Paediatric dentistry: Optimal view in the mouths of small patients
Some of the most important foundations for long-term oral health are laid down in our childhood. As such, it is imperative that visits to the dentist are as relaxed as possible for young patients. Dr Dinah Fräßle-Fuchs and her colleagues at the Kinderzahnordination Salzburg (Salzburg Paediatric Dentistry Clinic) specialize in the treatment of children. Their 25-strong team takes care of around 70 little patients every day. The practice uses methods tailored specifically to the treatment of children and focusing on the personal requirements of the individual patient.
State-of-the-art technology whose design and functions are intended to make the treatment as stress-free and atraumatic as possible also plays an essential role. The greatest challenges in paediatric dentistry are the restrictions when working in a small oral cavity and the fact that children are often less patient and cooperative during dental treatment. The dentists in the clinic use the W&H TK-94 L microturbine to perform the treatments quickly and safely. With its small head diameter and light, ergonomic design, the instrument is ideal for dentists treating primary dentition. In a recent interview, Dr Fräßle-Fuchs was kind enough to offer us a deeper insight into her challenging specialty.
Compared with adult patients, children are far less patient when it comes to dental treatment, so procedures have to be performed as quickly and with as little stress as possible. We employ special behavioural techniques in our practice with the aim of facilitating work on small patients.
In fact, the entire practice concept is specially designed to make it child-friendly. For example, standardized workflows and a set number of instruments ensure that the dentist can focus her entire attention on communicating with the little patient and addressing his or her needs.
Fast and efficient work on young patients
Working in small oral cavities is one of the particular challenges of paediatric treatment. “When working on our small patients, we are subject to some quite tight spatial restrictions – for physiological reasons, of course. As such, we have to be able to handle our instruments quickly, safely and easily. It is also very important for the children themselves that the instruments look harmless and make as little noise as possible,” explained Dr Fräßle-Fuchs.
She uses the W&H TK-94 L microturbine in her day-to-day work and appears particularly taken with its ergonomic features. “In combination with the short-shank burs, the small turbine head is extremely compact, which greatly facilitates working in children’s mouths.” A good view of the treatment site so as to be able to perform the procedures quickly and efficiently is also particularly important to her. The ultimate goal of every procedure is to keep the treatment as short as possible and not subject the young patients to any unnecessary stress.
“The microturbine ensures that the operating field is well illuminated. The LED+ in the instrument head gives me an excellent view of the treatment site and creates clear contrasts in the mouth, allowing me to work quickly and efficiently. Yet another highlight is the 5x spray, which ensures optimal cooling and provides me with additional safety support during procedures,” explained the dentist from Salzburg, Austria.
Good light quality at the treatment site is one of the fundamental requirements on the instruments employed in the paediatric dental practice. In addition to the TK-94 L, they also use the Synea Vision TK-97 L turbine. Equipped with a 5x ring LED+, it ensures shadow-free illumination of the entire treatment site.
With its slender design, low weight and the small turbine head, it, like the microturbine, is ideal for paediatric dentistry. “We use the W&H turbines in our clinic because they are the best solution for our requirements for ergonomics, performance and light quality. In the course of our work with the children, we have only ever had positive experiences with the compact W&H handpieces,” added Dr Fräßle-Fuchs.
TK-94 L – a symbiosis of functionality and ergonomics
Dr Fräßle-Fuchs also emphasized the fact that caries is the most common condition encountered in her young patients’ mouths. Primary dentition displays a lower degree of mineralization, which allows caries to advance more quickly. The comparatively large pulp chamber means that live teeth need to be extracted and root treatments need to be performed more regularly.
“Taking of x-rays is essential for accurate diagnosis. Clinically, 90% of all cases of interdental caries in primary dentition go undiagnosed. The reason for this is the opaque colouring of the primary dentition, which prevents the visualization of the carious lesion in most cases.” According to Dr Fräßle-Fuchs, failure to treat such cases can result in a lack of support in the posterior region in particular.
Just like in adult teeth, advanced caries can result in pain, inflammation and infections. In addition, chronic infections of the primary dentition can damage the corresponding adult tooth germ – resulting in enamel hypoplasia (Turner’s tooth).
The use of handpieces offering a good view in the smallest of mouths is decisive for tailored and atraumatic treatment designed for preservation of the dentition. In addition to the ergonomic features and light weight, Dr Fräßle-Fuchs also appears very taken with the benefits offered by the W&H microturbine in terms of its simple maintenance, reliability and high value retention as well as its long service life.
“The microturbine has proven itself very robust and durable so far. To date we have not had any incidents requiring repairs,” said the dentist happily. Her only hope for the future would be a more extensive range of short-shank bur models, which would allow her to benefit from the space savings offered by the W&H microturbine in other applications as well.