As an ADA Success program speaker, I am always honored to speak to dental students from across the country on topics such as practice management, leadership and ethics, and the state of the dental profession. No matter what topic I speak on, however, I am always questioned about something that I mention in my introduction: I am a general dentist who limits my practice of dentistry to treating pediatric patients.
Many students have approached me, expressing an interest in treating pediatric patients in their future general practice, but they’re unsure of how to get experience in ways that do not involve attending a pediatric residency. Dental schools offer varied training in pediatrics, so it is completely reasonable that you may feel like you need more experience to be comfortable treating children. This is a patient population that has unique needs, often different from your adult patients, and you owe it to them to have a great foundation before you start treating them in your practice. Every child deserves to be treated in a manner that is safe, comfortable and time-effective. Luckily, there is a lot you can start working on right now to gain the skills required to successfully treat pediatric patients as a general dentist.
Here are my five tips to set you up for success in treating pediatric patients in your future general practice:
- Consider completing a General Practice Residency (GPR) or Advanced Education in General Dentistry (AEGD) program. Do you believe you will enjoy treating children, but don’t want to attend a pediatric residency? Perhaps you love general dentistry and do not want to “give up” the ability to practice in a non-pediatric population if you specialize. If these sound like you, completing a GPR or AEGD that regularly treats children can be a great alternative to gaining experience in pediatrics without specializing. Most kids are not going to patiently wait for you to take two hours to complete a restoration, so an extra year of focused clinical time is a great opportunity to build your speed and confidence with restorative dentistry and treatment planning. It will also allow you time to practice behavior management techniques and become more comfortable using nitrous oxide on children. Not all AEGDs/GPRs have significant exposure to pediatrics, so it is important to ask program directors and residents directly about the experience they offer treating this population. In my GPR, we treated pediatric patients daily and performed full-mouth rehabilitation cases for children in the operating room. Because of this experience, I was much more confident in my ability to treat children once I entered private practice.
- Attend (a lot of) CE. If you are going to treat this special population, remember that it is your ethical obligation to deliver the same quality and level of care that a specialist would. Without understanding what that level of care is, it is difficult to know if you are treatment planning the same way a pediatric dentist would. There are some great pediatric CE courses out there to help you understand how pediatric dentists work and get you started on the right path. The American Academy of Pediatric Dentistry (AAPD) has a Comprehensive Review Course that would be a great starting point. Bonus: The course is 50 percent off for students.
- Join the AAPD. Speaking of the AAPD, I would highly recommend joining as a student member now and then as an affiliate member once you are a dentist. The AAPD has been a great resource to me as a general dentist. I get notifications about the most up-to-date policies and recommended methods of practice, access to their journals and resources, and alerts about CE opportunities near me. I would also recommend purchasing The Handbook of Pediatric Dentistry. It’s a great go-to guide and overviews many of the topics you will need to know when treating pediatric patients. I use this book daily in my practice.
- Attend a pediatric residency externship or shadow a pediatric dentist. I decided to return to pediatric residency later than most, so when I did an externship visit, I had already been in practice for several years. Even after treating children for four years, I was pleasantly surprised by the number of valuable techniques I was able to bring back to my practice after a short three-day visit to a residency program. Though most students who do pediatric externship visits plan to apply to pediatric residency, this extra exposure would be great for anyone interested in treating this patient population. Shadowing a local pediatric dentist or attending an extern visit at a pediatric residency program are both great ways to learn how to manage pediatric patients, present treatment plans to parents and get exposure to the latest pediatric dental technology.
- Know when to refer. Treating children is, of course, more than just diagnosing and treating caries. Discussions on appropriate growth and development, nutrition and habit counseling, in addition to an understanding of special-needs patients, are part of the job. If you are uncomfortable or do not feel that you have the foundation to discuss a child’s dental development and complete oral health care needs as a provider, then you should refer to a specialist until you are ready. When you are prepared to incorporate these patients into your practice, plan to start small (prophies, sealants, small restorations) and then work your way up to more complex procedures. If a child is anxious and you are unable to provide safe treatment, despite your behavior management skills, it is your duty to refer them to a specialist. These specialists treat high-anxiety and complex pediatric patients daily, and can potentially offer sedation or hospital treatment options to successfully treat the patient.
Treating pediatric patients has been the most fun and rewarding part of my practice as a general dentist. Fortunately, the number of pediatric patients visiting the dentist has been on the rise for the last decade, so if you have an interest in treating this population, there is an opportunity and need for you to do so.
Best of luck to you, and feel free to comment with any questions or concerns. I am happy to be a resource to you on your journey to treating a pediatric patient population in your future general practice.
~Dr. Alexandra Barton Otto, Virginia ‘2013
Dr. Alexandra Barton Otto was the 2012-2013 national ASDA vice president and a member of the 2017 ASDA National Leadership Conference planning committee. After obtaining her DDS degree from Virginia Commonwealth University's School of Dentistry in 2013, Dr. Otto completed a general practice residency at Denver Health Medical Center in 2014. She has been in general practice for four years, treating pediatric, adolescent and special health care needs patients in privately owned, pediatric-focused group practices in Colorado and Texas. Her love of treating pediatric patients has led her back to training, and she has recently accepted a residency position at NYU Langone in Anchorage, Alaska, which will start this fall.