Edelstein B L
Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, USA.
Dent Clin North Am. 1995 Oct;39(4):721-36.
Ultimately, the dentist's role is to guide children through their growth and development free of disease. The dentist must recognize each child's unique susceptibility to caries and each parent's interest, competency, and accomplishment in controlling this disease. With this recognition, it is possible to tailor the frequency and content of dental visits necessary to maintain a child caries-free. Similarly, the frequency of examinations, office topical fluoride treatments, radiographs, and other diagnostic or preventive interventions depends upon the dentist's assessment of how intense professional efforts need to be to help parents maintain their children in health. Goldman and Burket summarized the relationship between science and practice and detailed the responsibilities of clinicians with the following words: "The practice of dentistry is an art in which the teachings of dental science are put to their practical application. A patient visits the dentist for consultation on the state of health of the dentition, with the expectation that everything possible will be done not only to repair or help heal by therapeutic correction any disease present but also to prevent disease from occurring, if possible." Treating caries at the level of the disease process to prevent its expression, progression, and ultimate dental destruction is the highest calling and deepest challenge facing dentists who care for young children. Techniques including risk assessment, triage, tailored care, and thoughtful treatment grounded in dental and behavioral science have put that goal within reach of dentists and parents to the great benefit of children.
最终,牙医的职责是引导儿童在成长发育过程中远离疾病。牙医必须认识到每个孩子患龋齿的独特易感性,以及每位家长在控制这种疾病方面的兴趣、能力和成就。有了这种认识,就有可能调整维持儿童无龋所需的看牙频率和内容。同样,检查频率、诊室局部用氟治疗、X光片以及其他诊断或预防性干预措施,取决于牙医对专业努力强度的评估,即需要付出多大努力来帮助家长保持孩子的健康。戈德曼和伯克特总结了科学与实践之间的关系,并用以下的话详细阐述了临床医生的职责:“牙科实践是一门艺术,牙科科学的理论在其中得到实际应用。患者找牙医咨询牙列健康状况,期望牙医尽一切可能,不仅要通过治疗矫正来修复或帮助治愈任何现存疾病,还要尽可能预防疾病的发生。”在疾病过程层面治疗龋齿以防止其表现、进展以及最终的牙齿破坏,是照顾幼儿的牙医面临的最高使命和最深层次的挑战。包括风险评估、分诊、个性化护理以及基于牙科和行为科学的周到治疗等技术,已使这一目标触手可及,让牙医和家长都从中受益,极大地造福了儿童。