Developing the Personal Care Plan Flashcards
What elements are required for a care plan to be successful?
- tailored to a realistic assessment of childs ability to accept treatment
- aim to increase likelihood of behavioural change to improve oral health
- gain parent/carers support in bringing child for care and in supervising preventive interventions
What are the priorities of a paediatric personal care plan (start with the most important)?
- manage pain if present
- caries prevention
- managing caries (asymptomatic sepsis), if present
What must be included in ALL childrens personal care plan?
caries prevention
List some approaches for caries prevention
- toothbrush instruction
- diet advice
- fluoride application
What are the factors that complicate caries management in children?
- children can finde operative treatment unpleasant (white coat syndrome)
- clinicians can find operative treatment on children difficult to provide
- children with decay tend to have multiple teeth affected?
How would you possibly go about treating a child with caries lesions on multiple teeth?
GA to take all carious teeth out
Primary teeth have a limited life span, how does this simplify the treatment we are able to provide?
- as opposed to a restoration or extraction, slowing caries progression may be sufficient before subsequent exfoliation ot the tooth
Early childhood caries is also known as …
bottle caries
What is the aetiology of ECC?
- on demand night time feeding >1 years
- breast milk, formula
- juice or sweet drinks befoe nap/bed time (slow saliva production)
- dipping pacifiers in sweet drinks
How can ECC be prevented?
- only water at night time
- fluoride application
- changing bottle to cup (training cup) - children tend to fall asleep with their bottles
What is the first priority of a personal care plan in a child if no pain is present?
*[caries prevention]
keeping the 6s and the 7s free from both occlusal and approximal caries
What is the second priority of the personal care plan for children?
reduce the risk of caries in primary dentition resulting in pain and sepsis before it exfoliates
What should come first, preventive interventions for permanent teeth or treatment of primary teeth?
preventive interventions for permanent teeth should come before treatment for primary teeth
e.g. fissure seal permanent teeth before restoring permanent teeth
In the initial care plan, you should inform parent/carer of the expected number and duration of appointments. What should you keep in mind to maintain cooperation of the child?
splitting them into manageable bite sized chunks - dividing treatment into stages
predict more appointments than you think you will need
What was the relevance of the Law Reform Act 1969 in healthcare?
- permits a patient of 16, of sound mind to legally give valid consent
- does no preclude (prevent) children under 16 from giving consent
if <16 can understand proposed treatment proposed and they can come to an informed decision
A child under 16 is considered to be Gillick competent if…
- they are able to understand the nature of the treatment and purpose
- understand risks + limitations
- compare alternative, including no treatment
It is prudent to get a gillick competent child to discuss with their parent. True or false
True
In a case where the parent is unavailable for a gillick competent child, how should you treat this patient?
- childs best interest should be put first
- do the minimum treatment possible- the main priority should be resolving the pain
Parental responsibility is defined by …
the Children Act 1989
Parents are unable to delegate parental responsibility. True or false
false
In what instance to both parents have automatic parental responsibility of a child/.
if they are married at the time of conception
What is an easy opening question to ask fathers to detemine parental responsibility?
“Are you married dad or partner dad”?
In what instances does an unmarried father have parental responsibility?
- father has acquired PR via court order or PR agreement
- couple subsequently marry
- named on birth certificate
A legally appointed guadian has parental responsibility. How is a legal guardian appointed?
- court
- parent with PR in the event of their own death
