Paediatric dentistry  has the  advantage of allowing the clinician to be able to move within well defined operating limits. This is  largely  attributed to the presence of the national guidelines for promoting oral health and preventing oral diseases in developmental years, promoted by the Italian Ministry of Health. These guidelines are subject to periodic updates and, in this regard, it is important to consider the update work carried out in countries that share a similar structure regarding, in particular, similar guidelines and in general, the organisation of the national health service. Great Britain is a suitable example in this sense: Brown and Harford recently published an important retrospective study there involving a total of 661 patients with an average age of 15. Work of this type also plays a key role in qualitative assessment of health services in different countries.
The first part of the work takes the preventive approach into consideration, certainly the most important one to consider,   with regard to the guidelines.
The use of sealing grooves and dimples is one of the cornerstones of the caries prevention in primary dentition in the paediatric field. The guidelines also support the use of fluorine-based products. The authors refer to encouraging data provided by the British Health Service, which reported an increase of 11% and 20% respectively for the two measures. These indications, however, appear not to overlap perfectly with the sample investigated: for example, 15% of the records considered do not refer to fluoroprophylaxis: this could be due to failure to complete the medical record in this regard, but it is likely that some of these refer to patients to whom the treatment was simply not offered.
One of the clear consequences, then, is failure to monitor any carious lesions (caries recording). These indications are even weightier compared to what was reported by another recent retrospective work based on data from the Swedish health service.
In this context, where the figure of the paediatric dentist is consolidated, the data suggests that half of all patients were sent by the general dentist without the implementation of preventive treatments. According to the authors, this methodology, combined with the lack of a behavioural approach, is decisive in compromising the relationship with the patient, and inevitably leads to an increase in requests for general anaesthesia, which should instead be reserved for cases that cannot be treated another way. This data is even more evident when compared to that provided by the American Board of Pediatric Dentistry, 86.9% of whose members (at least 1300 who responded to the survey, representing more than a third of the total) apply general anaesthesia in their own practices.

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