NEET MDS Lessons
Pedodontics
Postnatal Period: Developmental Milestones
The postnatal period, particularly the first year of life, is crucial for a child's growth and development. This period is characterized by rapid physical, motor, cognitive, and social development. Below is a summary of key developmental milestones from birth to 52 weeks.
Neonatal Period (1-4 Weeks)
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Physical Positioning:
- In the prone position, the child lies flexed and can turn its head from side to side. The head may sag when held in a ventral suspension.
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Motor Responses:
- Grasp reflex is active, indicating neurological function.
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Visual Preferences:
- Shows a preference for human faces, which is important for social development.
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Physical Characteristics:
- Face is round with a small mandible.
- Abdomen is prominent, and extremities are relatively short.
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Criteria for Assessing Premature Newborns:
- Born between the 28th to 37th week of gestation.
- Birth weight of 2500 grams (5-8 lb) or less.
- Birth length of 47 cm (18 ½ inches) or less.
- Head length below 11.5 cm (4 ½ inches).
- Head circumference below 33 cm (13 inches).
4 Weeks
- Motor Development:
- Holds chin up and can lift the head momentarily to the plane of the body when in ventral suspension.
- Social Interaction:
- Begins to smile, indicating early social engagement.
- Visual Tracking:
- Watches people and follows moving objects.
8 Weeks
- Head Control:
- Sustains head in line with the body during ventral suspension.
- Social Engagement:
- Smiles in response to social contact.
- Auditory Response:
- Listens to voices and begins to coo.
12 Weeks
- Head and Chest Control:
- Lifts head and chest, showing early head control with bobbing motions.
- Defensive Movements:
- Makes defensive movements, indicating developing motor skills.
- Auditory Engagement:
- Listens to music, showing interest in auditory stimuli.
16 Weeks
- Posture and Movement:
- Lifts head and chest with head in a vertical axis; symmetric posture predominates.
- Sitting:
- Enjoys sitting with full truncal support.
- Social Interaction:
- Laughs out loud and shows excitement at the sight of food.
28 Weeks
- Mobility:
- Rolls over and begins to crawl; sits briefly without support.
- Grasping Skills:
- Reaches for and grasps large objects; transfers objects from hand to hand.
- Vocalization:
- Forms polysyllabic vowel sounds; prefers mother and babbles.
- Social Engagement:
- Enjoys looking in the mirror.
40 Weeks
- Independent Sitting:
- Sits up alone without support.
- Standing and Cruising:
- Pulls to a standing position and "cruises" or walks while holding onto furniture.
- Fine Motor Skills:
- Grasps objects with thumb and forefinger; pokes at things with forefinger.
- Vocalization:
- Produces repetitive consonant sounds (e.g., "mama," "dada") and responds to the sound of their name.
- Social Play:
- Plays peek-a-boo and waves goodbye.
52 Weeks
- Walking:
- Walks with one hand held and rises independently, taking several steps.
- Object Interaction:
- Releases objects to another person on request or gesture.
- Vocabulary Development:
- Increases vocabulary by a few words beyond "mama" and "dada."
- Self-Care Skills:
- Makes postural adjustments during dressing, indicating growing independence.
1. Behavior Modification: Aversive Conditioning (HOME)
- Definition: Aversive conditioning is a behavior modification technique used to manage undesirable behaviors in children, particularly in a dental setting.
- Method: Known as the Hand-Over-Mouth Exercise
(HOME), this technique was introduced by Evangeline Jordan in 1920.
- Procedure: The dentist gently places their hand over the child’s mouth to prevent them from speaking or crying, allowing for a calm environment to perform dental procedures. This method is intended to help the child understand that certain behaviors (e.g., crying or moving excessively) are not conducive to receiving care.
2. Dental Materials: Crowns
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Cheng Crowns:
- Composition: These crowns feature a pure resin facing, which makes them stain-resistant.
- Design: Pre-crimped for ease of placement and adaptation to the tooth structure.
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Pedo Pearls:
- Description: Aluminum crown forms coated with tooth-colored epoxy paint.
- Durability: Relatively soft, which may affect their long-term durability compared to other crown materials.
3. Oral Hygiene for Infants
- Gum Pad Cleaning:
- Timing: Cleaning of gum pads can begin as early as the first week after birth.
- Parental Responsibility: Parents should brush or clean their baby’s gums and emerging teeth daily until the child is old enough to manage oral hygiene independently.
4. Indicators of Trauma and Abuse in Children
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Frenum Conditions:
- Maxillary Labial Frenum: A torn frenum in a young child may indicate trauma from a slap, fist blow, or forced feeding.
- Lingual Frenum: A torn lingual frenum could suggest sexual abuse or forced feeding.
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Signs of Abuse:
- Bruising or Petechiae: Presence of bruising or petechiae on the soft and hard palate may indicate sexual abuse, particularly in cases of oral penetration.
- Infection or Ulceration: If any signs of infection or ulceration are noted, specimens should be cultured for sexually transmitted diseases (STDs) such as gonorrhea, syphilis, or venereal warts.
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Neglect Indicators:
- A child presenting with extensive untreated dental issues, untreated infections, or dental pain may be considered a victim of physical neglect, indicating that parents are not attending to the child’s basic medical needs.
5. Classical Conditioning
- Pavlov’s Contribution: Ivan Petrovich Pavlov was the
first to study classical conditioning, a learning process that occurs
through associations between an environmental stimulus and a naturally
occurring stimulus.
- Relevance in Dentistry: Understanding classical conditioning can help dental professionals develop strategies to create positive associations with dental visits, thereby reducing anxiety and fear in children.