KNEE TO KNEE LAP EXAM

Question 1

INDICATIONS:
(2)

Answer 1

 Child who will/can not sit
in the dental chair on their
own (usually <3 y.o.)
 Child 1 year of age or 6
months after the eruption
of first tooth

Question 2

 Child 1 year of age or 6
months after the eruption
of first tooth
 It is important to see children
early to check for

Answer 2

normal
development and most
importantly to provide
PARENT EDUCATION!

Question 3

HOW TO PREPARE:
(4)

Answer 3

1. Check out BOE kit
2. Wear full PPE
3. Patients do not need
   glasses or bib
4. Doctor’s chair facing
   chair with no wheels for
   parent & patient
5. Place overhead light
   within reach over chairs

Question 4

FOR AXIUM:
o On the computer:

Answer 4

o Add “Oral evaluation <3 years”
o Do start check
o Get height and weight if child is
cooperative, otherwise ask parent for
child’s approximate height and weight
o Add Pedo Forms
o Only fill out applicable forms!

Question 5

WHEN YOUR PATIENT ARRIVES:
(4)

Answer 5

 Encourage only one parent in the cubicle
with you, there is a pedo waiting room
close by for all other accompanying adults
 Obtain child’s height and weight if able or
ask parent for approximate height and
weight
 Let child sit comfortably with parent
while obtaining medical history,
medications, etc.
 Complete appropriate forms for child’s
age and fill out all questions you can prior
to a clinical/visual exam

Question 6

INFORM THE PARENT BEFORE YOU START!
(5)

Answer 6

 Sit with your knees touching
parent’s knees
 Position the light over your lap
 Ask parent to hold their child
facing them (bear hug) and
straddle their child’s legs
around their waist/hips.
 When ask to lean the child back,
ask parent to hold their child’s
hands.
 Child may cry for a short while
and that it is okay (When a child
cries, their mouth is open!)

Question 7

WHEN YOU ARE READY:

Answer 7

ASK A PEDO FACULTY TO
COME WATCH YOU
COMPLETE YOUR EXAM!

Question 8

WHAT YOU’RE LOOKING FOR:
(5)

Answer 8

 Number of teeth present
 Obvious caries
 Soft tissue abnormalities
 Plaque
 Habits

Question 9

AFTER THE EXAM:
(7)

Answer 9

 Give parent child’s home care
kit and “big” toy
 Discuss findings and
recommendations
 Answer parent questions or
concerns
 Complete all necessary forms
before dismissing your patient
 Document everything that
you discuss with the parents
 Reappoint patient for
appropriate recall (6-12
months)
 Give appropriate referral if
needed

Question 10

ERUPTION :
(INFORM PARENTS OF WHAT THEY SHOULD EXPECT)
(4)

Answer 10

 Primary Teeth
 20 in number (A-T)
 Erupt from 6 to 30 months
 Begin formation in utero
 as well as the 1st permanent molar

Question 11

ERUPTION :
 Pattern:
(5)

Answer 11

 Mandibular centrals & laterals (n,o,p,q)
 Maxillary centrals & laterals (d,e,f,g)
 1st primary molars (b,i,l,s)
 Canines (c,h,m,r)
 2nd primary molars (a,j,k,t)

Question 12

Brushing & flossing the child’s teeth:

Answer 12

 Twice a day with a toothbrush or damp
washcloth

Question 13

 Toothpaste use:
o 6-36 months –
o 3 y and above –

Answer 13

only a smear of fluoride
toothpaste on toothbrush or washcloth
“pea” size amount of
toothpaste on the toothbrush with adult
supervision

Question 14

Replace toothbrush

Answer 14

every few months
or when the bristles start flaring

Question 15

Floss every day
(2)

Answer 15

 cleans between teeth where a toothbrush
can’t reach
 not necessary if there are spaces between
teeth

Question 16

No bottle/breast feeding at
bedtime and/or throughout the
night
(3)

Answer 16

 This can lead to baby bottle
tooth decay (shown below)
 Primarily seen on maxillary
anterior teeth
 Suggest water instead of milk or
juices

Question 17

Reduce snacking in between meals

Answer 17

o Crackers are especially cariogenic!

Question 18

Avoiding sugared drinks, candy, and sticky snacks throughout the day
(3)

Answer 18

o Do not put sugared drinks in bottles or sippy cups
o Dilute juice drinks
o Suggest that parents limit the consumption of sugary drinks to meal
times

Question 19

Fluoride Varnish Application
(2)

Answer 19

o Can apply fluoride varnish if child is cooperative
o If incipient lesions are found

Question 20

Discuss:
(4)

Answer 20

o Proper Fl amounts
o Dietary sources of Fl for infants and children
o Water fluoridation
o Mechanical action of Fluoride

Question 21

FLUORIDE CHART

Answer 21

• Graph to use when deciding if an ingestible fluoride supplement
  needed (oral and systemic – not topical)

Question 22

CLINICAL COMPETENCY
(4)

Answer 22

 Two previous experiences in
our clinic needed before
challenging competency
 Competency may be
challenged either D3 or D4
Year