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The classic concept of a child’s dental consultation solely in an emergency is long overdue. According to the new guidelines of the European Academy of Pediatric Dentistry (EAPD) (1) dental monitoring of the child should start as early as possible and should last throughout life.

…The aim of the present commitment is monitoring the correlation among eating habits, food intake, oral hygiene and occlusal disorders in children, adolescents, adults and older adults before and after orthodontic and dental interventions in the perspective of a long-life active prevention and healthy ageing and in order to support some useful long life-course prevention programs(2).

Until last year, in the Netherlands, for example, the first consultation at the age of 3 years was mandatory and 100% compensated by the dental health insurance law. Now, the obligation of scheduling the child for the first consultation refers to the age of 2 years, which means before the end of the baby teeth eruption. In Romania, this type of preventive practice is not yet considered by our decision makers and therefore it is far from being legislated, although the Health Insurance Act- which also includes dental health- clearly stipulates the right to free medical care for the entire period of childhood up to 18 years, but without financial coverage. However, without the protocols of pediatricians, including the obligation of monitoring temporary teeth in Romania, in a salutary way, some family doctors/pediatricians initiated children’s early dental consultations and recommended early visits –first tooth first visit- at private offices for Pediatric Dentistry, but overwhelmingly private ones.  On their first visit in private cabinets, parents can be asked to conclude a collaboration contract (between the dental team and the child’s parents):

Dental subscription for children.

This subscription is based on the following approach principles:

  1. Primary consultation within the first familiarization visit. After the playing time and space in the waiting room, the child is introduced to the office team, the offices from the building, the equipment and their functions, the counting of the teeth: all this in their way of understanding.
  2. The global approach of the little patient in an individualized way, specific to their age group and their stage of development. We are interested in identifying the psychological profile, the vicious habits, the eating or hygiene habits, the family context, the child’s hobbies.
  3. Interdisciplinary approach by consulting the orthodontist, pediatrician, speech therapist, dietitian.
  4. Long-term monitoring through regular consultations depending on the dental caries’ degree of risk and the type of parent + child dyad.

During the secondary consultation and the family’s anamnesis, the type of subscription corresponding to the age and the existing problem is established, alongside the treatment plan, which aims at rehabilitating the patient in a short time and with non or minimally invasive methods. Subscriptions can be prophylactic or prophylactic-therapeutic.

Basically, a subscription includes:

  1. Protection of healthy teeth through professional caries prevention treatments.
  2. Treatment of ill teeth.
  3. Education of children and parents (caregivers) regarding the child’s hygiene and nutrition.
  4. Dental emergencies.

Through this contract, the collaborative relationship between the dentist, the parent and the child will become an important fact for the little one. They will also be able to understand the role of the dentist in their life. Each stage in the child’s development brings with it new approaches to the little one. This is the reason why they must be approached and treated periodically and according to their age, capacity for understanding, and especially taking into account their psychological background.

Therefore, the dental subscription (4) represents the dentist’s care and responsibility for the patient’s health corroborated with the interest and effort of the parents, so that the development of the child’s dentition is a beneficial one, without creating any psychological traumas. This concept is not only an extra step in Pediatric Dentistry, but it also demonstrates its effectiveness for the children’s health. In all European countries –and not only (3,4)- in which this collaboration exists and is carried out in good conditions, there has been a radical decrease in the incidence of children’s dental caries, and of course a big improvement in oral and general health.

 

  1. https://ec.europa.eu/info/policies/justice-and-fundamental-rights/rights-child/eu-action-rights-child_en
  2. https://ec.europa.eu/eip/ageing/commitments-tracker/a3/influence-occlusal-disorders-food-intake-and-oral-hygie
  3. https://eeas.europa.eu/headquarters/headquarters-homepage/68434/eeas2019op0032-%E2%80%93-medical-and-dental-advisor-services-eu-health-insurance-local-agents-eu_en
  4. https://www.deltadental.com/us/en/product/individual-dental-insurance.html