Pedo 4 3y1z4n

Emergency care, relief of pain  Preventive care  Surgical treatment  Restorative treatment  Orthodontic treatment  Extensive restorative, further surgical  management Recall and review 

Collect general observations:  Child/parent interactions, behavior Address reason for presenting FIRST  Start with history:  Medical, dental, family, social Record past dental care 

Conduct head and neck exam  Perform a complete oral examination  Use a thorough and detailed form  Establish a provisional diagnosis  Obtain any additional tests:  Radiographs, study models, medical consults, etc..

Finalize diagnosis and treatment plsn  Present case to patient/parents  Outline recommended treatment plan  Involve parents in planning  Secure parental consent 

Treat existing problems  Prevent progression of existing problems  Prevent anticipated future problems  Plan periodic exams, preventive care  and treatment

Consider behavior (eg. Desensitizing  app/procedure, modeling) Involve parent in treatment choices, but  don’t be dictated to! Incorporate prevention 

Plan efficient use of LA  (QUADRANT THERAPY) Treat comprehensively with definitive  treatment, not patchwork Consider full coverage if using GA 

Establish a follow up/review/recall plan  based on established criteria (eg. AAPD) Make referrals in writing and expect a  written report back

First visit: Examination, Diagnosis and treatment planning, Prophylaxis, OHI, dietary advice Second visit: Quadrant 1 Third visit: Quadrant 2 Fourth visit: Quadrant 3 Fifth visit: Quadrant 4, Fluoride application

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Review and recall  SPACE MANAGEMENT IF EXTRACTION IS DONE

Initials  DOB  Initial exam  Age at exam  Parents  Marital status  Siblings  Residence 

NH  13/11/1999  23/05/2003  3 ½ years  AO, AH  Married  No siblings  Melbourne 

CVS  Endocrine  GIT  Bleeding  UGS  Respiratory  CNS  Allergies  Past surgery  Immunization up to date 

NORMAL

Birth  Speech  Locomotion  Weight  Height 

Full term, Normal  delivery Normal  Normal  100.8 cm, (50th)  15 kg, (50th) 

Recently moved from Eritrea  Non-English speaking family  Single child  Goes to Kinder  Good social development  Bottle-feeding at night 

Past dental history  First dental visit Referral  Referred from North Yarra community health services for management of dental caries

Spontaneous pain in upper anterior  teeth Pain disturbing sleep  Pain interfering with eating 

Use of systemic F  Water Fluoridation Use of topical F  Fluoridated toothpaste

Facial symmetry  Eyes  Skin colour  Nails  Hair  TMJ  Lymph nodes 

Symmetrical Brown Dark complexion Normal Normal Normal Normal

SOFT TISSUES Gingiva  Alveolar mucosa  Palate  Buccal mucosa  Tongue  Sublingual area  Soft palate  Oropharynx 

NORMAL

Periodontal  tissues Oral hygiene 

Normal  Fair 

HARD TISSUES Primary dentition stage  Extensive dental caries  Hypoplastic upper and lower central  incisors

SOFT TISSUES

Facial profile  Lip line  Lip seal  Habits  TRANSVERSE RELATIONSHIP

Slightly convex Normal lip line Incompetent lips Everted lips None Normal

A-P RELATION Primary I’s  Class I Primary M’s Flush terminal 2mm Overjet  VERTICAL RELATION Facial type  Mesiofacial Overbite  3mm SPACING Primate spaces

EDCBA

ABCDE

EDCBA

ABCDE

EARLY CHILDHOOD CARIES Behaviour Frankle ( - )

PREVENTIVE PHASE Oral hygiene instructions  Dietary counselling  Dental prophylaxis  Topical fluoride application  Antimicrobial therapy (CHX)  RESTORATIVE PHASE Under GA 

Oral hygiene instructions, Dietary advice,  Prophylaxis, Fluoride application Quadrant 1: Exo 51,52buccal, 54 MOD, 55  occlusal Review OH and diet changes Quadrant 2: Exo 61, 64 MOD, 65 occlusal  Quadrant 3: 74 MOD, 75 occlusal  Quadrant 4: 84 DO, 85 occlusal  Review 3/12 for Fluoride application, OHI  and monitoring

Oral hygiene instructions  ( Brushing and Flossing) Diet analysis  Parent education regarding feeding  habits

Pre-operative Rt & Lt BW Prophylaxis 52 Buccal- GIC 54 MOD- Formocresol pulpotomy, IRM, SSC, Ketac cement 55 Occlusal- vitrebond liner, GIC base, Amalgam restoration

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84 DO- vitrebond liner, GIC,  SSC, Ketac cement 85 Occlusal- vitrebond liner,  GIC, SSC, Ketac cement

64 MOD-vitrebond liner,  GIC, SSC, Ketac cement 65 Occlusal- vitrebond  liner, Amalgam restoration

74 MOD- vitrebond liner,  GIC, SSC, Ketac cement 75 Occlusal- Formocresol  pulpotomy, IRM, SSC, Ketac cement

Extraction of 51, 61  Duraphat application  Post-operative Rt & Lt BW. 

Good oral hygiene  Diet modified  Improved feeding and sleeping  Overall improvement in the quality of life  Prescribed CHX Gel 

Very good prognosis  Excellent patient and parent’s  compliance

Review 3/12 BW,  OH and Diet monitoring,  Topical Fluoride application  Monitor growth changes 