Opening a Pediatric Dentistry Clinic - Coursework Example

Lecturers’ Opening a pediatric dentistry clinic Introduction Every child dreads a visit to the dentist. But then it is the perception that they have of dentists that make them fear these dental visits. However children should start getting dental checkups as soon as they start teething. Children who have regular dental checkups tend to have healthier mouths as compared to their counterparts who do not. In dental practice, both children and adults are served in the same clinic where most tooth extractions are done especially for adults. This makes the children fear dentist clinics even more. This is where pediatric dental clinics come in. Pediatric clinics are meant to be child friendly and allay the fears of children about dentists. According to the NIH and the American Dental Association, children should make their primary visit to the dentist when they start teething. Children are at risk of developing cavities as compared to older people since they are prone to sleep with food in their mouths ( NIH, 1). A pediatric dental clinic will make it easier to cater to the children and their dental needs which in most cases are preventives and do not involved tooth extractions. A pediatric dentistry clinic will be able to give children a place where they can be taken care of, taught about oral hygiene and how to take good care of their teeth. Most parents and caregivers do not take their children to the dentist unless there is a problem. Through pediatric dentistry clinics, parents can be told of the importance of regular dental checkups and how to take care of their children’s teeth. The challenge however is getting parents and caregivers to the clinic. Children under the age of five are usually taken to the clinic almost on a monthly basis, therefore a pediatric dental clinic should be set up in an immunization clinic or have an immunization clinic. This will enable the pediatric dental practitioners to inform the parent about the importance of pediatric dental care. This will equip the parents and caregivers with the necessary tips on how to take care of their child’s teeth as soon as they begin teething. Dental caries normally affect children aged between 2 and 11. If care is not taken early on, this may progress and lead to tooth extraction in adulthood (NIH, 1). Data collection in a pediatric dentistry clinic is usually through questionnaires and interviews conducted by the doctors or other clinic staff. Through interviews, pediatric dentistry practitioners can be able to generate data. This can be done by talking to the parents and caregivers. When questionnaires are used, they are distributed to the parents and caregivers who are expected to fill and return them. However, some parents and caregivers fail to return the questionnaires introducing a significant bias in the estimates obtained from the returned questionnaires. In this regard, epidemiological studies like prospective, retrospective and cross-sectional studies need to be evaluated. Methods The information of the prevalence and the need for pediatric dentistry clinic can be obtained from statistics, reports and surveys. To this end, data will be mainly collected from parents who have children aged between one and eleven. Other sources of data like statistics, surveys and reports will also be used. Data from the National Institute of Dental and Craniofacial Research will also be used. As stated earlier, in epidemiological research the studies to be evaluated are; prospective studies which examine the relationship between determinants and the number of times an event takes place; Retrospective studies which examine past records of cases in a given population in a bid to get the determinant under scrutiny. Retrospective studies are beneficial because they are obtained from existing data which make them easy and economical to obtain. Cross sectional studies examine and look at the prevalence of a particular disease in subsets of populations at a given time. In cross, sectional studies census and sample surveys are used. Cross sectional studies have one advantage they provide data on many variables that can be used in a pediatric dentistry clinic survey. The studies are further divided into cohort, case control and cross sectional studies. Cohort studies are prospective in nature and are done in two approaches (Hammer and Blettner, 667). Pediatric dentistry patients are selected and put in groups known as cohorts. The researcher then introduces the determinant under study to one group (cohort) leaving the other free of the issue under study. The two groups are then observed and compared over a period of time. Cohort studies, however, require that the researcher be in control of the subjects under observation. Cohort study makes it possible to assess patients in their environments and is less bias since the exposure is examined before a health status is known. It is, however, very costly, time consuming and the most difficult kind of study to carry out. Retrospective studies, on the other hand, make use of case control where past records and cases are examined, and conclusions are made on the presence or absence of the determinant under investigation. Case control studies usually make a comparison between two groups. Like why some children have dental caries while other don’t. The children with dental caries are the cases while those without are the controls. As opposed to cohort studies, case control studies are cheap and easy to conclude since the researcher does not have to collect information from many people in order to obtain a conclusion. It is also prone to bias because the health status ‘case’ is established before the exposure ‘control’. Another disadvantage of case control study is that it denies the researcher a chance to collect data broadly. The population under study in a pediatric dentistry clinic is children aged between one and eleven. This is because they are the ones at risk of developing dental caries that affect them later in life. There are, however, certain limitations in working with children. Just like any kind of research study, epidemiology has challenges (Hammer and Blettner, 665). Some of the challenges faced in an epidemiologic study include; selection bias, recall bias, misclassification bias and confounding. A selection bias occurs when an epidemiologic study makes use of subjects that are not eligible for the study. In the case of a pediatric dentistry clinic, it would be the inclusion of children under one and those above twelve in the study. Selection bias can make a study be invalidated. Care should be taken to avoid a selection bias in any kind of study. Recall bias affects a study when a participant fails to remember a past event making an epidemiological study inaccurate. Parents and caregivers who take care of more than two children tend to forget dental history of their older children. This makes hard to get reliable data from them. Misclassification, on the other hand, involves mischaracterizing a study object or subject. Like in pediatric dentistry it is believed that children of Hispanic, Black and those from low income families experience more dental caries and tooth decay. Misclassification can also come from information obtained from the patients. Like when children are asked how often they brush their teeth. Those who do not brush their teeth might lie that they brush often while they don’t. This will make researchers classify non brushers as regular brushers. This will eventually give a contrasting result that brushing does not have an effect on tooth decay or dental caries which might not be the case. Another problem in epidemiological studies is confounding. Confounding associates a disease or condition with the wrong reason. Confounding can lead to deflation or inflation of the true risk involved. In a pediatric dental clinic, parents and children may associate tooth decay to different reasons (Hammer and Blettner, 668). Children will mostly associate it with having a sweet tooth while some children develop dental caries in their primary teeth. A research might reveal otherwise, or that both may lead to dental caries. In cases of confounding, researchers scrutinize and look at the factors more closely to get conclusive results. Results According to the NIH, 42 percent of children between the age of two and eleven have dental caries in their primary teeth while Hispanic and black children have more tooth decay. Children in this age group that come from low income backgrounds also have more tooth decay. In their studies, they also discovered that 23 percent of children in the age group under study had untreated dental caries with Hispanic, Black and children from low income families having more untreated tooth decay. Generally 1.6 teeth in children aged between two and 11 are decayed primary teeth and a further 3.6 teeth are decayed primary surfaces. The severity of tooth decay is higher in Hispanic, Black and children from low income families. These groups of children also have more untreated primary teeth. Managerial epidemiology Managerial epidemiology can be used as a tool to aid in improved decision making among health care executives. Managerial epidemiology makes it possible to use epidemiological principles and tools in the decision making process. The data obtained in an epidemiological study can be used by health executives to make informed decisions. These decisions are supposed to help health executives make decisions that will benefit people who need it most (Fleming, 148). The results obtained show that tooth decay is prevalent in young children aged between two to eleven and that those who need pediatric dental attention more are children of Black and Hispanic descent and also those who come from low income families. This will help decision makers to setup the pediatric dental clinic to an area where it is needed most. Conclusion In the case of dental pediatric clinic, the clinic should be setup in an area where there are young children aged between two to eleven. The services should further be devolved to neighborhoods with a higher number of Blacks, Hispanics and children who come from low income families. Since most Blacks and Hispanics live in low income areas, the clinic should be set up in a low income neighborhood. The data obtained helped in identifying the need for a pediatric dental clinic that caters to the need of children and help prevent tooth decay in adult teeth. However future research need to focus more in children lower than two years because oral hygiene is paramount and should start when children start teething. More research should also be done to look into the level of tooth decay in Caucasian, Asian and children from families with higher income. Works Cited Fleming, Steven. Managerial Epidemiology. Journal of Primary Care and Community Health 4.2 (2013): 148-149. Web. Prel, Hammer and Blettner, Mark. Avoiding bias in observational studies. Dtsch Arztebl Int, 106. 41 (2009): 664-668. Web. National Institute of Dental and Craniofacial Research (NIH). Dental caries in children age 2 to 11. 06 January 2014. Web. 26 February 2014. Read More