INTRODUCTION PEDIATRIC DENTISTRY - SUMMARY DENTAL PEDIATRICS - SUMMARY DENTISTRY, Lecture notes of Dentistry

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INTRODUCTION PEDIATRIC DENTISTRY I - N1 - 5th PERIOD _ CONTROLS SOME FEELINGS; _ ABLE TO INFLUENCE PARENTS' ATTITUDES; _ START TO DESIGN SENTENCES; _ FEELINGS OF FEAR, ENVY, JOY, IMPATIENCE, TENDERNESS, JEALOUSY, sympathy, HOSTILITY; _ FEAR OF STRANGE PEOPLE, NOISES AND Abrupt MOVEMENTS; _ PARENTS' SEPARATION MAY CAUSE ANXIETY; _ ABLE TO MAINTAIN ACTIVITY FOR 8 MINUTES; _ PROCEDURES MUST BE BRIEF; _ PARENTS' PRESENCE IN THE ROOM IS IMPORTANT TO THE FEEL OF SAFETY BOTH: PARENTS AND CHILDREN; _ THEY FEEL MOTIVATED BY PRAISE AND AWARDS; _ THE PROFESSIONAL MUST MAINTAIN VISUAL CONTACT WITH THE CHILD AND USE SIMPLE AND CLEAR LANGUAGE; _ DON'T LIKE TO BE FIXED; _ REACTION TO DEMANDS MADE OF THEM;   THE PROFESSIONAL MUST: - LOVE THE CHILDREN; - MAKE YOURSELF LIKED BY THE CHILDREN; - KNOWING CHILD PSYCHOLOGY; - HAVE PATIENCE; - HAVE INTUITION AND COMMON SENSE; - PERSUASION; - SUITABLE TONE OF VOICE; - CREATIVITY; - FITNESS FOR THE SPECIALTY; - A CERTAIN AUTHORITY; OTHER IMPORTANT ASPECTS > È THE APPEARANCE OF THE OFFICE, PROFESSIONAL AND ASSISTANT. THEY SHOULD BE PLEASING IN THE EYES OF THE CHILD, AND NOT FEAR HER.   SECOND CHILDHOOD: EARLY PERIOD - 3 YEARS  INITIAL CONTACT _ WANT TO LISTEN; _ NOT JUDGING; _ DEMONSTRATE UNDERSTANDING BY THE PATIENT AND THEIR RESPONSIBLES; _ IDENTIFYING WHAT THE PATIENT AND THEIR PARENTS WANT AND NEEDED, STARTING THE GOOD RELATIONSHIP WITH THE CHILD AND THE FAMILY. _ RICH VOCABULARY; _ THERE IS ALMOST NO DIFFERENTIATION BETWEEN REAL WORLD AND FANTASY (PIAGET); 4 TO 5 YEARS _ CURIOSITY AND SOCIABILITY (PHASE OF THE “WHY”); _ ENJOY THE PLAY OF “FAZ DE ACCOUNT”; _ AGE OF IMAGINATION; _ DON'T LIKE TO BE PRESSED AND DON'T PASSIVELY ACCEPT ADULT ORDERS;  PROFESSIONAL + RESPONSIBLE _ PARTNERSHIP AND TRUST RELATIONSHIP   IT'S NECESSARY: _ SCIENTIFIC KNOWLEDGE _ FIRMING DECISIONS _ DEDICATION _ SUBJECT _ ORGANIZATION INTERMEDIATE PERIOD OF SECOND CHILDHOOD. BETWEEN 6/7 TO 9/10 YEARS _ MORE SOCIABLE AND COMMUNICATIVE; _ BETTER COOPERATION IN THE OFFICE; _ LIKE TO BE COMPLIED; _ POSSIBILITY OF BODILY INJURY-NEEDLES, BLOOD, MAY CAUSE EXTREME FEAR REACTIONS;   PROFESSIONAL + CHILD _ EMPATHY; _ PATIENCE; _ CREATIVITY; _ SELF CONTROL; _ AUTHORITY WITHOUT AUTHORITY; _ RECOGNITION OF THE POSSIBILITIES AND RESPECT FOR THE LIMITS OF THE CHILD;   LATER PERIOD OF SECOND CHILDHOOD – 9 TO 10 YEARS _ PERIOD OF GREATEST PARENTAL INDEPENDENCE; _ EASILY PERCEIVE THE BEHAVIOR OF ADULTS (LIES AND FORGETTING); _ ARE MORE RESPONSIBLE AND BETTER UNDERSTAND THE EXPLANATIONS ABOUT THE NEED FOR TREATMENT;   THIRD CHILDHOOD - BETWEEN 10 AND 12 YEARS _ DON'T LIKE TO BE TREATED LIKE A CHILD; _ CHILDREN'S LANGUAGE SHOULD BE AVOID; _ ARE ABLE TO UNDERSTAND THE EXPLANATION OF THE PROCEDURES WELL; _ IN GENERAL THEY ARE COOPERATORS;   PARENTS AND CAREGIVERS _ TRANSMIT THEIR FEARS AND ANGUISHES TO THEIR CHILDREN _ CHILDREN'S HEALTH HISTORY (PREGNANCY, BIRTH, ILLNESSES) INFLUENCE THE PARENT'S ANXIETY AND THE WAY OF EDUCATING THE CHILD; _ NEED THE PROFESSIONAL'S NECESSARY GUIDANCE, WITH CLARITY, BEFORE STARTING THE TREATMENT; _ MUST PARTICIPATE IN THE TREATMENT, WITHOUT INTERFERING WITH THE PROFESSIONAL'S AUTHORITY; _ THEY NEED TO BE AWARE OF THEIR RESPONSIBILITIES FOR THE PROMOTION AND MAINTENANCE OF THE CHILD'S ORAL HEALTH; FORMS OF TREATMENT THE FIRST CONSULTATION MUST NOT BE WITH THE CHILD, BUT AS A RESPONSIBLE. AT SIX MONTHS OF AGE, THE CHILD IS GOING THROUGH A PHASE OF SYMBIOSIS, WHERE THE MOTHER IS THE ONLY BEING.   CHARACTERISTICS OF HUMAN DEVELOPMENT _ MATURITY IS A PROCESS WHERE DIFFICULTIES ARE OVERCOME; _ THE CHILD IS ABLE TO OVERCOME THE DIFFICULTIES AND WHEN OVERCOMING THEM, THEY GROW; _ INTERPERSONAL RELATIONS ARE THE BASIS OF THIS LEARNING.   OBJECTIVE FEAR EXPERIENCES LIVED DIRECTLY BY THE CHILD. - FEAR DIRECT OBJECTIVE: PREVIOUS UNPLEASANT EXPERIENCE THAT OCCURRED DURING DENTAL TREATMENT; - INDIRECT OBJECTIVE FEAR: PREVIOUS UNPLEASANT EXPERIENCE THAT OCCURRED FOR EX. IN THE DOCTOR.   HEREDITARY AND ENVIRONMENT _ THE INDIVIDUAL CHARACTERISTICS OF EACH CHILD ARE MAINTAINED DURING THEIR DEVELOPMENT, HOWEVER THEY MAY BE CHANGED IN THE WAY OF MANIFESTING AS A RESULT OF THE EDUCATIONAL PROCESS;   SUBJECTIVE FEAR IT OCCURS BY UNPLEASANT EXPERIENCES EXPERIENCED BY ANOTHER PERSON. EX: _ CHILDREN CRUSHING, RESTLESS OR THOSE QUIET;   FRANKEL BEHAVIOR RATING SCALE • DEFINITELY NEGATIVE: CRY VIGOROUSLY, TOTAL REJECT, VERY AFRAID OR SOME OTHER EVIDENCE OF EXTREME NEGATIVISM; • NEGATIVE: RELUCTANCE TO ACCEPT THE TREATMENT, NON-COOPERATION, EVIDENCE OF A NEGATIVE ATTITUDE, BUT NO PRONOUNCEMENT (BLURTHERED AND WITHDRAWN). • POSITIVE: ACCEPTANCE OF TREATMENT, GOOD WILL TO OBEY THE DENTIST, RESERVED, BUT FOLLOW THE DENTIST'S INSTRUCTIONS COOPERATIVELY; • DEFINITELY POSITIVE: GOOD COMMUNICATION WITH THE DENTIST, INTERESTED IN US DENTAL PROCEDURES, LAUGHING AND ENJOYING THE SITUATION.   DEVELOPMENT = CHILDREN + LEARNING _ GROWTH - ATTRIBUTED TO PHYSIOLOGY _ LEARNING - CHANGE IN BEHAVIOR DEVELOPMENT IS THE RESULT OF THE ASSOCIATION OF THESE TWO PROCESSES INTERCONNECTED AND DEPENDENT EACH OTHER.   DEVELOPMENT AS A TRANSFORMATION PROCESS _ THE HUMAN BEING UPON DEVELOPING IS TRANSFORMED AND TRANSFORMS THE ENVIRONMENT IN WHICH HE LIVES; _ SPEAK, REASON, INFLUENCE, DECIDE;   BASIC CONDITIONS FOR THE TREATMENT OF CHILDREN • LOVE THE CHILD / MAKE YOURSELF DEAR; • LIKE CARING FOR CHILDREN; • MAKE YOURSELF LIKED BY THE CHILDREN; • KNOWLEDGE OF DENTAL PEDIATRICS; • GOOD COMMUNICATION; • PATIENCE / AUTHORITY; • ABILITY TO CONVINCE. THE CHILD'S PSYCHOLOGICAL DEVELOPMENT _ EARLY CHILDHOOD - 0 TO 3 YEARS; _ SECOND CHILDHOOD: INITIAL (3 TO 6/7 YEARS) INTERMEDIATE (6/7 TO 9/10 YEARS) SUBSEQUENT (10 YEARS); _ THIRD CHILDHOOD – BETWEEN 10 AND 12 YEARS;   POSITIVE ATTITUDES • TO PRAISE; • DO NOT LIE; • KNOWING AWARDS; • IMPOSE LIMITS; • EXPLAIN STEP BY STEP; • LISTEN TO THE PATIENT.  FIRST CHILDHOOD: 0 TO 3 YEARS _ ABILITY TO LISTEN, EMIT SOUNDS, SCREAMS AND CRY TO CRY FOR ATTENTION; _ HAS OLFACTIVE AND GUSTATORY TACTILE SENSITIVITY; _ FEELS ABANDONED WHEN SEPARATED FROM MOTHER;   RECOMMENDATIONS: 1 - TIME • DO NOT LET THE CHILD STAY FOR A LONG TIME AT THE RECEPTION; • MORNING CONSULTATIONS; • DURATION OF THE CONSULTATION; 3 TO 9 MONTHS OF LIFE: _ REACTS WHEN FRUSTRATED, TO LOUD OR UNFRIENDLY VOICES AND TO YOUR NAME ALSO; _ HOW THE BIRTH OF TEETH BEGINS TO BITE (SENSATION OF PLEASURE); 2 - PARENT-CHILD SEPARATION • PARENTS OFTEN REPEAT THE ORDERS, CREATING THE DISORDER FOR BOTH THE DENTIST AND FOR THE CHILD; • PARENTS ADD THEIR INSTRUCTIONS, BECOMING A BARRIER TO THE DEVELOPMENT OF A HARMONIOUS RELATIONSHIP BETWEEN THE DENTIST AND THE CHILD; • IN THE PRESENCE OF THE PARENTS, THE DENTIST HAS DIFFICULTY IN USE OF THE PROPER VOICE INTONATION, FEARING THEY WILL GET ANNOYED; • THE CHILD'S ATTENTION IS DIVIDED INTO THE DENTIST AND THE PARENTS; • DENTIST'S ATTENTION IS DIVIDED BETWEEN CHILDREN AND PARENTS; 9 to 18 MONTHS: _ FIGHT AGAINST THE WILL OF ADULTS IN FAVOR OF THEIR OWN WILL; _ STIMULATE YOUR SPEECH AND LANGUAGE KEEPING A SIMPLE LANGUAGE WHILE TAKING CARE OF IT; _ NAMES OF THINGS AND PEOPLE, MUSIC, VERSINHOS, HELP IN UNDERSTANDING THE DENTAL ENVIRONMENT; DENTITION CRISIS > IRRITABILITY; UNEASINESS; CRY; SLEEP DISORDERS; REFUSAL; SENSITIVITY; 3 - GENERAL • ORDER AND CARE WITH THE INSTRUMENTALS (THEY SHOULD NOT BE IN SIGHT OF THE CHILD, ONLY WHEN HE IS INTERESTED); • SKILL AND FAST; • WORK COSTUMES; 18 TO 36 MONTHS (3 YEARS): _ MAKES A GESTURE TO SHOW OR EXPRESS WISHES; _ ANSWER “YES” AND “NO”;   GUIDELINES FOR PARENTS / GUARDIANS • MOTHER IF YOU ARE QUIET, YOUR CHILD WILL SURELY WILL BE ALSO; • DON'T BE ANNOYED BY YOUR CHILD'S CRYING. IN THE RANGE OF 0 TO 3 YEARS IS THE WAY CHILDREN ON XPRESSAM; • YOUR CHILD WILL NOT BE TRAUMATED; • BRING A CLEAN CLOTHING CHANGE; • A MOTHER WHO TALKS TOO MANY TIMES BUGS. CLINICAL EXAMINATION   PATIENT IDENTIFICATION > FULL NAME; SEX; AGE; BIRTH DATE; NAME FROM PARENTS; ADDRESS; TELEPHONE; MEDICAL HISTORY > PRENATAL; TRANS-NATAL; CHILDREN'S HEALTH; MEDICINES; SURGERY; ALLERGY; HEART PROBLEM; NEUROLOGICAL DISORDERS; HEPATITIS; DIABETES; BLEEDING; SEIZURE; Fainting; CHILDHOOD DISEASES; FAMILY HISTORY.     DENTAL HISTORY > MAIN COMPLAINT; PREVIOUS DENTAL TREATMENT; ANESTHESIA  COMMUNICATION • LOCAL ANESTHESIA: “WATER FOR THE TOOTH TO SLEEP” • INSULATION CLAMP: "TOOTH RING" • HIGH ROTATION: “TOOTH SHOWER” • SUCKER:"GIRAFFE THAT SUCKS WATER FROM THE MOUTH" • RUBBER DIKE: SUPER MAN COVER/TOOTH SKIRT" • EXPLORER:" BITES FISHING ROD" • AIR SYRINGE: "TOOTH DRYER" • WATER SYRINGE: “WATER JET” • HIGH ROTATION: "TRACTOR THAT KILLS THE BIGGIES" • LIGHTNINGX: "PHOTOGRAPHIC MACHINE" • RADIOGRAPHY:"TOOTH PHOTO" • COTTON ROLLER: "TOOTH TOWEL" (REACTION?); 1st CONSULTATION; DENTAL TRAUMA; 1st TOOTH; HERPES, SAPINHO, AFTA; FLUORINE. HYGIENE HABITS > BRUSHING; WHO DOES BRUSH?; DENTAL CREAM (FLUOROSIS); FLOSS; MOUTH RINSE. EATING HABITS • BREASTFEEDING (FREQUENCY); • BABY BOTTLE; (CONTENT; FREQUENCY). • CANDY. HARMFUL HABITS _ SUCK YOUR FINGER, PACIFIER, BOTTLE BOTTLE, MOUTH RESPIRATOR, gnawing your nails, nibbling your lips.         EXTRA-ORAL EXAMINATION (OBSERVING THE PATIENT AS A WHOLE) - FACE; HEIGHT AND WEIGHT (IDENTIFYING ABUSE); - HAIR (EXCESSIVE OR LACK - MAY INDICATE HORMONAL DEFICIENCY OR VITAMINS) - HANDS AND nails, - SPEECH (SOME LANGUAGE PROBLEMS WITH DYSLALIA) - EYES (YELLOWISH - BULIRUBINE - STRABISMUS) - SKIN: YELLOWISH OR PURPLE - PALPATION OF THE GANGLION CHAINS - HERPES IN THE VESICULATE PHASE AND PATIENT WITH CONJUNCTIVITIS CANNOT BE ATTENDED. PROHIBITED WORDS > NEEDLE; INJECTION; BLOOD; DRILL; PICKING; ACHE;   BEHAVIORAL MANAGEMENT TECHNIQUES _ VERBAL COMMUNICATION > SPEAK – SHOW – DO; POSITIVE REINFORCEMENT; DISTRACTION; MODELING; _ NON-VERBAL COMMUNICATION > VOICE CONTROL; HAND OVER MOUTH; PHYSICAL RESTRAINT; CONSCIOUS SEDATION; GENERAL ANESTHESIA.   GANGLION CHAINS:TALK - SHOW - DO • EXPLAIN THE PROCEDURE; • DEMONSTRATE VISUAL, AUDITORY AND OLFACTORY APPEARANCE TO THE PATIENT; • COMPLETE THE PROCEDURE. _ INFLAMMATORY: DEFINED AND MOVABLE FORM - SMOOTH AND PAINFUL SURFACE. _ TUMOR: INCREASED VOLUME – ROUGH, PAINLESS SURFACE, CONTOUR NOT DEFINED.   INTRA-ORAL EXAMINATION SOFT TISSUES - HARD TISSUES - OCCLUSION ASSESSMENT  POSITIVE REINFORCEMENT • EFFECTIVE TO REWARD THE CHILD FOR THE DESIRED BEHAVIOR AND REINFORCE THE RECURRENCE OF IT (NON-SOCIAL); • CARRIED OUT THROUGH SATISFIED FACIAL EXPRESSION, STATEMENTS OF AFFECTION, PRAISE AND/OR AWARDS (SOCIAL).   SOFT TISSUES > TONGUE; LIPS; PALATE; ORAL FLOORS; JUGAL MUCOSA; TONLS STRUCTURAL AND PATHOLOGICAL ANALYSIS > GEOGRAPHICAL LANGUAGE: LINGUA FISSURE; MICROGLOSSIA; MACROGLOSSIA; GINGIVAL RODETS; CHRISTMAS TEETH; NEONATAL TEETH; EPTEIN PEARL; BOHN NODULE; LIP BRAKE; ANKYLOGLOSSIA; GINGIVITIS; PERIODONTITIS; MUCOCELLS; MOUTH ULCERS; ERUPTION HEMATOMA.   DISTRACTION _ THE CHILD IS PLACED IN A STATE OF RELAXATION IN ORDER TO NOT EXPOSE HIM TO DENTAL SITUATIONS THAT CAUSE HER FEAR AND ANXIETY.   HARD FABRICS TEETH > SIZE; FORM; COLOR; NUMBER; IDENTIFICATION OF EACH TOOTH; EROSION; ABRASION; FRACTURES; RESTORATION; MOBILITY; CARIES STRUCTURAL AND PATHOLOGICAL ANALYSIS > SUPERNUMERARY TEETH; DIASTEMA; MICRODONTICS; MACRODONTICS; HYPOCALCIFICATION; HYPOPLASIA OF ENAMEL; AMELOGENESIS IMPERFECT; DENTINOGENESIS IMPERFECT; ALVEOLYSIS; TWINNING; FLUOROSIS; FRACTURED TOOTH; OCCLUSION > FACIAL SYMMETRY; RELATIONSHIP BETWEEN MOLARS; RELATIONSHIP BETWEEN CANINES; MEDIUM LINE.   MODELING _ PATIENT EXPOSURE TO ONE OR MORE INDIVIDUALS WHO SHOW APPROPRIATE BEHAVIOR   VOICE CONTROL • GET THE CHILD'S ATTENTION; • DEMONSTRATE THE PROFESSIONAL'S AUTHORITY; • REJECT UNACCEPTABLE BEHAVIOR OF THE CHILD; • IMPOSING LIMITS.   TREATMENT PLAN SYSTEMIC PHASE > CARDIAC; DIABETES; RHEUMATIC FEVER. URGENCY PHASE > INFLAMMATION; ACHE PREPARATORY PHASE > RESTORATION WITH CIV; EXODONTICS; ENDODONTICS; PERIODONTICS; FLUORINE; SEALANTS. RESTORE PHASE > RESIN RESTORATION; PROSTHESIS. MAINTENANCE PHASE > HIGH RISK ONCE A MONTH; MEDIUM RISK EVERY 3 MONTHS; LOW RISC0 6 IN 6 MONTHS; PREVENTIVE ORTHODONTICS.   HAND OVER MOUTH _ THE PROFESSIONAL PLACES HIS HAND OVER THE CHILD'S MOUTH, CLOSES TO IT AND SPEAKS VERY LOW IN THE CHILD'S EAR “ IF YOU WANT ME TO REMOVE MY HAND YOU MUST STOP SCREAMING AND MUST LISTEN TO ME. I JUST WANT TO TALK TO YOU AND LOOK IN YOUR EYES.”   MACRI _ CHILD LAYS DOWN AND PUTS HIS LEGS INTO THE TWO HOLES “SIT ON HORSEBACKS” AND PASS THE CLOTH OVER HIM AS IF YOU WILL PACK THE CHILD. RADIOLOGY IN PEDIATRICS _ PREPARATION OF DIAGNOSIS; _ DEVELOPMENT OF TEETH; _ DEVELOPMENT CHANGE; _ PATHOLOGICAL PROCESSES; _ FRACTURES; _ CARIES; _ RESORPTION; _ PERIODONTAL AND PERIAPICAL SPACE; _ PLANNING AND MONITORING;   KNEE TO KNEE • THE MOTHER HOLDS THE CHILD'S ARMS AND THE CHILD'S HEAD STAYS ON THE SURGEON'S LEG; • CLINICAL EXAMINATION, PROPHYLAXIS, EXTRACTION, RESTORATION, CAN TEACH HARMFUL ACTION X PATIENT'S AGE   GARDEN / SWEATSHIRT PLACING THE CHILD'S ARMS INSIDE THE GARDEN BOX / SWEATSHIRT PUT HIM ON, PREVENTING HER MOVEMENT. _ ULTRA FAST FILMS; _ GOOD TECHNIQUE; _ POSITIONERS; _ APRON; _ RADIOGRAPH AS NECESSARY (CONTROL); _ APPLIANCE WITH ALUMINUM FILTER; _ APPLIANCE WITH LOCATION CYLINDER;   IN LADY'S LAP • CHILD FEELS PROTECTED AND THE MOTHER HELPS HIM CONTENT FROM BEHIND; • THE UNPLEASANT BECAUSE THE MOTHER CAN'T SEE WHAT THE DENTIST IS DOING. CLINICAL AND ASSISTANT _ USE OF BARRIERS; _ DISTANCE OF 1.80 FROM THE BEAM; _ BEHIND THE PATIENT'S HEAD; _ COMPANION.   LYING ON THE CHAIR AND MOTHER WATCHING _ THE MOTHER JUST NEEDS TO BE WATCHING, SHE MUST STAY CLOSE BECAUSE IT'S A BABY. THIS IS NECESSARY BECAUSE THE MOTHER GIVES SAFETY TO THE CHILD. RECOMMENDATIONS _ INSTRUCTING THE CHILD; _ REGULATE ANGULATION, TIME OF EXPOSURE; _ COMPATIBLE FILM; _ START WITH EASIER REGIONS;   LYING ON THE CHAIR AND MOTHER HELPING CONTAIN THE CHILD CHILD LAY IN THE NORMAL CHAIR AND THE MOTHER LAY ABOVE THE CHILD, HOLDING THE ARMS. TYPES OF MOVIES _ PERIAPICAL STANDARD (3.1 X 4.0 CM): _ OCCLUSAL (5.6 X 7.6 CM): _ CHILDREN (2.2 X 3.4 CM): SMALL AREAS.   CHAIRS • WAS DEVELOPED MAINLY FOR SPECIAL PATIENTS; • PLACED ON THE TEAM, GIVING SAFETY TO THE CHILD, WHEN THERE IS NEED CAN PASS A STRIP AROUND TO HOLD THE CHILD. REQUIREMENTS FOR RADIOGRAPHIC TAKES • HEAD POSITION:   PEDIATRIC PACKAGE • ROLLS A LINEN ON THE CHILD WHO IS THE MOTHER BEHIND THE HOME; • SIGN A TAPE WINDLY. – ANTHROPOLOGICAL PLANS: • MEDIAN SAGITAL PLANE; • CAMPER PLAN. – REFERENCE LINES: • LABIAL COMISSURE BREAKDOWN.  CONSCIOUS SEDATION • INHALATION OF OXYGEN - NITROUS OXIDE; • CHLORAL HYDRATE; • BENZODIAZEPINES. INTRA-OROURAL TECHNIQUES _ HEAD FORWARD; _ PSM PERPENDICULAR TO THE GROUND;   GENERAL ANESTHESIA • UNCONSCIOUS; • LOSS OF PROTECTIVE REFLECTIONS; • LOSS OF PHYSICAL STIMULUS; • VERBAL COMMAND. • JAW: – CAMPER PLAN PARALLEL TO THE GROUND; • JAW: _ BREAKDOWN-LABIAL COMISSURE LINE PARALLEL TO THE GROUND. CENTRAL REGION OF THE FILM > CENTRAL REGION TO BE RADIOGRAPHED; PACKAGE FACING THE OCCLUSAL; NAUSEA.       PRE - ERUPTIVE: 7th to 10th WEEK OF LIFE IU; ERUPTIVE: POST-ERUPTIVE:   NOLLA INTERNSHIPS 0 - ABSENCE OF CRYPT 1 - CRYPT PRESENCE two - INITIAL CROWN CALCIFICATION 3 - 1/3 OF CROWN FORMED. 4 - 2/3 OF THE CROWN MINERALIZATION OF THE CROWN 5 - CROWN ALMOST COMPLETE 6 - FULLY MINERALIZED CROWN 7 - 1/3 OF THE FORMED ROOT 8 – 2/3 OF THE FORMED ROOT 9 - PRACTICALLY FULL ROOT OPEN APEX 10 - FULL ROOT - APEX CLOSED 2 TO 3 YEARS AFTER ERUPTION                         SYMPTOMATOLOGY ASSOCIATED WITH THE ERUPTIVE PROCESS > FEVER; LOW; DIARRHEA; INAPPETENCE; IRRITATION; SLEEP DISORDERS; INCREASE IN SALIVATION.   DETERMINANTS> GENETICS; SOMATIC GROWTH; ENVIRONMENTAL; SYSTEMIC; PLACES. _ SEX: GIRLS; _ ENVIRONMENT: - GANDES CENTERS / RURAL AREA; - TROPICAL COUNTRIES – EARLY ERUPTION.   SYSTEMIC: _ HYPOTHYROIDISM; _ HYPOITUITARISM; _ CLEIODOCRANIAL DYOSTOSIS (PERMANENT DELAYED OR DON'T ERUP); _ DOWN SYNDROME (CHANGES IN SEQUENCE AND DELAY); _ ECTODERMIC DYSPLASIA, OSTEOPOROSIS (SLOW); _ STATES OF MALNUTRITION (VIT. A, CED). _ PREMATURES; _ NUTRITIONAL DEFICIENCIES;   IMPORTANT STAGES _ 02 - INITIAL CALCIFICATION; _ 06 – _ 08 – INITIATION OF ERUPTIVE MOVEMENTS – CROWN COMPLETE; TIME OF DENTAL IRRUPTION – 2/3 COMPLETE ROOT.   CLINICAL IMPORTANCE _ DIAGNOSIS OF CHANGES; _ INDICATION OF ULECTOMY; _ RHIZOLYSIS OF THE CANINE (1/3 AND 2/3) – GERM IN STAGE BETWEEN 7 AND 8 OF NOLLA; _ REABSORPTION <1/3 – GERM BETWEEN STAGES 5 AND 6; _ MOLARS: RHIZOLYSIS BETWEEN 1/3 AND 2/3 – STAGE ≥ 6. _ PLACES: _ ERUPTION HEMATOMAS; _ ERUPTION CYST (INCISIVES); _ ANKYLOSIS (DECIDUOUS SECOND MOLAR); _ TEETH INCLUDED (TRAUMA); _ GINGIVAL FIBROSIS; _ PREMATURE LOSS OF THE DECIDUOUS. JAW > 6 1 2 4 5 3 7 JAW> 6 1 2 3 4 5 7   VARIATIONS OF DENTAL ERUPTION NATAL AND NEONATAL TEETH: _ LOWER CENTER INCISIVES; _ FEW ARE SUPRANUMERARIES; _ CHRISTMAS (AT BIRTH): 3:1 MIL; _ NEONATALS (1st MONTH OF LIFE:   1:2 MIL; _ EPSTEIN PEARLS: _ BOHN NODULES: VEL OF DENTAL CRESTS AND PALATE. _ INCLUSION CYSTS: DENTAL CRESTS.   EVOLUTIONARY CYCLE _ 6th WEEK SAW: EXPANSION OF THE BASAL LAYER; _ 4th MONTH SAW: CALCIFICATION OF DECIDUOUS; _ 6th MONTH SAW: ALL TEETH IN CALCIFICATION PROCESS; _ 1 YEAR OF LIFE: END OF THE CALCIFICATION PROCESS;   DECIDUOUS ERUPTIVE STAGE _ 6TH TO 30TH MONTH OF THE CHILD'S LIFE. _ NORMAL INTERVALS IN THE SEQUENCE; _ FOLLOWS GENETIC PATTERN; _ EXPOSED TO CHANGES: _ LOWER PRIOR TO SUPERIOR; _ FAVORABLE SEQUENCE; _ DISORDERS FOR THE DEVELOPMENT OF OCCLUSION; _ CHRONOLOGY TABLES; SEQUENCE OF INSTALLATION OF DENTITIONS _ DECIDUOUS DENTITION ± 6 TO 36 M _ MIXED DENTITION ± 6 TO 12 YEARS _ PERMANENT DENTITION: 6 YEARS: FIRST MOLARS AND INCISIVES; 11-12 YEARS: SECOND MOLARS; 16 -25 YEARS: THIRD MOLARS.   FAVORABLE SEQUENCE (ORDER) AND APPROXIMATE CHRONOLOGY (AGE) OF THE DECIDUOUS ERUPTION: _ LOWER CENTER INCISIVES - 6 MONTHS _ LOWER SIDE INCISIVES - 6 MONTHS _ UPPER CENTER INCISIVES - 7 ½ MONTHS _ UPPER SIDE INCISIVES - 7 ½ MONTHS _ LOWER FIRST MOLARS - 12 MONTHS _ UPPER FIRST MOLARS - 14 MONTHS _ UPPER CANINES - 18 MONTHS _ LOWER SECOND MOLARS - 20 MONTHS _ UPPER SECOND MOLARS - 24 MONTHS.   FAVORABLE SEQUENCE 1. LOWER FIRST MOLAR; 2. UPPER FIRST MOLAR; 3. LOWER CENTER INCISIVE; 4. LOWER SIDE INCISIVE; 5. UPPER CENTER INCISIVE; 6. UPPER SIDE INCISIVE; 7. LOWER CANINE; 8. LOWER FIRST PREMOLAR; 9. FIRST UPPER PREMOLAR; 10. SECOND LOWER PREMOLAR; 11. SECOND UPPER PREMOLAR; 12. TOP CANINE; 13. LOWER SECOND MOLAR; 14. UPPER SECONDMOLAR.   SEQUENCE + COMMON ERUPTION _ UPPER PERMANENT TEETH _ 1st MOLAR _ CENTRAL INCISIVE _ SIDE INCISIVE _ 1st PREMOLAR _ 2nd PREMOLAR _ CANINE _ 2nd MOLAR _ LOWER PERMANENT TEETH _ 1st MOLAR _ CENTRAL INCISIVE _ SIDE INCISIVE _ CANINE _ 1st PREMOLAR _ 2nd PREMOLAR _ 2nd MOLAR   DIDACTIC DIVISION _ FIRST TRANSACTIONAL PERIOD: - INCISIVES; FIRSTMOLARS _ INTERTRANSACTIONAL PERIOD: - DECIDUOUS STOP EXFOLIATION; - STABLE MIXED DENTITION; _ SECOND TRANSACTIONAL PERIOD: - CANINES; PREMOLARS.  STAGES OF MINERALIZATION OF PERMANENT TEETH _ NOLLA, 1960; _ DENTAL EVOLUTION GRADED FROM 0-10; _ COMPARE RADIOGRAPHY AND DRAWING; _ USE AVERAGE VALUE OR HIGHER VALUE; _ CLINICAL ERUPTION – ¾ FORMED ROOT.   DENTAL EXFOLIATION: PULPAR REPAIR POTENTIAL: FULL DECIDUOUS ROOT 1.5 YEARS AFTER IRRUPTION; - RELATIONSHIP BETWEEN DECIDUOUS AND PERMANENT: FOR EACH THIRD FORMED OF THE ROOT OF THE PERMANENT REABSORBERS A THIRD OF THE DECIDUOUS ROOT. 1/3 IS EQUAL TO 1 YEAR, SO FOR EVERY 1/3 OF RIZOLISE OF THE DECIDUO WE HAVE ALSO 1/3 RHIZOGENESIS FOR THE PERMANENT. STAGE 0 TO 10 NOLLA TAKES AN AVERAGE 10 YEARS TO COMPLETE. BETWEEN STAGES 7 AND 8 OF NOLLA THE PERMANENT TOOTH ERRUPTION BEGINS.   LAW RULE (CHILDREN UNDER 1 YEAR OLD) AGE OF THE CHILD EMMESES X MAXIMUM DOSE FOR AN ADULT /150 EX: 6-MONTH CHILD WILL RECEIVE LIDOCAINE 6 X 8.3 / 150 = 0.33 PEDIATRIC EMODONTAL ANESTHESIA   VASOCONSTRICTOR • ADRENALINE: + POWERFUL (1:100,000) AGAINST INDICATED: CARDIOPATHICS AND HYPERTHYROIDS • NORADRENALINE (1:50,000) FAST ACTION! CONTRA INDICATED: HYPERTHYROIDS • FELIPRESSINA ( OCTAPRESSIN) INDICATED: CHILDREN, ELDERLY, HYPERTENSIVE AND DIABETIC.   ACHE • PHYSICAL APPEARANCE - NERVOUS STIMULUS • EMOTIONAL ASPECT - CHILD'S CONDITIONING   LOCAL ANESTHETICS > DRUGS USED TO BLOCK THE CONDUCTION OF THE NERVOUS IMPULSE, LEADING TO LOSS OR REDUCTION OF PAINFUL SENSITIVITY WITHOUT INDUCING UNCONSCIOUSNESS.   PEDIATRIC EMODONTO ANESTHESIA AGAINST - INDICATIONS:  PSYCHOLOGICAL ASPECTS ANAMNESIS: _ HAS THE CHILD ALREADY BEEN ANESTHESIAD? _ HOW DID IT BEHAVE? _ WHICH TECHNIQUE IS USED?   • ALLERGIC PATIENTS • COAGULATION DISORDERS • RENAL AND LIVER DYSFUNCTION IMPORTANT: _ AUTHORIZATION BY DOMESTIC WRITING _ WHICH ACCOMPANIES THE CHILD     AFFIRMATIVE RESPONSE _ REACTIONS NEGATIVE ANSWER _ NERVOUS OR FRIGHTENED CHILDREN?   RISKS - ASPIRATION  • ACCIDENTAL INTRAVASCULAR INJECTION • DRUG INTERFERENCE • HIGH DOSEIMPORTANT: GUIDE PARENTS TO AVOID WORDS THAT CAUSE FEAR   PSYCHOLOGICAL ASPECT • PAIN CONTROL; • PROPER CHILD MANAGEMENT; • TECHNICAL CAPACITY OF THE PROFESSIONAL; • RECONDITION THE PATIENT WHO PRESENTS DIRECT OBJECTIVE FEAR; • CHILD'S CONFIDENCE (NOT LYING); • EXPLAIN WHAT WILL HAPPEN, THE FEEL AND THE SYMPTOMS; • ATTEND THE SIGNS OF FEAR.   BEWARE OF OVERDOSAGE LOW SAFETY MARK • SLIGHT TREMOR TO SEIZURE • REDUCTION OF BLOOD PRESSURE TO HEART ARREST • NEWBORN - BORN: + TOXIC • IMMATURE LIVER AND RENAL SYSTEM   NEEDLES • SHORT • EXTRA – SHORT • LONG (NEVER) - DENTAL PEDIATRICS   BE CAREFUL WITH THE SYRINGE ANXIETY CONTROL / EMOTIONAL SUPPORT APPROPRIATE INFORMATION - ACCESSIBLE LANGUAGE: _ DRIPPING MEDICINE FOR THE TOOTH TO SLEEP _ “THE FACE WILL FEEL DIFFERENT” _ WHEN YOU GET HOME YOU WILL WAKE UP   ANATOMOPHYSIOLOGICAL ASPECTS • BONE: + POROUS E - CALCIFIED _ ANESTHETIC + RAPID DIFFUSION • POSITION THE CHILD COMFORTABLY • HEAT THE TUBE • ESTABLISH COMMUNICATION CRITERIA • DO NOT EXPOSE THE DISCOVERED SYRINGE AND NEEDLE • LIMIT THE VIEW OF THE CHILD WITH HAND SUPPORT • QUIET PHYSIONOMY • SLOWLY APPLY 2 MINUTES • SPEAK / SING / TELL STORIES • AVOID - NEEDLE, BLOOD, PICKING, PAIN MASTER OF TECHNIQUE   ERGONOMICS _ JAW > THE SEAT Â DE _ 150° AS THE BACKREST _ JAW > Â OF THE SEAT AS CHAIR BACK WILL BE REDUCED TO 110° NOTE: PROFESSIONAL ALWAYS AHEAD AND TO THE RIGHT OF THE PATIENT WITH DIRECT SIGHT   TOPICAL ANESTHESIA INDICATIONS: • DURING MOLDING • DURING RADIOGRAPHIC EXAMINATION • ALWAYS BEFORE ANY LOCAL ANESTHESIA • IN THE REMOVAL OF DECIDUOUS TEETH WHEN WITH FULLY RESORBED ROOTS _ GIVE PREFERENCE TO THOSE WITH A PLEASANT TASTE     DESIRABLE PROPERTIES _ MUST NOT BE IRRITANT TO TISSUES _ RAPID EFFECT _ SHORT DURATION WITHOUT SYSTEMIC EFFECTS   TOPICAL ANESTHESIA   ELECTION ANESTHETIC LIDOCAINE: _ XYLOCAINE 2% _ NOVOCOL _ LIDOSTESIN 3% _ ALPHACAINE 2% _ 3 TO 5 HS TECIDOMOLE • GEL • OINTMENT • SPRAY - ATTENTION     APPLICATION TECHNIQUE • DO ANTISEPSY OF THE MUCOSA • DRY THE MUCOSA TO AVOID DILUTION • COTTON AS ANESTHETIC • CONTACT FOR 3 MINUTES • SUCKER USE _ ROUGH APPEARANCE IN THE MUCOSA • INDICATED FOR CHILDREN • CONTRAINDICATED: HEPATOPATHIES (METABOLIZED IN THE LIVER)   MEPIVACAINE _ LIDOCAINE-LIKE EFFECT _ SLOWER RESORPTION TRADE NAME > CABOCAÍNA, SCANDICAINE, MEPIADRE   INFILTRATIVE ANESTHESIA - TERMINAL OR PERIPHERAL RECOMMENDATION • UPPER DECIDUOUS AND PERMANENT TEETH • DECIDUOUS AND PERMANENT LOWER ANTERIOR TEETH • LOWER DECIDUOUS MOLARS (UP TO 6 YEARS)     PRILOCAINE • INDICATION: HYPERTENSIVE, DIABETIC, CHILDREN AND ELDERLY • CONTRAINDICATION: PREGNANT WOMEN • RAPIDLY DEGRADED BY THE LIVER TRADE NAME > CITANEST, CITOCAINE CAUTION: • METAHEMOGLOBINEMIA – ANEMIA • CYANOSIS FINGERS, LIPS, GINGIVAS, FACE SKIN   TECHNIQUE • ANTI-SEPSY OF THE PUNCTURE SITE • DRYING THE MUCOSA • TOPICAL ANESTHETIC FOR 3 MIN • STABILIZE THE HEAD • REMOVE LIP • BEVEL - BONE • PULL THE LIP AGAINST THE NEEDLE IN THE FULL FURROW REGION • TILT NEEDLE 30º - APEX • INJECT THE ANESTHETIC SLOWLY   BUPIVACAINE _ FOR LONGER DURATION DENTAL PROCEDURES _ (8 HS FOR JAW AND 5 HS FOR JAW) _ AGAINST - INDICATION: CHILDREN UNDER 12 YEARS OF AGE TRADE NAME > NEOCAÍNA   TECHNIQUE ADAPTATION INTRAPAPILLARY AND PALATINE • WHEN IT IS NECESSARY TO PLACE CLAMPS FOR ABSOLUTE INSULATION, MATRIX OR EXODONTICS • THE NEEDLE IS INSERTED INTO THE VESTIBULAR PAPILLA, PERPENDICULAR TO THE LONG AXIS OF THE TOOTH, SLOWLY PENETRATED FROM V TO L/PE DEPOSITING THE ANESTHETIC SLOWLY DURING THE PATH. _ ISCHEMY   MAXIMUM DOSE OF ANESTHETIC FOR CHILDREN   MAXIMUM ADULT DOSES COMMERCIAL NAME CITANEST 3% 2% CARBOCAIN 3% CITOCAINE 2% LIDOCAINE NOVOCOL A 100 PROPACAINE 2% XYLOCAIN MAXIMUM DOSE 5.5 TUBES 5.5 TUBES 5.5 TUBES 8.3 TUBES 5.5 TUBES   ANATOMICAL DIFFERENCES - CHILDREN • ASCENDING BRANCH OF THE JAW IS SHORTER • ANTERO-POSTERIOR BRANCH DIAMETER IS SMALL • THE LINGULA OF THE JAW MAY BE LOCATED BELOW THE OCCLUSAL PLAN OF THE DECIDUOUS MOLARS 5.5 TUBES 8.3 TUBES   CLARK FORMULA (MAXIMUM PEDIATRIC DOSE) CHILD'S WEIGHT IN KG X MAXIMUM DOSE FOR AN ADULT /70 EX: CHILD WITH 20 KG WHO WILL RECEIVE LIDOCAINE 20 X 8.3 / 70 = 2.37   PTERYGOMANDIBULAR • INDICATIONS: DECIDUOUS MOLARS, PREMOLARS AND PERMANENT MOLARS • INTERVENTIONS ON THE LOWER LIP • LANGUAGE INTERVENTIONS • MUCOUS TISSUE AND JAW BONE • DECIDUOUS DENTITION - MODIFIED TECHNIQUE CURRENTLY ASSIGNED THE SUPERFICIAL POSITION OF THE DEVELOPMENT OF THE GERM DENTAL, WHICH PREDIDES THE TOOTH TO ERUP EARLY. TREATMENT DEPENDING ON THE SITUATION DOES THE EXODONTIC TO AVOID ULCERATIONS ON THE TONGUE OF THE BABY OR ON THE BREAST OF THE MOTHER NOTE: PTERYGOMANDIBULAR ANESTHESIA IN CHILDREN SHOULD BE PERFORMED WITH THE NEEDLE INTRODUCING A SLIGHTLY LOWER POSITION THAN ADULTS. ORAL NERVE _ IT ISSUES BRANCHES THAT REACH THE VESTIBULAR MUCOSA AND GINGIVA IN THE MOLAR AND PREMOLAR REGION   HYPODONTICS: ANODONTICS REFERS TO THE ABSENCE OF DENTAL GERM FORMATION. HYPODONTICS– THE LACK OF DEVELOPMENT OF ONE OTHER TEETH. OLIGODONTICS– THE LACK OF DEVELOPMENT OF SIX OR OTHER TEETH. ANODONTICS– TOTAL LACK OF DENTAL DEVELOPMENT.   LINGUAL NERVE _ INERVAS THE ANTERIOR TWO-THIRDS OF THE TONGUE, SUBLINGUAL MUCOSA AND LINGUAL GINGIVA OF THE LOWER TEETH _ REACHES THE TONGUE IN ITS BACK PORTION GOING TO END IN ITS PREVIOUS PORTION THE DISEASE MAY HAVE ORIGIN AUTOSOMIC OR HETEROSOMICAL AND REACH LOWER AND UPPER DENTITION, AS WHICH ALSO CAUSE SEVERAL CHANGES, BOTH IN THE FORM AND SIZE OF SUCCESSOR AND HOMOLOGOUS TEETH. THE TEETH MOST AFFECTED BY SUCH ANOMALY ARE THE THIRD MOLARS, PRE- MOLARS AND SIDE INCISIVES TREATMENT REPLACEMENT OF MISSING TEETH WITH PROSTHESIS OR IMPLANTS. NOTE: BETWEEN CANINE AND UPPER DECIDUOUS 1ST MOLAR   INDIRECT TECHNIQUE ORAL NERVE / LINGUAL NERVE / ALVEOLAR NERVE _ INTRODUCE THE NEEDLE + OR - 1CM AND DEPOSIT A THIRD OF THE ANESTHETIC TO ANESTHESIA THE LINGUAL NERVE _ INSERT NEEDLE + OR – 2 CM AND DEPOSIT THE REMAINING ANESTHETIC _ INSERT NEEDLE PARALLEL TO THE OCCLUSAL PLANE _ SLIGHTLY TILT THE SYRINGE _ SLOWLY INJECT     HYPERDONTIC: IT IS THE DEVELOPMENT OF A GREATER NUMBER OF TEETH, AND ADDITIONAL TEETH THEY ARE CALLED SUPRANUMERARIES. MESIODENT: NEAR THE MIDDLE MAXILLARY LINE; DISTOMOLAR: POSITION DISTAL OF THE 3rd MOLARS; PARAMOLAR: THEY APPEAR TO THE VESTIBULAR OR PALATINE, IN RELATION TO THE 3rd MOLAR   INTRALIGAMENTATE _ INTRODUCE THE NEEDLE INTO THE PERIODONTAL LIGAMENT IN THE PROXIMAL REGIONS _ RECOMMENDATION: EXODONTICS SUPERIOR. DENTAL EXTRACTION TREATMENT.   FUSION:   INTRAPULPAR _ INTRODUCE THE NEEDLE INTO THE PULPAR CHAMBER AND _ INJECT THE ANESTHETIC _ INOMINATION: PULPECTOMY - DENTISTRY THE UNION OF TWO NORMALLY SEPARATE DENTAL GERMS, RESULTING IN A TOOTH ATTACHED WITH DENTIN CONFLUENCE. THEY OCCUR IN DECIDUOUS AND PERMANENT DENTITIONS FREQUENTLY IN THE REGIONS PREVIOUS UPPER. DEPENDING ON THE SITUATION, THE TREATMENT CAN BE MADE OF DENTAL SECTION.   SYMPTOMS • PERCEIVED AFTER A TIME OF 5 TO 10 MINUTES • EXPLAIN TO THE CHILD THAT SHE MAY FEEL HEAT, TINGING, SWELLING AND ETC; AND THAT THESE SENSATIONS ARE PASSENGER • CONFIRM THE ANESTHESIA EFFECT BY LIGHTLY TOUCHING THE MUCOSA OF THE REGION   GERMINATION: WHEN A SINGLE DENTAL GERM DIVIDES, RESULTING IN THE FORMATION OF ONE TOOTH WITH CROWN BIFIDA. A ROOT, AND A ROOT CHANNEL IN COMMON. THE TREATMENT DEPENDS ON THE DEGREE AND MORPHOLOGICAL APPEARANCE, BEING AESTHETIC CORRECTION AND OCCLUSION BALANCE IS NECESSARY, DUE TO SELECTIVE WEAR OR ORTHODENTICS.   COMPLICATIONS AND ACCIDENTS TRAUMATIC ULCER - ALWAYS NOTIFY • COMMON LOWER LIP • AVOID CONSISTENT AND HOT FOODS • GUIDE THE MOTHER TO OBSERVE THE CHILD AFTER LEAVING THE OFFICE _ TREATMENT > ROUTINE WITH WARM WATER AND SALT (LOCAL ANTI-SEPSY)   "GEMINATION AND FUSION LOOK SIMILAR BEING DIFFERENTIATED BY DETERMINATION OF THE NUMBER OF TEETH IN DENTITION. GEMINATION PRESENTS A SINGLE ROOT CHANNEL”.   DENTINOGENESIS IMPERFECT: DENTINOGENESIS IMPERFECT IS A GENETIC DISEASE OF DEVELOPMENT DENTAL. THIS CONDITION CAUSES DECOLORATION OF TEETH, MOST OF THE TIME IN BLUE-GRAY OR BROWN-YELLOW AND TRANSLUCENT. THE TEETH ARE ALSO WEAKER THAN NORMAL, MAKING THEM MORE EXPOSED TO FAST WEAR, BREAKAGE, AND CARIES LOSS. DENTAL RESTORATION TREATMENT AND PROSTHETIC CROWNS.   BRUISES • OCCUR DUE TO BLOOD EXTRAVASATION INSIDE TISSUES AFTER RUPTURE OF BLOOD VESSELS • POORLY PERFORMED TECHNIQUES • SPONTANEOUS REGRESSION   PAIN AFTER - ANESTHESIA • CONTAMINATED NEEDLE • FAST INJECTION • DAMAGED NEEDLE • MUSCLE INJECTION: MUSCLE TISSUE VERY SLOWLY ABSORBES THE ANESTHETIC, AND IT IS BEHAVIORING AS A FOREIGN SUBSTANCE   - IMPERFECT AMELOGENESIS: IMPERFECT AMELOGENESIS INCLUDES A COMPLEX SET OF CONDITIONS WHICH SHOW DEVELOPMENT CHANGES IN THE STRUCTURE OF ENAMEL.   THE DEVELOPMENT OF ENAMEL CAN BE DIVIDED INTO 03 MAIN STAGES: 1 – FORMATION OF THE ORGANIC MATRIX. 2 – MATRIX MINERALIZATION. 3 – MATURATION OF ENAMEL.   INTRAVASCULAR INJECTION _ ANESTHETIC INTRODUCED INTO THE BLOOD CURRENT, MAY BE TAKEN TO THE HEART OR TO THE BRAIN CENTERS, ALWAYS PERFORM ASPIRATION.   TRISH _ TEMPORARY PARALYSIS OF THE JAW THAT MAY OCCUR DUE TO TRAUMA TO THE MUSCLE DURING THE INSERTION OF THE NEEDLE, LIMITING MOVEMENT _ TREATMENT: ANALGESICS NOTE: AVOID USING THE CORRECT TECHNIQUE   HEREDITARY DEFECTS OF ENAMEL FORMATION ARE ALSO DIVIDED ALONG THESE LINES: 1 – HYPOPLASTIC. 2 – HYPOCALCIFIED. 3 – HYPOMATURED. DENTAL RESTORATION TREATMENT AND PROSTHETIC CROWN.   PARESTHESIA _ TRAUMA OF A SENSITIVE NERVE THAT CAN RESULT IN PROLONGED LOSS OF PARTIAL OR TOTAL SENSITIVITY _ TREATMENT: PHYSIOTHERAPY WITH HEAT - LASER APPLICATIONS   HUNTCHISON INCISIVES (SYPHILIS): APPEARANCE SIMILAR TO SCREWDRIVER, MAY BE BEVELED, SHAPE OF BANNER OR BARREL. STRICTLY AESTHETIC TREATMENT WITH CROWNS.   INFECTIONS _ CAUSED BY INSERTING THE NEEDLE IN FLAMED OR SUPURED LOCATIONS _ TREATMENT: ANTIBIOTICS   FLUOROSIS: INGESTION OF EXCESSIVE AMOUNT OF FLUORINE RESULTS IN SIGNIFICANT ENAMEL DEFECTS CAUSING FLUOROSIS. WHICH ARE STAINS, IN GENERAL WHICH OR YELLOWISH, THAT APPEAR IN THE TEETH USUALLY SYMMETRICALLY. IT AFFECTS CHILDREN FROM 0 TO 12 YEARS. DENTAL RESTORATION TREATMENT OR PROSTHETIC CROWN.   NEEDLE FRACTURE • DO NOT INSERT THE ENTIRE NEEDLE • STABILIZE THE PATIENT'S HEAD • POOR QUALITY NEEDLES   TETRACYCLINE STAINING: CHILDREN TREATED WITH ANTIBIOTICS FROM THE CHEMICAL GROUP OF TETRACYCLINES, DURING THE TEETH FORMATION PERIOD, THEY HAVE A DEGREE OF PIGMENTATION IN THE CROWNS, VARYING FROM YELLOW TO BROWN AND GRAY TO BLACK. RESTORATIVE DENTAL TREATMENT OR PROSTHESIS.   SYSTEMIC • ALLERGIC REACTIONS _ DERMATITIS: URTICARIA/EDEMA/ITCHING _ SYSTEM GASTROINTESTINAL: COLIC/DIARREAA/VOMITING/ NAUSEA _ SYST. RESPIRATORY: BRON / COSPASMO / LARYNX EDEMA • SEIZURES   MICRODONTICS: THE UPPER SIDE INCISIVE IS MOST OFTEN AND GENERALLY AFFECTED APPEARS AS A CONE-SHAPED CROWN OVER A ROOT OF NORMAL LENGTH. ISOLATED MICRODONTICS USUALLY AFFECTS THIRD MOLARS. RESTORATIVE DENTAL TREATMENT. PATHOLOGICAL DENTISTRY   NATAL AND NEONATAL TEETH: THOSE TEETH PRESENT AT BIRTH ARE CALLED CHRISTMAS TEETH, WHILE THOSE THAT ERUPUTE WITHIN 30 DAYS AFTER BIRTH ARE CALLED NEONATAL TEETH. A MATURE CHRISTMAS OR NEONATAL TOOTH IS ONE THAT SHOWS A NORMAL DEVELOPMENT, HAVING A GOOD PROGNOSIS. THE MOST AFFECTED TEETH ARE THE LOWER DECIDUOUS CENTRAL INCISIVES.   MACRODONTIC: AND THE CHANGE IN THE DEVELOPMENT OF THE DIMENSIONS OF THE TEETH, THE DIFFUSE MACRODONTICS HAS BEEN ASSOCIATED WITH PITUITARY GIGANTISM. THE TREATMENT OF DENTITION IS NOT NECESSARY UNLESS FOR REASONS AESTHETICS. NOTE: TEETH OF NORMAL SIZE MAY LOOK LARGER WHEN CROWNED IN GNATIC BONES SMALLER THAN NORMAL. HISTORICALLY CALLED RELATIVE MACRODONTIC, BUT IT REPRESENTS MICROGNATHY.  FOR MANY YEARS THE CAUSE OF THE PREMATURE ERUPTION WAS SUGGESTED IN THE FACTORS: _ HYPOVITAMINOSIS; _ HORMONAL STIMULUS; _ TRAUMA; _ FEVERED STATES; _ SYPHILIS.