ICP-30 History and Examination of Child Patient Flashcards
What are the first few things you should do when establishing rapport with a patient
- Greet child and parent in waiting area
- Ensure you have correct patient info, name, d.o.b, address
- Ask what patient prefers to be known as
- Lead patient and parent to clinical area chatting about non-dental info
- If patient expresses anxiety, reassure them how easy today will be
What are the common complaints that are presented in child patients
- Double teeth/shark teeth
- Eruption cyst/pain
- Gingival/gum operculum
- Supernumeries/mesiodens
- Anterior open-bite: digit/dummy sucking
- Dental caries and sequelae (pain, infection, swelling, loss of sleep etc)
What is pulpitis
Inflammation of the dental pulp
What are the clinical features of reversible pulpitis
- Short duration pain
- Sharp pain
- Sweet/hot/cold stimuli
- Removing stimulus can remove pain
- Analgesics help
What are the clinical features of irreversible pulpitis
- Longer duration pain
- Dull throbbing ache
- Spontaneous pain
- Can wake child from sleep
- Analgesics may not help
What factors are to be considered when assessing the disease risk of a patient
- Past disease experience
- Current dental status
- Family history
- Diet considerations
- Concomitant medical conditions
- Social factors: recent migration, language barriers, ethnic and cultural diversities
What factors suggest a low risk patient
- No caries
- Favourable family history: diet, siblings, oral hygiene
What factors suggest a moderate risk patient
One or two new lesions per year
What factors suggest a high-risk patient
- Three or more lesions per year
- Ortho treatment
- Chronic illness/medically/physically compromised
- Social factors
When taking history of a patient what are the 5 key things to document about
CO - Complains of HPC - History of present complaint MH - medical history PDH - previous dental history G&SH - General and social history
How do you take the “complains of” part of the patient history
- Carefully documented
- Use patients/parents own words
- Document to area pointed at by patient
- Might include nature, type of pain, exacerbating and receiving factors, lack of eruption and oral ulceration
How do you take the “history of present complaint” part of the patient history
Ask and record the:
- Presentation
- Frequency
- Duration
- Severity
- Precipitating factors and alleviating factors
How do you take the “Medical History” part of the patient history
Take is systematically: - CVS - CNS - Endocrine - GI tract - Respiratory system - Past operations/treatment/medications etc etc etc
How should you record the growth and development of a patient
- Infant record book
- Developmental milestones
- Speech and language development
- Motor skills
- Socialisations
How should you record the family and social history of a patient
- Who do they live with?
- Family history of serious illness
- Family pedigree tree
- Schooling, help in class
- Speech and language problems
- Pets, hobbies and other interests
What aspects of a Patient Dental History are important in a child patient
- Previous treatment
- Eruption times/dental development
- Preventive treatment received
- Previous methods of pain control
- Para-functional habits
What things need to be examined when doing an extra oral examination
- Size, general appearance, interaction with parents
- Facial symmetry
- lips competent
- Eyes, sclera, pupils, globe conjunctiva
- Skin, colour and appearance
- TMJ, deviation, clicking, trismus, gape
- Cervical, submandibular and occipital lymph nodes, enlargement or tenderness
What are the soft tissues that need to be checked in an intra-oral examination
- Lips and labial mucosa
- Buccal mucosa (including keratinisation, linear alba, cheek biting)
- Palatal hard/soft mucosae
- FOM, lower lingual area
- Oropharynx and tonsils
- Oral hygiene and periodontal status
When do dentists start doing BPE examinations
From age 7 upwards/when marker teeth are present (permanent centrals/1st permanent molars)
What are the BPE scores in children and what do they indicate
0 = healthy 1 = bleeding 2 = calculus
What should be recorded when dental hard tissues are being examined
- Chart teeth present and missing on appropriate form
- Record dental decay of varying severity
- Record restorations
- Tooth surface loss
- Tooth abnormalities
- Fluorosis
- Dental trauma
- Occlusion
- Orthodontics
What pulp sensitivity (vitality) testing methods are there
Thermal
Electric
Percussion
Trans-illumination
How many teeth are in the primary dentition and when does eruption begin and when does the dentition complete
20 teeth
Eruption begins at about 6 months
Dentition complete at about 2.5 years
When do patients present with mixed dentition
6-13 years
