Pedo 4
Pedo 4
Pedo 4
Collect general observations: Child/parent interactions, behavior Address reason for presenting FIRST Start with history: Medical, dental, family, social Record past dental care
Conduct head and neck exam Perform a complete oral examination Use a thorough and detailed form Establish a provisional diagnosis Obtain any additional tests: Radiographs, study models, medical consults, etc..
Finalize diagnosis and treatment plsn Present case to patient/parents Outline recommended treatment plan Involve parents in planning Secure parental consent
Treat existing problems Prevent progression of existing problems Prevent anticipated future problems Plan periodic exams, preventive care and treatment
Consider behavior (eg. Desensitizing app/procedure, modeling) Involve parent in treatment choices, but dont be dictated to! Incorporate prevention
Plan efficient use of LA (QUADRANT THERAPY) Treat comprehensively with definitive treatment, not patchwork Consider full coverage if using GA
Establish a follow up/review/recall plan based on established criteria (eg. AAPD) Make referrals in writing and expect a written report back
First visit: Examination, Diagnosis and treatment planning, Prophylaxis, OHI, dietary advice Second visit: Quadrant 1 Third visit: Quadrant 2 Fourth visit: Quadrant 3 Fifth visit: Quadrant 4, Fluoride application
Initials DOB Initial exam Age at exam Parents Marital status Siblings Residence
CVS Endocrine GIT Bleeding UGS Respiratory CNS Allergies Past surgery Immunization up to date
NORMAL
Full term, Normal delivery Normal Normal 100.8 cm, (50th) 15 kg, (50th)
Recently moved from Eritrea Non-English speaking family Single child Goes to Kinder Good social development Bottle-feeding at night
Past dental history First dental visit Referral Referred from North Yarra community health services for management of dental caries
Spontaneous pain in upper anterior teeth Pain disturbing sleep Pain interfering with eating
Facial symmetry Eyes Skin colour Nails Hair TMJ Lymph nodes
SOFT TISSUES Gingiva Alveolar mucosa Palate Buccal mucosa Tongue Sublingual area Soft palate Oropharynx
NORMAL
Normal Fair
HARD TISSUES Primary dentition stage Extensive dental caries Hypoplastic upper and lower central incisors
SOFT TISSUES
Slightly convex Normal lip line Incompetent lips Everted lips None Normal
A-P RELATION Primary Is Class I Primary Ms Flush terminal 2mm Overjet VERTICAL RELATION Facial type Mesiofacial Overbite 3mm SPACING Primate spaces
EDCBA
EDCBA
ABCDE
ABCDE
PREVENTIVE PHASE Oral hygiene instructions Dietary counselling Dental prophylaxis Topical fluoride application Antimicrobial therapy (CHX) RESTORATIVE PHASE Under GA
Oral hygiene instructions, Dietary advice, Prophylaxis, Fluoride application Quadrant 1: Exo 51,52buccal, 54 MOD, 55 occlusal Review OH and diet changes Quadrant 2: Exo 61, 64 MOD, 65 occlusal Quadrant 3: 74 MOD, 75 occlusal Quadrant 4: 84 DO, 85 occlusal Review 3/12 for Fluoride application, OHI and monitoring
Oral hygiene instructions ( Brushing and Flossing) Diet analysis Parent education regarding feeding habits
Pre-operative Rt & Lt BW Prophylaxis 52 Buccal- GIC 54 MOD- Formocresol pulpotomy, IRM, SSC, Ketac cement 55 Occlusal- vitrebond liner, GIC base, Amalgam restoration
84 DO- vitrebond liner, GIC, SSC, Ketac cement 85 Occlusal- vitrebond liner, GIC, SSC, Ketac cement
64 MOD-vitrebond liner, GIC, SSC, Ketac cement 65 Occlusal- vitrebond liner, Amalgam restoration
74 MOD- vitrebond liner, GIC, SSC, Ketac cement 75 Occlusal- Formocresol pulpotomy, IRM, SSC, Ketac cement
Good oral hygiene Diet modified Improved feeding and sleeping Overall improvement in the quality of life Prescribed CHX Gel
Review 3/12 BW, OH and Diet monitoring, Topical Fluoride application Monitor growth changes