Paediatric Dentistry

This service is for children and adolescents up to 15-16 years of age dependent on their development, and manages complex preventive and therapeutic dental problems.

Care may be offered within two different streams of Paediatric Dentistry clinics dependant on the reason for referral. For example, some children may have behavioural difficulties that make general treatment in the dental chair impossible for them.

Specialist Paediatric Dentistry

Clinical criteria:

• Complex dental pathology requiring specialist management (cysts, MIH)
• Special needs (intellectual, physical and sensory disabilities)
• Syndromes and other genetic disorders including amelogenesis imperfecta and dentinogenisis imperfecta)
• Medically compromised conditions such as Haemolytic disorders (e.g. Haemophilia, leukaemia, thrombocytopaenia etc.)
• Dental anomalies (supernumerary teeth, dilaceration, odontomes, missing teeth, ankylosed teeth)
• Behaviour management requiring relative analgesia
• Interceptive orthodontics, including management of conditions such as dehiscence, space maintenance, anterior and posterior cross bites, ectopic eruptions or non-eruption, habits, etc
• Early childhood caries that require complex surgical restoration procedures

Prerequisite for referral:

• completion of the RDHM Paediatric Dentistry Referral Form

General Paediatric Dentistry

Clinical criteria:

• Behavioural difficulties that may require management under general anaesthesia

Prerequisite for referral:

• Where behavioural difficulties are experienced, treatment should be attempted by at least two different operators under local anaesthesia first.
• Junior operators should seek assistance from more senior operators prior to referring patients.
• completion of the RDHM Paediatric Dentistry Referral Form

Emergency Care in Paediatric Dentistry:

The referring clinician is to contact RDHM Patient Services on (03) 9341 1000 and ascertain the ability of the clinic to provide care on the same day or coordinate care for another day.

Due to demand, it may not be possible to provide the care proposed for a particular patient on the same day. This particularly applies to patients requiring general anaesthesia. However, patients with potential serious infections (e.g. spreading cellulitis, submandibular abscess) will be seen on the same day.

Once an appointment has been arranged, the patient must be provided with a completed RDHM Referral Form and any available radiographs and directed to proceed to the main hospital reception. Patients with acute symptoms should have their RDHM Referral Form clearly marked as urgent, indicating reasons for urgent attention

General Anaesthetic:

Patients assessed as needing procedures under general anaesthesia (GA) will be referred on to the Day Surgery unit.  Waiting times are generally shorter for procedures that can be performed under local anaesthesia.

Exclusions:

If a general anaesthetic is required, patients with the following should be referred directly to the Department of Dentistry at The Royal Children's Hospital:

• patients with Type 1 daibetes
• blood dyscrasias or bleeding disorders
• severe respiratory disorders