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
dont 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

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 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, (50
th
)
15 kg, (50
th
)
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 Is
Primary Ms
Overjet
VERTICAL RELATION
Facial type
Overbite
SPACING


Class I
Flush terminal
2mm


Mesiofacial
3mm
Primate spaces


E D C B A A B C D E

E D C B A A B C D E
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
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 parents
compliance
Review 3/12
BW,
OH and Diet monitoring,
Topical Fluoride application
Monitor growth changes