Child/family-oriented approach: the teeth come after

The aim of this paper is to promote reflection on the dentist's approach to the dental care of young patients, considering not only their oral care needs, but also the management of their behaviour, that is intrinsic to their life needs and to those of their families.

This approach to dental care management stems from a thorough evaluation of the patient, the reason for dental visit, whether the child had previous dental visit(s), which might not have been positive, the family involvement and the emotional characteristics of the child and their parents. We should design a progressive customized path, sometimes starting only from secondary prevention in order to "comfortably" avoid the worsening of a given clinical condition, stimulate a concomitant positive behavioural response of all parties involved, until the child and their family are ready to take the next step, in terms of integrated restorative dentistry and/or paediatric orthodontics, where and when needed.

"The teeth come after" means that dental and oral care of the children may not be achievable goals unless we first address their wellbeing and that of their families, and that sometimes "the perfect is the enemy of the good", especially when we incorrectly consider only the clinical outcome. In this scenario, psychological skills and clinical feelings, comfort techniques, technologies, new materials and a more "medical less" surgical approaches are the bases for a child/family-oriented approach.