As they grow and develop, children have differences in physiology, or anatomy. Their emotional perception varies from year to year, or from one child to another, therefore treating the individual is never more important.
Medical differences should also be fully understood. The impact of trauma, or disease on the developing facial skeleton, or dentition is not the same as an adult, causes of conditions also vary.
To protect their future, oral & maxillofacial surgeons should appreciate the impact on a younger person, of a wide range of issues.
Good management of treatment starts with sound diagnosis. TMJ disorders are uncommon in children but shouldn’t be set aside, tonsillar, adenoidal, or congenital conditions are a more likely reason for airway obstruction.
Facial bone fractures are less common, partly due to bone flexibility. Those that occur are more often fractures of the jaw and treatment needs to take into account the rapidity of healing, along with developing tooth buds.
Finding oral cysts is almost part of childhood, yet they require close inspection. Certain eruptive, or gingival cysts may be accompanied by inflammatory cysts, which warrant treatment.
Many issues will have subtle, or marked differences, requiring dedicated paediatric treatment planning for the best outcome.
Treating With Care
A positive psychological response to treatment matters more for a child, part of returning them to a condition for safe discharge. How they feel about the care they receive may also influence treatment throughout life.
Quality of care should promote welfare, safety and understanding. This helps to prevent adverse feelings, or disruptive behaviour, which may simply be defensive behaviour from a perceived onslaught.
Included within this are decisions on anaesthesia. Pain free treatment is paramount but delivering this through conscious sedation is preferable, even where children are more anxious than the norm.
Effective communication throughout treatment can allay anxiety, a better option than higher risk sedation techniques, or physical restraint.
There can be cases, perhaps in very young children, or extensive surgery, where deeper sedation is required. In the main, continuity of verbal contact and knowledge of what is taking place often proves more positive.
In paediatric maxillofacial care, alongside a unique, growing body, we are treating a growing mind. Succeeding in freeing both from trauma is the real measure of our success.
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