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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.

The purpose of Workshop B was to discuss the implications of this symposium for training of pediatric dental residents and predoctoral dental students, as well as continuing education for general dentists as related to behavior guidance. Participants also considered the implications of the symposium proceedings for practice in terms of informed consent, practice patterns, and provision of information to patients regarding behavior guidance. Workshop B identified a variety of dental educational methodologies used to promote understanding among dentists who provide pediatric dental care to diverse populations. There was a consensus that the indications, use, and documentation of basic behavior guidance techniques need to be defined and clarified by the American Academy of Pediatric Dentistry and disseminated appropriately. Workshop participants called for the development of asynchronous learning activities such as webinars and instructional videos to further educate dental providers treating children and to legitimize the techniques with parents, healthcare providers, and the general public. Major recommendations from the workshop included: 1) solicit, support, and fund research in behavior guidance for diverse populations, 2) clarify best practices for the use and documentation of basic behavior guidance techniques, 3) identify and define new behavior guidance techniques, 4) promote training in motivational interviewing, 5) encourage integration of symposium proceedings throughout dental education curricula, 6) encourage mentorship networks among general dentists treating children and geographically contiguous pediatric dentists, and 7) develop a library of informational videos for parents and the general public about appropriate behavior guidance techniques used when treating children in dental settings.

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]

The authors comment on the Image Gently in Dentistry Campaign aimed at improving radiation safety for children in dental practice. The campaign advocates six steps for minimizing children's radiation exposure in the dental office. The steps are said to be consistent with the American Academy of Pediatric Dentistry's (AAPD) guidelines on prescribing dental radiographs.

Purpose: The purpose of this study was to identify patterns of functional, extraoral, and intraoral examination characteristics that correlate with increased risk of sleep disturbances and develop a functional airway screening tool to help clinicians for early diagnosis of pediatric sleep-disordered breathing. Methods: From March 2018 until March 2019, a cross-sectional study was conducted of 96 mixed dentition children during dental examinations at the UCLA pediatric dental clinic. Outcome measures included a sleep index score by the Sleep Disturbance Scale for Children (SDSC) completed by parents. Clinical assessment tool measurements assessing functional, extraoral, intraoral soft tissue, and intraoral hard tissue determinants were recorded during a routine dental examination by pediatric dental residents. Results: The mean age was 8.9 years (±1.9 years standard deviation), with 46 males and 50 females participating. Mouth-breathing (functional), mentalis strain (extraoral), tonsillar hypertrophy and ankyloglossia (intraoral soft tissue), dental wear, and narrow palate (intraoral hard tissue) were found to be the most clinically deterministic of higher SDSC scores (P<0.01). A clinical assessment tool for sleep-disordered breathing in pediatric dental patients (FAIREST-6) was developed, comprising these six clinical factors. Conclusions: The FAIREST-6 is a concise and validated clinical assessment tool that may aid in early diagnosis and intervention of pediatric sleep-disordered breathing. [ABSTRACT FROM AUTHOR]