Module 8 Exam 2 Flashcards
When is the best time to schedule pediatric patients
in the morning or after naps
When should a child first be seen by the dentist
by 6 months or after the the eruption of the first primary tooth by no later than age 1
What does anticipatory guidance in oral health counseling do
helps parents learn what to expect of a child during the current and next developmental stage
Review tables on pg 756-757
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What are some barriers to care in ped patients
- lack of knowledge about prevention
- language
- cost
- fear
- no dental home
- dentist doesnt see under age of 3
- hours dont match up
- transportation
- dentist doesnt accept ins
What are the things that should be discussed in an interview of the parents of a pediatric patient
- family configuration
- prenatal and perinatal history
- medical history of the child
- dental history of parents and children
- feeding patterns infant, toddler and preschool
- fluoride exposure
what are some things that should be discussed in the family configuration?
- socioeconomic status, education level of parents
- number of people in house, caregivers
what some some things that should be discussed about the prenatal and perinatal history
- history of diseases
- record or freq. of visits
- prenatal care for mother
- problems with pregnancy or deliver
- drugs, alcohol, tobacco use during preg.
what are some things that should be discussed about the medical history of the child?
- fam. history of disease/infection
- allergies
- hospitalizations/surgery
- ear infections
- fever
- current meds
What are some things that should be discussed in the dental history of the parents and children
- parents OH habits
- teething problems of child
- deep pits and fissures
- caries and perio experience of family
what are some thingd discussed in the interveiw about the feeding patterns of an infant (birth to 1 year)
- bottle
- fluoride content of water
- fequency, method of feeding
- problems with feeding or sleeping
- pacifier, thumb sucking, finger sucking
- liquids in bottle or sippy cup
- age others in family were weaned
what are things that should be discussed in the interview about feeding patterns of toddlers (1-3 years) and preschool children (3-5 years)
- snacks per day and time period
- types of snacks
- amt of juice or sweet drinks per day
- use of bottle sippy cup
- availability of snack without supervision
- problems with eating
- special diet prescribed
what things should be discussed in the interview about fluoride
- history of exposure
- fluoride level in water supply
- well water
- type of toothpaste, amt, frequency
- use of fl2 supplements
how should you position for access in an infant oral exam
- seat parent knee to knee
- place childs head on lap of examiner
what is the exam sequence in an infant oral exam?
-examine for signs of abuse
-parent control childs extremities
-observe condition of anterior teeth
- look for biofilm, discoloration, malformation, caries
-
how should you prepare a toddler for a dental visit
- make visit pleasant
- children told dentist and hygienist take good care of teeth
- dont use negative words such as hurt or pain
- when child isnt present, ask if they have any fears
how should you position the toddler in the dental chair
-they are able to sit, position headrest if needed
how do you have the parents involved in the planning assessment and treatement
- ask parents to provide a statement of childs temperment and ability to cooperate
- determine expected dev. milestones of child
how do you evaluate if parents need to accompany the child
- have parents offer non verbal reassurance
- at first visit parent usually accompanies
What characteristics does healthy gingiva of the primary dentition have
- pink, slightly/red
- tissue appearance is thick, rounded or rolled, and shiny
- tissue isn’t tight to teeth, less fibrous
- interdental papilla are flat and saddle shaped
what does unhealthy gingiva of primary dentition have
swelling, redness, and bleeding on brushing or debriding
how should the hygienist evaluate anterior teeth?
- look for white spot leisons, demineralization along cervical areas and proximal areas
- observe discolored leisons, caries
What should the hygienist evaluate for in posterior teeth
- pits and fissures of primary molars
- dark discolorations in pits and fissures
- look for open dental carious leisons
what should you evaluate for in occlusion of primary teeth
- lack of spacing
- malposed, crowded or congenitally missing teeth
- tooth eruption delays
- discrepancies in size of mouth and teeth
- early loss of primary molars
When should you refer a child related to occlusion
- severly crowded, missing or malposed teeth
- overbite, overjet, crossbite
What are indications of radiographic exposures of primary dentition
- primary molars close together and interfere with visualization and exploration
- trauma
- suspected pathology
- problems with growth and development
what film size should be used on a child
size 1, one film on each side
What are risk factors for gingivitis
visible biofilm, mouth breathing, crowded teeth
What is the purpose of oral prophylaxis in a child
- remove biofilm, stain and calc
- educate parents and children on proper biofilm control
- teach parents how to examine their childs mouth
what kinds of oral prophylaxis is best for kids under 3
usually only require a wet toothbrush
What kind of fluoride is recommended for children under the age of 6
fluoride varnish only, reduces inadvertent ingestion
What age should fluoride be started who are at a moderate to high risk of caries
1 year old
What do pacificers decrease the risk of
SIDS
what are normal sucking
sucking on fingers, thumb or pacifiers is normal and acceptable behavior
at what age should you introduce a pacifier
after 1 month old
what shouldn’t you do with a dirty pacifier
-shouldnt be cleaned in the parent/caregivers mouth since caries producing bacteria can be transferred
how should you clean a pacifier
in warm soapy water or sterilize
What are 4 important things to know about a bottle
- only formula or milk in the bottle
- dont place child in bed with bottle
- no juice or sweet liquids in bottle
- dont use bottle as pacificer
what shouldn’t you allow with breast feeding
prolonged, at will feeding after teeth erupt
What happens when an infant falls asleep after sucking
milk collects around teeth and causes demineralization
What are teething behaviors
- excessive chewing and drooling
- irritability
- chang in appetite
- interrupted sleep patterns
- crying
What are palliative measures for teething
chewing on objects (cold wash cloth, teething ring, rub gums with finger)
are otc numbing solutions recommended for teething?
no, may numb entire oral cavity and if swallowed suppress the gag reflex
What are some other names for early childhood caries
nursing caries, baby bottle caries, rampant caries
What kind of bacteria in high levels in saliva and biofilm are indicators of ECC
high levels of mutans streptococi, and high levels of lactobaccilli in biofilm
What is early childhood caries
-one or more decayed missing of frilled tooth surfaces in any primary tooth
what is severe early childhood caries
smooth surface caries in children younger than 3
What are predisposing factors for ECC
- sippy cup in bed
- bottle has sweetened milk or sweet fluid
- prolonged at will feeding
- ineffective or no daily biofilm removal
What teeth are the first to be effected in ECC
max. anterior teeth and primary molars
why are the mandibular anterior teeth rarely effected in ECC
the nipple covers them
What are things to look for in the start of ECC
- demineralization at cervical area
- later stage presents with brown or dark brown spots
- teach parents to look for these
when teeth erupt how often and how much tooth paste are they brushed with
2 times a day with a smear of toothpaste
at what age is the greatest incidence to primary dentition
at 2 to 3 years of age
What is important for an child in brushing and flossing
- established routine
- gain cooperation
- parental supervision
What will help establish a routine in brushing and flossing
-in the morning after breakfast and before bedtime, specify most critical time is before bedtime
how can you gain cooperation in brushing a childs teeth
- make it fun
- connect it with w fun activity like brushing teeth and then reading a story
- disclosing agent
what should parents supervise in helping their children with biofilm removal
- keep toothpaste out of reach
- assist with brushing and flossing
true or false, childrens toothpaste contains the same amount of fluoride as adult toothpaste
true
what can cause dental fluorosis in children
when they swallow large amounts of toothpaste
when is the use of fluoride toothpaste that causes mild fluorosis most pronounced
at 24 months
How much toothpaste should children under 2 years of age with a moderate or high caries risk use
a small smear
how much toothpaste should a child age 2-5 used
a small pea sized amount spread the length of toothpaste head
when is the most critical time for fluorosis to develop in primary teeth
during the middle to first year of life
What should alert the hygienist to the possibility of fluorosis of the permanent incisors
identification of primary fluorosis
when are esthetically significant permanent teeth most suceptible to fluorosis
the first 1-3 years of life
what are causes of oral malodor in children
- bacteria at base of tongue
- bacteria between tongue
- postnasal drip
what are dietary and feeding pattern recommendations for children
small, healthy meals during the day
what should juice intake in children be limited to
4-6 ounces per day for children 1-6 years
what is associated with narrow maxillary arch width, anterior open bite, posterior cross bite, in creased overjet and decreased overbite
prolonged thumb and finger sucking
at what age should finger or thumb sucking be stopped
by 3 years old
how should thumb or finger sucking be stopped
with positive reinforcement, reminders
