1. Chapter 50 The Pediatric Patient

2. Copyright © 2017 Wolters Kluwer All Rights Reserved Learning Objectives 1. Describe the specialty of pediatric dentistry. 2. Discuss the use of a caries risk assessment tool to identify an individual patient’s risk and preventive factors. 3. Identify age-appropriate anticipatory guidance/ counseling factors to educate parents/caregivers of toddlers, schoo laged children, and adolescents. 4. Identify age and caries risk level appropriate preventive and therapeutic oral healthcare interventions for children. 5. Discuss oral health home care needs, adjunct aids, and continuing care recommendations for children. 2

3. Copyright © 2017 Wolters Kluwer All Rights Reserved Pediatric Dentistry I.The Specialty of Pediatric Dentistry II. The American Academy of Pediatric Dentistry (AAPD) 3

4. Copyright © 2017 Wolters Kluwer All Rights Reserved The Child as a Patient I.The Dental Home II.Barriers to Dental Care III.Child Dental Visits 4

5. Copyright © 2017 Wolters Kluwer All Rights Reserved Patient Management Considerations I.Toddlers (1–2 Years of Age) II.Preschoolers (3–5 Years of Age) III.School Age Children (6–11 Years of Age IV.Adolescents (12–18 Years of Age) 5

6. Copyright © 2017 Wolters Kluwer All Rights Reserved Components of The Dental Hygiene Visit I.Initial Interview/New Patient Visit II.Child and Family Medical/Dental History III.Intra- and Extra-Oral Examination IV.Developing Dentition, Occlusion, and TMJ V.Radiographic Assessment 6

7. Copyright © 2017 Wolters Kluwer All Rights Reserved Components of The Dental Hygiene Visit con’t VI. Dietary Assessment VII.Oral Prophylaxis VIII.Prevention 7

8. Copyright © 2017 Wolters Kluwer All Rights Reserved 8

9. Periodontal Risk Assessment I.Gingival and Periodontal Evaluation II.Periodontal Infections 9

10. Copyright © 2017 Wolters Kluwer All Rights Reserved Caries-risk Assessment I.Purpose II.Principles III.Steps IV.Classification of Caries Risk V.Early Childhood Caries (ECC) 10

11. Copyright © 2017 Wolters Kluwer All Rights Reserved FIGURE 50-4 Visualize the Caries Balance 11

12. Copyright © 2017 Wolters Kluwer All Rights Reserved FIGURE 50-5 Progression of ECC 12

13. Copyright © 2017 Wolters Kluwer All Rights Reserved FIGURE 50-6 White-Spot Lesions 13

14. Copyright © 2017 Wolters Kluwer All Rights Reserved FIGURE 50-7 Cavitation of White Lesion Areas 14

15. Copyright © 2017 Wolters Kluwer All Rights Reserved Anticipatory Guidance I.Dietary and Feeding Pattern Recommendations II.Oral Health Considerations for Toddlers/Preschoolers III.Speech and Language Development IV.Digit Habits V.Accident and Injury Prevention 15

16. Copyright © 2017 Wolters Kluwer All Rights Reserved Anticipatory Guidance Con‘t VI. Oral Malodor VII. Oral Health Considerations for Adolescents VIII. Tobacco/Piercings/Substance Abuse IX. Referral 16

17. Copyright © 2017 Wolters Kluwer All Rights Reserved FIGURE 50–8 Dentifrice for a Child 17

18. Copyright © 2017 Wolters Kluwer All Rights Reserved FIGURE 50-9 Effects of Prolonged Thumb Sucking on Teeth 18

19. Copyright © 2017 Wolters Kluwer All Rights Reserved Treatment Planning and Consent DH diagnosis to develop care plan Discuss Inform Signed consent Medical clearance Parent approval 19

20. Copyright © 2017 Wolters Kluwer All Rights Reserved Documentation Overall appraisal of physical status and key health history findings. Existing pathology: soft tissue, gingiva, caries, occlusal status. Oral hygiene status and caries-risk assessment. 20

21. Copyright © 2017 Wolters Kluwer All Rights Reserved Factors to Teach the Patient Parent’s health affect child’s Bacteria transferral Fluoride benefits Methods for prevention Parent examination Rationale for maintenance Preparation for dental visits 21