Pediatric Dentistry for Special Child Priya Verma Gupta
Chapter Notes

Save Clear

1Pediatric Dentistry for Special Child
A meeting was held quite far from Earth:
“ It's time again for another birth.”
Said the Angels to the Lord Above,
“ This special child will need much love.”
Her progress may seem very slow,
Accomplishments she may not show
And she'll require extra care
From folks she meets way down there.
She may not run or laugh or play
Her thoughts may seem quite far away:
In many ways she isn't adapt
And she'll be known as handicapped.
So let's be careful where she's sent
We want her life to be content.
Please, Lord, find the parents who
Will do a special job for you.
They will not realize right away
The leading role they're asked to play
But with this child sent from above
Comes a stronger faith and richer love.
And soon they'll know the privilege given
In caring for the Gift from Heaven.
Their precious charge,
so meek and mild
Is Heaven's Very Special Child.
— Edna Massimilla
3Pediatric Dentistry for Special Child
First Edition
Editor Priya Verma Gupta MDS FPFA Professor and Clinical Head-Suneedhi Department of Pedodontics and Preventive Dentistry Divya Jyoti College of Dental Sciences and Research Modi Nagar, Niwari Road, Ghaziabad Uttar Pradesh, India Associate Editor Amitha M Hegde MDS Professor and Head Department of Pedodontics and Preventive Dentistry AB Shetty Memorial Institute of Dental Sciences Mangalore, Karnataka, India Foreword StefanosStefanidis Gisele da SilvaDalben
Jaypee Brothers Medical Publishers (P) Ltd
Jaypee Brothers Medical Publishers (P) Ltd
4838/24, Ansari Road, Daryaganj
New Delhi 110 002, India
Phone: +91-11-43574357
Fax: +91-11-43574314
Overseas Offices
J.P. Medical Ltd
83 Victoria Street, London
Phone: +44-2031708910
Fax: +02-03-0086180
Jaypee-Highlights Medical Publishers Inc.
City of Knowledge, Bld. 237, Clayton
Panama City, Panama
Phone: +1 507-301-0496
Fax: +1 507-301-0499
Jaypee Medical Inc.
The Bourse
111 South Independence Mall East
Suite 835, Philadelphia, PA 19106, USA
Phone: +1 267-519-9789
Jaypee Brothers Medical Publishers (P) Ltd
17/1-B Babar Road, Block-B, Shaymali
Mohammadpur, Dhaka-1207
Mobile: +08801912003485
Jaypee Brothers Medical Publishers (P) Ltd
Bhotahity, Kathmandu, Nepal
Phone: +977-9741283608
© 2016, Jaypee Brothers Medical Publishers
The views and opinions expressed in this book are solely those of the original contributor(s)/author(s) and do not necessarily represent those of editor(s) of the book.
All rights reserved. No part of this publication may be reproduced, stored or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission in writing of the publishers.
All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book.
Medical knowledge and practice change constantly. This book is designed to provide accurate, authoritative information about the subject matter in question. However, readers are advised to check the most current information available on procedures included and check information from the manufacturer of each product to be administered, to verify the recommended dose, formula, method and duration of administration, adverse effects and contraindications. It is the responsibility of the practitioner to take all appropriate safety precautions. Neither the publisher nor the author(s)/editor(s) assume any liability for any injury and/or damage to persons or property arising from or related to use of material in this book.
This book is sold on the understanding that the publisher is not engaged in providing professional medical services. If such advice or services are required, the services of a competent medical professional should be sought.
Every effort has been made where necessary to contact holders of copyright to obtain permission to reproduce copyright material. If any have been inadvertently overlooked, the publisher will be pleased to make the necessary arrangements at the first opportunity.
Inquiries for bulk sales may be solicited at:
Pediatric Dentistry for Special Child
First Edition: 2016
Printed at
5Dedicated to
my dear father Late RP Verma
father-in-law Late Padamshree Dr LC Gupta
for teaching me that great things are born from tiny sparks of
inspiration.…… miss you dad6
  • Abhishek Gupta MD DRM DNB MNAMS
  • Consultant and Head, Nuclear Medicine
  • Pushpanjali Crosslay Hospital
  • NDSEI, Delhi, India
  • Anjula Vij MBBS
  • USA
  • Ankit Sharma MPT (Cardiopulmonary)
  • Senior Editor
  • Jaypee Brothers Medical Publishers (P) Ltd.
  • New Delhi, India
  • Ashmitha Shetty MDS
  • Associate Professor
  • Department of Pedodontics and Preventive Dentistry
  • MS Ramaiah Dental College
  • Bengaluru
  • Karnataka, India
  • Balaji Manohar MDS MFDS RCPS (Glasgow)
  • Professor
  • Department of Periodontics
  • Pacific Dental College and Hospital
  • Debari, Udaipur
  • Rajasthan, India
  • Brinda Godhi MDS
  • Reader
  • Department of Pedodontics and Preventive Dentistry
  • JSS Dental College
  • Mysore
  • Karnataka, India
  • Deepak Verma LLB
  • Advocate
  • Delhi High Court
  • New Delhi, India
  • Dinesh B Rao MDS
  • Professor
  • Department of Pediatric Dentistry
  • Pacific Dental College and Hospital
  • Udaipur, Rajasthan, India
  • Divya Tomar MDS
  • Assistant Professor
  • Department of Pedodontics and Preventive Dentistry
  • Shree Bankey Bihari Dental College and
  • Research Centre
  • Hapur Road, Ghaziabad
  • Uttar Pradesh, India
  • Harish Chellani MD DCH
  • Consultant and Associate Professor
  • Neonatology Division
  • Department of Pediatrics
  • Vardhaman Mahavir Medical College and
  • Safdarjung Hospital
  • New Delhi, India
  • Harsh Mohan MD FAMS FIC (Path) FUCC
  • Professor and Head
  • Department of Pathology
  • Government Medical College
  • Sector-32A, Chandigarh
  • India
  • Jyoti Gupta MDS
  • Professor
  • Department of Oral Medicine and Radiology
  • Career Post Graduate Institute of Dental Sciences,
  • and Hospital
  • IIM Road Ghaila, Lucknow
  • Uttar Pradesh, India
  • Kiran Bhatt MDS
  • Professor
  • Bangalore Institute of Dental Sciencies
  • Wilson Garden, Bangalore
  • Karnataka, India
  • Krishna Shama Rao MBBS MDS FRCS (Edin)
  • FDSRCS (Eng)
  • Professor and Director
  • Centre for Craniofacial Anomaly
  • President Maya Foundation
  • Yenepoya Dental College
  • Mangalore, Karnataka, India
  • 8Neeraj Gugnani MDS
  • Professor
  • Department of Pediatric Dentistry
  • DAV (C) Dental College
  • Yamuna Nagar, Haryana
  • India
  • Nidhi Agarwal MDS
  • Professor & Head
  • Department of Pedodontics and Preventive Dentistry
  • IDST College of Dental Studies and Research
  • Modi Nagar, Ghaziabad
  • Uttar Pradesh, India
  • Nikhil Marwah MDS
  • Professor
  • Department of Pedodontics and Preventive Dentistry
  • Mahatma Gandhi Dental College
  • Jaipur, Rajasthan, India
  • Muhamad Nishad Thayath MDS
  • Professor & Head
  • Department of Pedodontics and Preventive Dentistry
  • Shree Bankey Bihari Dental College and
  • Research Centre Hapur Road,
  • Ghaziabad Uttar Pradesh, India
  • Pooja Ahmad MFDSRCS (ENG)
  • Fox Hall Dental Practice
  • Ipswiph, Sussolk
  • United Kingdom
  • Prasad Musale MDS
  • Professor
  • Department of Pedodontics and Preventive Dentistry
  • MA Rangoonwala College of Dental Sciences and Research Centre Azam Campus
  • Pune, Maharashtra, India
  • R Arun MDS
  • Professor
  • Department of Pedodontics
  • Kalinga Institute of Dental Sciences
  • Bhubaneswar, Orissa, India
  • Ravighna P MDS
  • Associate Professor
  • Department of Pedodontics and Preventive Dentistry
  • SVS Institute of Dental Sciences
  • Mahaboob Nagar, Hyderabad
  • Andhra Pradesh, India
  • Sangeetha P Venkatesh MDS
  • Specialist Pediatric Dentist
  • Badr All Samaa Al -khoud
  • Muscat, Sultanate of Oman
  • Shrirang Sevekar MDS
  • Associate Professor
  • Department of Pedodontics and Preventive Dentistry
  • MGM Dental College and Hospital
  • Kamothe, Navi Mumbai
  • Maharashtra, India
  • Srinivas Namineni MDS
  • Professor and Head
  • Department of Pedodontics and Preventive Dentistry
  • Sri Sai College of Dental Surgery
  • Vikarabad, Telangana, India
  • Sreekanth Kumar Mallineni MDS
  • Associate Professor
  • Department Paediatric and Prventive Dentistry
  • Saraswati-Dhanwantari Dental College & Hospital & Post Graduate Research Institute
  • Dr. Prafulla Patil Educational & Hospital Campus,
  • Pathri Road, National Highway 222
  • Parbhani - 431 401 (M.S.) INDIA
  • Subhadra HN MDS
  • Associate Professor
  • Department of Pedodontics and Preventive Dentistry
  • Yerala Dental College and Hospital
  • Navi Mumbai
  • Maharashtra, India
  • US Krishna Nayak MDS
  • Dean Professor and Head
  • Department of Orthodontics and
  • Dentofacial Orthopedics
  • AB Shetty Memorial Institute of Dental Sciences
  • Mangalore, Karnataka, India
  • Vijay Prakash Mathur MDS
  • Additional Professor
  • Department of Pedodontics and Preventive Dentistry
  • All India Institute of Medical Sciences
  • New Delhi, India
This book is a remarkable effort to initiate the general dentist into the topics of Special Care Dentistry and Pediatric Dentistry. It offers an introduction to the treatment of children with special needs and the medically compromised child.
The issues of mental and physical disability are presented with adequate detail and linked to their implications on designing and executing a dental treatment plan. The most common syndromes of the Head and Neck are presented in a concise way, providing all necessary information concerning oral manifestations and their management. An important chapter is dedicated to behavior management with sedation, using pharmaceutical substances and introduces to the use of nitrous oxide inhalation technique.
I believe that it is a very useful guide to the dentist with a special interest in Pediatric and Hospital Dentistry. It is also a handy reference guide to the Pediatric Dentist as well as to those working in a hospital environment. Using this book, one can refresh his Knowledge on the spot and gain self-confidence when treating challenging patients. I definitely recommend it.
Stefanos Stefanidis DDS, PhD
Director Coordinator
Dental Department,
Agios Dimitrios General Hospital
Thessaloniki, Greece10
I am very pleased to receive the most honorable invitation to write the foreword for the book “ Pediatric dentistry for special child”. Dental professionals delivering care to children with special needs know how hard, and also how rewarding, this task may be. The inherent difficulties of dental care are further complicated by the lack of physical and mainly human resources, which are usually insufficient for the demand.
This lack of specialized personnel highlights the relevance of this book, from both scientific and humanistic standpoints. Soon in the Table of Contents, the reader may have a hint on what comes next. The book is carefully divided into sections according to the type of special need, and each section is further subdivided to properly present the different challenges under the scope of “ special needs”. This is most convenient, as a didactic source of information, and mainly for dentists in clinical practice, who may easily find the information they need by searching the book, even in the consultation room as a chairside auxiliary tool.
However, from the humanistic standpoint, the book assumes its greater relevance. By achieving thorough, complete, reliable and accessible information about special needs, dental professionals may then feel empowered and keen to offer care for this needed population; and this, once begun, will never stop! The sensation of really doing a useful job, of helping someone in REAL need, and the attempts of communication of these children with their dentist – often through eye movements, hand signs, or even a weak but sincere smile – are the greatest reward for health professionals wishing to do their best for these little angels.
So now move on, start turning the pages, and dive deep into the amazing world of pediatric dentistry for the special child! Information and emotion are waiting for you on the following pages of this book – and of your professional life.
Dr. Gisele da Silva Dalben
DDS, MSc, PhD, Pediatric dentist
Hospital for Rehabilitation of Craniofacial Anomalies,
University of São Paulo (HRAC/USP)
Bauru, SP, Brazil12
Pediatric dentistry is a specialty dedicated to the oral health of children from infancy through the adolescence. The branch reserves a special place in the field of dentistry for both dental and medical anomalies. Treating children is not easy and it becomes more complex in case of special children. The concept of this book was perceived when I realized that there is no core book to understand this complicated yet interesting segment of pediatric dentistry. Lack of literature leaves students perplexed about the information required to treat special child. This benightedness has created a vacuum forcing the dental practitioners to run away from the situation and treating them as weary load thereby making extraneous referral to the hospital.
Consequently, these children are abnegated the rightfully desired treatment. Because of brobdingnagian scope and literature it is impossible to cover entire pediatric dentistry in one book. This book is my sincere effort to fill the void in the dental care of special children. Efforts have been made to cover most conditions which are not seen often in routine practice but are important from the perspective of special children.
The book is divided in eight sections. First section explains various aspects, i.e. needs, family environment, home care, finances, and mental status of child and family. The subsequent sections give detailed insight of all conditions of intellectual, physical, medical, genetic and emotional origin. The book sums up with the management of pediatric patients in hospital settings along with admission procedure and medico legal issues. A chapter on nitrous oxide inhalation sedation has been added to understand modern chair side anesthesia in dentistry.
I hope this book will prove as a stepping stone in the treatment of special children and you will not only enjoy this compilation, rather this book will provoke debate and discussion amongst you and your colleagues on how to treat special child the best.
Priya Verma Gupta14
As I come towards the end of the book, I would like to express my gratitude for those without whose sincere efforts this would not have been possible for me to achieve. I would like to express my profound heartfelt gratitude to my mentors and Prof Dr N Sridhar Shetty and Shri NV Hegde for guiding and encouraging me throughout my professional career.
I thank all my contributors for their contributions and timely submissions of the manuscript.
A very special word of thanks to all those wonderful children and special child institutions who were glad to be a part of this book for the sake of knowledge.
I profusely thank Shri Jitender P Vij (CEO), Mr Ankit Vij (Group President), Dr Ankit Sharma (Senior Editor), Dr Rishab Malhotra (Development Editor), Mr Ashutosh Shrivastava (Assistant Editor), Mr Shekhar Bhatt (Typesetter) and Mr Nitesh Jain (Graphic Designer) of M/S Jaypee Brothers Medical Publishers (P) Ltd, New Delhi for their enthusiasm and constant efforts in bringing out this book.
I sincerely thank my husband Dr Abhishek Gupta for always being a source of encouragement and support. Mere words will do no justice for describing the immense gratitude I have for him. I would also like to thank my two wonderful kids Aarin and Ansh for being extremely cooperative.
My expression of deepest gratitude goes to my mother Dr GL Verma and mother-in-law Dr Kusum Gupta for their unconditional love, support, blessings and sacrifices. No words can explain their invaluable presence in my life.
Above all, I faithfully thank God Almighty for blessing me with such a wonderful family, a loving husband and also for showering His choicest blessing in each and every endeavor of mine, making it worthwhile. I offer my sincere prayers to Him.
Priya Verma Gupta1617181920