Assessing the Child and Family Flashcards
1
Q
What are the key recommendations for Prevention of Dental caries in Children?
A
- Provide all children with personalised oral health promotion advice
- Encourage and support children to brush teeth or brushed for them at least twice a day with fluoride toothpaste
- Advise children and parent/carer about how healthy diet can help prevent caries
- For all children place fissure sealants on permanent molars as early as poss after eruption
- For all children aged 2 and over apply sodium fluoride varnish at least twice a year
2
Q
What are the aims when providing dental care for children?
A
- Prevent disease in primary and permanent dentition
- Reduce risk of child experiencing pain or infection or acquiring treatment induced dental anxiety if dental caries occurs
- For child to grow up feeling positive about oral health and with skills and motivation to maintain it
3
Q
What are the priorities of the dental team to achieve these aims?
A
- Involve child and parent/carer in decisions about childs oral health
- encourage parent to take responsibility for childs oral health and give advice for at home
- Obtain valid consent
- Relieve pain or infection if present
- Apply preventative measures in relation to childs risk of developing caries
- Focus on prevention of caries in permanent before management of caries in primary
- If caries in permament then diagnose early and manage properly
- Manage caries with technique that maximises tooth exfoliation without pain or infection and minimses risk of dental induced anxiety
- Identify as early as poss if concern about parent/carers ability to comply with dental health preventative advice and contact other professionals like GP, Childsmile etc.
4
Q
What are the stages in assessment and planning of a child?
A
- Assessing the child and family
- Provide additional support if needed
- Defining needs and developing personal care plan
5
Q
What are the main components when providing care for a child?
A
- If child is in pain then manage pain
- Caries prevention
- If caries present then manage caries
- Recall
6
Q
When should the first assessment be carried out of the child?
A
- Before 6 months old to determine if parent/carer can be encouraged to adopt optimum caries preventative practices
- Reviewed regularly as circumstances change
7
Q
What does a comprehensive assessment include?
A
- Parent/Carer motivation and responsibility
- Patient history
- Clinical examination
- Caries risk assessment
8
Q
Why is gaining a rapport with the child and Parent/carer important?
A
- May be feeling stressed, apprehensive or guilty
- All members of team are important
- Essential for participation of the child’s oral health
9
Q
How to gain rapport with child and parent/carer?
A
- Clinician or dental nurse take primary responsibility to welcome child or family to avoid confusion
- Welcome child as they enter surgery
- Make eye contact and greet by name and introduce self
- Gain rapport with parent/carer and discuss how they can support and encourage child in surgery
- Involve child as much as poss in all conversations and avoid talking over them
10
Q
What factors contribute to difficulty in establishing healthy behaviours?
A
- Education, Family health or social issues e.g. deprivation
- Individuals with differing life priorities
- Complex child care arrangements
- Children/families with intellectual, medical, mental health, physical or other disabilities
- Parent/carer lack knowledge or motivation regarding prevention of dental disease
11
Q
How to take a history for a child?
A
- Confirm reason for attendance and begin to asses oral health expectations and motivation of child and parent/carer
- Take full medical and dental history and ensure this is kept up to date
- Take social history to determine what adult provides care, What days and times are easiest for parent/carer, name of medical practice, name of nursery or school
- Ask about caries experience in parent and siblings
- Ask about toothbrushing habits
- Ask about diet
- Previous dental experiences
- Consider anxiety questionnaire if needed
- Ask parent/carer if any difficulty in bringing child in for dental visits
- use info to form assessment and attitude and ability for preventative care
12
Q
What to do when clinically assessing the child?
A
- E/O
- I/O
- Plaque level
- Childs or parent/carer toothbrushing knowledge
- Assess dentition on clean and dry teeth using tooth by tooth approach and discuss with parent/carer
13
Q
How do you assess primary dentition?
A
- Diagnose carious lesions
- Assess for pain and abscess/ infection
- Assess risk of pain or infection developing before exfoliation (shedding primary teeth and being replaced by permanent)
14
Q
What does a visual diagnosis of dental caries entail?
A
- Assess on clean and dry teeth
- Caries affected enamel has white chalky appearance
- Enamel dentine junction caries, lesion appears opalescent white
- Dentinal lesions appear darker
15
Q
Why does caries affected enamel have a white appearance?
A
- Acidic solutions from cariogenic plaque biofilm or acid etching solution disolve prism sheaths in enamel creating pores
- Pores refract light, reflecting it back instead of letting it pass through
16
Q
What indicates dentinal involvement of caries?
A
- Opalescent enamel adjacent to a stained fissure
- White opalescent enamel at marginal ridge indicates proximal lesion with dential involvement
17
Q
Stained pit or fissure findings
A
- If stained pit or fissure with no adjacent white opalescent enamel and no obvious radiographic signs
- Indicates carious lesion confined to enamel fissure
- No indication for restorative intervention
