Parents in the operatory.

Dentists who treat children must continually evaluate methods for managing patients. Psychological, physical and pharmacotherapeutic techniques have been described, reviewed and questioned in papers and presentations throughout the history of dentistry. This evaluation is important because it provides avenues for controversy and change, leading to improved patient care. The issue of parental presence in the dental operatory continues to generate conflicting opinions and to stimulate debates among practitioners. This controversy has resulted in divergent reports in the dental literature, with practitioners receiving contrasting information and advice for managing the patient/parent unit. The purpose of this paper is to review the history and issues surrounding parental presence in the dental operatory, and to present guidelines for allowing parents to be with their children during treatment.

Child abuse and neglect: dentistry's role.

While the actual incidence of child abuse has not been determined, the available statistics are grim. The dentist must view himself as a child advocate. Simply treating dental and facial injuries of abused children while ignoring the social needs of the child and family is unacceptable. State laws mandate reporting as well as protect the dentist from civil or criminal liability. Dentistry's contribution in the management of nonaccidental injuries is the recognition of the possibility of physical abuse, the treatment of orofacial injuries and reporting to the appropriate authorities.

Dental emergencies presenting to a children's hospital.

Most of the 222 dental patients with emergency situations, observed during the period described, had injuries involving the eight incisor teeth (86.1 percent). Patients or their parents facing these situations are often referred to the hospital emergency room, especially those that provide dental services.

Dental disease masquerading as suppurative lesions of the neck.

Three female patients ages 16, 16, and 12, and an 8-yr-old male presented with neck pathology/2 with abscesses, 1 with a submandibular mass and 1 with a spontaneously draining abscess. In 2 instances, routine oral cavity examinations including percussion of the teeth, failed to reveal significant pathology. A detailed examination by a dentist, intraoral roentgenograms, and in the first child a sinogram, identified the etiology of the lesions as periapical infections. Review of the literature reveals that these patients characteristically receive multiple surgical procedures and courses of antibiotics prior to the recognition of intra-oral disease. Extraction, or root canal, is the definitive therapy that leads to involution of the sinus tract. These four typical cases are reported to illustrate the presentation and pathogenesis of this disease entity, and the importance of an adequate dental examination prior to surgery for a draining sinus of the neck.