History, exam and tx planning of paediatric patients

Question 1

Who has parental consent?

Answer 1

ONLY biological mother and father on birth certificate

Question 2

What is involved in the social history of the child?

Answer 2

Preferred name
Age - compare dental age
Family - siblings? main carer? parental consent? who oversees diet and brushing? grandparents/split parents spoiling children.
School - important to contact if there is a non returning child
Attendance issues - parental time constraints, distance to travel, priority given to dental care - regular attender of attends only with pain.

Question 3

Medical history qs

Answer 3

MH
Allergies
Maternal pregnancy and labour - premature birth/severe morning sickness - MIH
Clotting issues - haemophiliac (pulpotomy over XLA)

Question 4

Dental history qs

Answer 4

How long the issue has been there for?
How it manifests - symptoms
Tx
Outcome of tx
OH
Fluoride
Diet
Emergency or regular attender?

Question 5

5 things on EOE

Answer 5

General appearance - size, weight
Unusual features - bruising, sparse hair
TMJ
Facial asymmetry
Habits

Question 6

IOE factors

Answer 6

Soft tissues and gingival tissues
Occlusion
Current position of teeth
Dentition
- Missing teeth
- Mobile teeth
- Restorations
- Caries
- Dental abnormalities, number, colour, position and morphology (bone resorption due to dead teeth)

Question 7

2 key developmental stages to check

Answer 7

8 - max central erupted
10 - palpate canines

Question 8

4 things when requesting a radiograph

Answer 8

type
justification
result
planned radiographic interval

Question 9

What to consider when beginning tx plan

Answer 9

OH - grubby score
fluoride
FS
Diet diary and advice
Caries risk status
Behavioural factors - anxiety/ability to cooperate

Question 10

How to complete a grubby score

Answer 10

UR6 UL1
LL1 LL6

Buccal and palatal of 4 teeth. Max score of 8. O’Leary of these teeth .
Bar chart

Question 11

What does the tx plan start with?

Answer 11

Prevention

OH
F
FS
Diet analysis

Question 12

If a tooth is pulpally involved, what is the tx plan?

Answer 12

Pulpectomy or XLA
Caries v deep
Remove coronal or radicular pulp
ZnOEu as GP not resorbable

Question 13

What are the principles of tx planning?

Answer 13

History and exam
Management of acute dental issues
Initial tx, accl, prevention, advice and stabilisation
Definitive tx, restoration +/-
XLA
Recall according to risk factors

Question 14

Problem list

Answer 14

Pain
Caries
Anxiety
Poor OH
Many younger siblings
Drinks squash and does not drink water