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Understanding the parent/child dynamic is important in the delivery of person-centered dental care to the child. However, the nature of parenting has changed and understanding of child development has continued to develop, affecting the ability of dentists to influence child behavior. The purpose of this paper is to review generational differences, the impact of parenting on child development and changes in approval of behavior guidance techniques to propose new approaches to child behavior. [ABSTRACT FROM AUTHOR]

There are a number of reasons for a child to misbehave in the dental setting. The aim of this study was to compare provider ratings of fear and defiance to standardized assessments of children's fear and defiance. Results suggest that misbehavior by defiant children in the dental setting is frequently thought to be related to fear. Providers may not be able to accurately distinguish between defiance and fear. [ABSTRACT FROM AUTHOR]

Purpose: Alterations of the lingual frenulum may contribute to oromyofacial dysfunction, speech and swallowing impediments, underdevelopment of the maxillofacial skeleton, and even predispose to sleep breathing disorder. This study aims to assess the utility of existing instruments for evaluation of restricted tongue mobility, describe normal and abnormal ranges of tongue mobility, and provide evidence in support of a reliable and efficient measure of tongue mobility. Methods: A prospective cohort study of 1052 consecutive patients was evaluated during a 3-month period. Age, gender, ethnicity, height, weight, BMI, maximal interincisal mouth opening (MIO), mouth opening with tongue tip to maxillary incisive papillae at roof of mouth (MOTTIP), Kotlow's free-tongue measurement, and presence of severe tongue-tie were recorded. Secondary outcome measures include tongue range of motion deficit (TRMD, difference between MIO and MOTTIP) and tongue range of motion ratio (TRMR, ratio of MOTTIP to MIO). Results: Results indicate that MIO is dependent on age and height; MOTTIP and TRMD are dependent on MIO; Kotlow's free-tongue measurement is an independent measure of free-tongue length and tongue mobility. TRMR is the only independent measurement of tongue mobility that is directly associated with restrictions in tongue function. Conclusions: We propose the use of tongue range of motion ratio as an initial screening tool to assess for restrictions in tongue mobility. 'Functional' ankyloglossia can thus be defined and treatment effects followed objectively by using the proposed grading scale: grade 1: tongue range of motion ratio is >80%, grade 2 50-80%, grade 3 < 50%, grade 4 < 25%. [ABSTRACT FROM AUTHOR]

The University of California, Los Angeles (UCLA) School of Dentistry has implemented a Health Resources and Services Administration-funded program to prepare dentists for the complex and comprehensive needs of pediatric patients within rapidly changing demographics and a paradigm shift in dentistry. Traditional dental education has focused on how to respond to oral disease, whereas UCLA's program shifts the paradigm to emphasize early assessment, risk-based prevention, and disease management. A holistic approach to dental care that considers social and environmental determinants is used with minimally invasive techniques for restorative care. To support this change, pediatric dental residents receive traditional training combined with new didactics, advocacy opportunities, and applied learning experiences at community-based organizations. These new elements teach residents to recognize the causal factors of disease and to identify interventions that promote oral health at the individual, family, community, and policy level. Consequently, they are better prepared to treat a diverse group of patients who historically have faced the greatest burden of disease as well as an increased number of barriers to accessing oral health care; these consist of low-income, minority, and/or pediatric populations including children with special health needs. The program's ultimate goal is for residents to deploy these skills in treating vulnerable populations and to demonstrate greater interest in collaborating with non-dental health providers and community organizations to increase access to dental services in private or public health practice settings. [ABSTRACT FROM AUTHOR]

There is a continuing shortage of academic dentists due to myriad factors. However, each graduating class of dental students includes a select group who choose to explore academic positions. It is this group of potential academic dentists that a four-year R25 initiative, funded by the National Institute of Dental and Craniofacial Research, has targeted with the intent of increasing their numbers and mentoring them for success in a future faculty position. The aims of the program at the School of Dentistry, University of California, Los Angeles, are to target and recruit potential clinician-scientists and to design and implement an Academic Track (AT) that complements existing clinical and research training with the comprehensive skill set of pedagogical, organizational, and personal strategies necessary to be successful in an academic career. Recruitment to the AT targeted candidates from a variety of sources including those enrolled in the dual D.D.S./M.S. and D.D.S./Ph.D. programs, dental residents, Ph.D. candidates in other disciplines, and predental students. Through a variety of professional development activities in the AT, selected students receive teaching, leadership, and mentoring experiences. Outcomes and lessons learned related to specific activities and lessons learned are presented in this article, and a model that recognizes the diverse paths to an academic career in dentistry is recommended. [ABSTRACT FROM AUTHOR]

Behavior management is significant to delivery of dental care to the child. We must be able to elicit cooperation of the child for dental procedures, and of child and parents, for adherence to a preventive home care regimen. However, society has changed, affecting the ability of dentists to influence children and their parents. The purpose of this paper is to review changes in parenting styles that have impacted the nature of oral care in the child. [ABSTRACT FROM AUTHOR]

One of the difficulties of the practice of dentistry is being responsible for the highest quality of care for patients while often having to propose alternate solutions for a variety of reasons, which include financial concerns. Dental practitioners treating young children have the added responsibility of gaining their patient's cooperation to render the best treatment. Determinants that influence the development of a behavioral strategy for a young patient include disease status, the child's physical and mental development, parental characteristics, and provider personality and capabilities. Classic strategies -- including a supportive office environment, "tell-show-do," successive approximation, distraction, behavior shaping, and retraining -- must be matched to the characteristics of each child and family situation. Current cultural trends suggest that disciplinary forms of behavior management strategies -- such as hand-over-mouth, physical restraint, and even voice control -- are losing societal acceptance. [ABSTRACT FROM AUTHOR]