l'enfance et plus tard dans la vie.

Die Behandlung von Zahnarztangst, -furcht und -phobie bei Kindern erfordert zun chst, dass man erkennt, wo das Kind auf dem Kontinuum zwischen normaler Angst und schwerer, behindernder Phobie steht. Zu den Faktoren, die dazu beitragen, geh ren das Temperament des Kindes, fr here schmerzhafte Zahnerfahrungen, elterliche ngste und das gesamte zahn rztliche Umfeld. Die Intervention erfolgt schrittweise, beginnend mit nicht-pharmakologischen Verhaltenslenkungstechniken wie Tell-Show-Do, positiver Verst rkung, Ablenkung, Modellierung, effektiver Kommunikation und allm hlicher Desensibilisierung. Bei Bedarf k nnen auch psychologische Methoden wie kognitive Verhaltenstherapie, Entspannungstraining, Hypnose oder technologiebasierte Hilfsmittel eingesetzt werden. In schwierigeren F llen kann eine pharmakologische Unterst tzung - z. B. Lachgas oder andere Sedativa - vorsichtig eingesetzt werden. Die bergeordneten Ziele sind die Gew hrleistung einer sicheren und wirksamen zahn rztlichen Versorgung, die Vermeidung traumatischer Erlebnisse und die F rderung einer positiven Einstellung gegen ber der Zahnmedizin, die eine regelm ige Teilnahme am Zahnarztbesuch w hrend der gesamten Kindheit und im sp teren Leben beg nstigt.

Cleft lip and palate (CLP) are the most common craniofacial anomalies, caused by both genetic and environmental factors. Management requires a multidisciplinary team (surgeons, orthodontists, pedodontists, speech therapists, nutritionists, psychologists etc.). Presurgical nasoalveolar molding (NAM), started in early infancy, aligns alveolar segments and nasal structures to improve surgical outcomes, reduce tension, and minimize revisions. Success depends on early intervention, parental compliance, accurate diagnosis, and clinical expertise. Comprehensive care also addresses speech, feeding, nutrition, aesthetics, and psychological support, with public health efforts focusing on prevention through maternal health education. Overall, timely, coordinated, and proportionate multidisciplinary care ensures better long-term functional, aesthetic, and psychosocial outcomes.

One of the important functions of primary teeth is to occupy the physiological space and guide the eruption of the replacement teeth. Primary teeth exfoliation followed by successor teeth eruption is a normal physiological process; interrupting which, may lead to mesial migration of the permanent teeth, crowding, impacted permanent teeth, formation of cross-bites, differences in the median line of teeth, and the supra-eruption of the antagonistic teeth. It is also reported to impact negatively on the children's quality of life regarding the emotional well-being; therefore; space maintenance at the primary stage is a major factor in preventive orthodontics. An early intervention with a space maintainer may prevent undesirable space loss; thereby, this very effort, is hence extremely significant; in preventing the need of any future complicated orthodontic treatment.

Probiotics and prebiotics are gaining attention in pediatric dentistry for their ability to promote oral health and manage common dental issues through microbiome modulation. Probiotics are live microorganisms, such as Lactobacillus rhamnosus, Lactobacillus reuteri, Bifidobacterium spp., and Streptococcus salivarius, that provide health benefits when consumed in adequate amounts. Their primary mechanism of action includes inhibiting pathogenic bacteria, competing for adhesion sites on oral tissues, producing antimicrobial substances, and modulating the host immune response. In pediatric dentistry, probiotics have shown significant potential in reducing the prevalence of dental caries by lowering levels of cariogenic bacteria such as Streptococcus mutans. Additionally, probiotics help in managing periodontal health by reducing inflammation, biofilm accumulation, and gingival bleeding, making them a useful adjunct in periodontal care for children. They also play a role in reducing halitosis by neutralizing volatile sulfur compounds and have been effective in managing fungal infections like oral thrush caused by Candida albicans.