Abstract:
Background: The initial dental experience may influence a child's anxiety, behavior, and adherence to treatment. Non-pharmacological behavioral management strategies, including appropriate communication, gradual familiarization with the dental environment, and positive reinforcement, may facilitate cooperation during clinical procedures. Pediatric dental visits also provide opportunities for early identification of developmental and occlusal alterations and for the implementation of individualized preventive and therapeutic interventions. This case report describes an integrated dental approach in a pediatric patient with no previous dental experience.
Methods: A 7-year-old male patient from Ponta Grossa, Paraná, Brazil, was referred to the Integrated Pediatric Dentistry Clinic at the State University of Ponta Grossa with pain associated with mobility of the anterior teeth and difficulty eating. According to his mother, the patient had never received dental care. During the first appointment, anamnesis, clinical examination, and oral hygiene instructions were provided, with emphasis on gradual familiarization with the dental environment. Clinical examination revealed the need for extraction of primary teeth 81 and 71 and a posterior crossbite. Treatment was progressively performed and included Class III restorations on teeth 51 and 61, prophylaxis, topical fluoride application, extraction of teeth 81 and 71, oral hygiene instructions, dietary assessment, and subsequent orthodontic intervention. After the initial adaptation phase, maxillary and mandibular impressions were obtained, and a quad-helix appliance was planned and installed to correct the transverse occlusal alteration.
Results: The planned progression of appointments allowed preventive, restorative, surgical, and orthodontic procedures to be performed without behavioral complications. Following the initial familiarization visits, the patient demonstrated adequate adaptation to the clinical environment and treatment procedures. After placement of the quad-helix appliance, the patient returned seven days later for evaluation and subsequently remained under periodic follow-up for appliance activation. Favorable clinical progress was observed, including adequate adaptation to treatment and improvement of the posterior crossbite initially identified.
Conclusions: This case highlights the importance of individualized behavioral management when introducing children without previous dental experience to clinical care. Gradual progression of treatment facilitated the delivery of preventive, restorative, and surgical procedures and subsequently enabled early orthodontic intervention. The integration of behavioral management, oral health promotion, comprehensive pediatric dental care, and interceptive orthodontic treatment provided an individualized approach to the patient's clinical needs.
Biography:
Renato Gomes do Prado is a dentist who graduated from the State University of Ponta Grossa (UEPG), Brazil. His academic and clinical interests include pediatric dentistry, oral health, clinical research, and comprehensive patient care. During his undergraduate training, he participated in clinical research, community oral health initiatives, and academic projects involving pediatric and preventive dentistry. He is currently practicing dentistry and pursuing postgraduate training in Orthodontics. His academic interests also include oral disease prevention, clinical outcomes, and the integration of clinical care and research.
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