The philosophy of paediatric dentistry
What is paediatric dentistry?
Paediatric dentistry is a specialty based not on a particular skill set, but encompassing
all of dentistry’s technical skills against a philosophical background of understanding
child development in health and disease. This new edition of the handbook emphasizes
again the broader picture in treating children. A dental visit is no longer just a dental
visit – it should be regarded as a ‘health visit’. We are part of the team of health
professionals who contribute to the well-being of children, both in an individual
context and at the wider community level. Children often slip through childhood to
adolescence in the blink of an eye and family life is more pressured and demanding.
Commonly, children spend more time on social media than interacting directly with
family and friends and, more than ever, the major influences on their lives, come from
outside the family.
The pattern of childhood illness has changed and with it, clinical practice. Children
presenting for treatment may have survived cancer, may have a well-managed chronic
disease or may have significant behavioural and learning disorders. There are increasing,
sometimes unrealistic, expectations, among parents/carers that the care of their
children should be easily and readily accessible and pain-free and result in flawless
aesthetics.
Caries and dental disease should be seen as reflective of the family’s social condition
and the dental team should be part of the community
Your [patients] don’t have to become your friends, but they are part of your social
context and that gives them a unique status in your life. Treat them with respect and
take them seriously and your practice will become to feel part of the neighbourhood,
part of the community.
(Hugh MacKay, psychologist, social researcher and novelist)
In the evolving dynamics of dental practice, we feel that it is important to change,
philosophically, the traditional ‘adversarial nature’ of the dental experience. It is well
recognized that for too many, the dental experience has been traumatic. This has
resulted in a significant proportion of the adult population accessing dental care only
episodically, for the relief of pain. Thus, it is vital to see a community, and consumer,
perspective in the provision of paediatric dental services. The successful practice of
paediatric dentistry is not merely the completion of any operative procedure but also
ensuring a positive dental outcome for the future oral health behaviour of that individual
and family. To this end, an understanding of child development – physical,
cognitive and psychosocial – is paramount. The clinician must be comfortable and
skilled in talking to children, and interpersonal skills are essential. It will not usually be
the child’s fault if the clinician cannot work with the child.

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