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Examination and TTT Plan

This document discusses the process of examining a pediatric patient and developing a treatment plan. It begins by outlining the importance of obtaining relevant patient and family information, parental consent, and performing a complete examination. It then discusses establishing a dental home for the patient, obtaining a preliminary medical and dental history, and conducting a clinical examination including dental caries assessment. Finally, it covers principles of treatment planning such as developing an anticipatory guidance plan, determining an appropriate recall schedule, and using caries assessment tools to evaluate disease risk.

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Anoos rabayarabaya
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329 views74 pages

Examination and TTT Plan

This document discusses the process of examining a pediatric patient and developing a treatment plan. It begins by outlining the importance of obtaining relevant patient and family information, parental consent, and performing a complete examination. It then discusses establishing a dental home for the patient, obtaining a preliminary medical and dental history, and conducting a clinical examination including dental caries assessment. Finally, it covers principles of treatment planning such as developing an anticipatory guidance plan, determining an appropriate recall schedule, and using caries assessment tools to evaluate disease risk.

Uploaded by

Anoos rabayarabaya
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Examination

&
Treatment Plan
(Part 1)
Dr.Lama M. Al-Sabe’
BA, M.Sc Paed Dent
Introduction
⚫ Traditionally, dentist should intially perform a complete
oral examination of the patient (ptn) and to develop a
treatment plan from the examination findings.
⚫ Then the dentist makes a case presentation to the ptn or
parents, outlining the recommended course of treatment.
⚫ This process should include the development and
presentation of a prevention plan and establishment of the “
dental home”.
Introduction
⚫ Before establishing a comprehensive oral health care
program for the pediatric ptn, it is essential to:
⚫ Obtain all relevant ptn and family information.
⚫ Secure parental consent.
⚫ Perform a complete examination.
The Dental Home
⚫ The dental home is the ongoing relationship between the
dentist and the ptn, inclusive of all aspects of oral health
care delivered in a comprehensive, continuously accessible,
coordinated, and family-centered way.
⚫ Establishment of a dental home begins no later than 12 ms
of age and includes referral to dental specialists when
appropriate.
Initial Parental Contact
⚫ Parents usually make the first contact with the dental office
by telephone.
⚫ This initial conversation between the parent and the office
receptionist is very important;
⚫ It provides the first opportunity to attend to the parent's
concerns.
⚫ The receptionist's responses should assure the parent that the
well-being of the child is the chief concern.
⚫ The information recorded by the receptionist during this
conversation constitutes the initial dental record for the patient.
Diagnostic Aids
Preliminary Medical and Dental
History
⚫ Before the dentist examines the child, the dental
assistant can obtain sufficient information to provide the
dentist with knowledge of the child's general health and
can alert the dentist to the need for obtaining additional
information from the parent or the child's physician.
Preliminary Medical and Dental
History
⚫ Information regarding the child's social and psychologic
development is important.
⚫ Accurate information reflecting a child's learning,
behavioral, or communication problems is sometimes
difficult to obtain initially, especially if the parents are aware of
their child's developmental disorder but are reluctant to discuss it.

⚫ Behavior problems in the dental office are often related to


the child's inability to communicate with the dentist and to
follow instructions.
Preliminary Medical and Dental
History
⚫ This inability may be attributable to a learning disorder.
⚫ An indication of learning disorders can usually be obtained
by the dental assistant while asking questions about the
child's learning process;
⚫ e.g. asking a young school-aged child how he or she is doing
in school is a good lead question.

⚫ Remember, though, to keep the questions age-appropriate


to the child.
Thank You

Any Question ???


Examination
&
Treatment Plan
(Part 2)
Dr.Lama M. Al-Sabe’
BA, M.Sc Paed Dent
Clinical Examination
Clinical Examination
⚫ The first examination is recommended at the time of
the eruption of the first tooth and no later than 12 ms
of age.
--+
Ringworm

Impetigo
• Any unusual breath odors and abnormal quantity or
consistency of saliva should also be noted.
Loe & Silness Plaque Index
Primary Molar Relationship

Flush terminal Mesial step Distal step


Thank You

Any Question ???


Examination
&
Treatment Plan
Part 3
Dr.Lama M. Al-Sabe’
BA, M.Sc Paed Dent
Primary Molar Relationship

Flush terminal Mesial step Distal step


⚫ Leeway space is the size differential between the primary posterior
teeth (canine, first and second molars labeled C, D and E in the picture),
and the permanent canine and first and second premolar (labeled 3, 4
and 5).
⚫ Usually the sum of the primary tooth widths is greater than that of their
permanent successors.
Leeway Space of Nance
⚫ Described by Nance in 1947.
⚫ Maxilla: 0.9 mm / segment = 1.8 mm
⚫ Mandible: 1.7 mm / segment = 3.4 mm
Angle’s Classification
Transverse Relationship
Midline discrepancy:
⚫ The upper midline is evaluated to the facial midline during
the facial evaluation.
⚫ This helps determine where the midline of the mand teeth
is relative to the face when it is compared the upper dental
midline.
Transverse Relationship
⚫ Posterior crossbite
Overbite & Overjet
Definition of canine eminence
⚫ : a prominence on the surface
of the superior maxillary bone
caused by the socket of the
canine tooth
Thank You

Any Question ???


Examination
&
Treatment Plan
Part 4
Dr.Lama M. Al-Sabe’
BA, M.Sc Paed Dent
Principles of Treatment
Planning
Anticipatory Guidance
•The plan should include recommendations designed to:
•Correct existing oral problems (or stop their progression).
•Prevent anticipated future problems.

•Anticipatory Guidance is the term often used to describe the


discussion and implementation of such a plan with the ptn
&/or parents..
Cont… Treatment plan
Recall
• Treatment Planning does not end with the completion of
one treatment journey.
• Determination of a recall schedule tailored to the needs of
the individual child is an essential part of the
treatment-planning process.
• In general, children receive dental assessment more
frequently than adults because:
• There is evidence that the rate of progression of dental
caries can be more rapid in children than in adults.
• The rate of progression of caries and erosive tooth wear is
faster in primary than in permanent teeth.
• Periodic assessment of orofacial growth and the developing
occlusion is required.
Cont…Recall
⚫ The exact recall interval should meet and vary with the
child’s needs.
⚫ This requires an assessment of disease levels as well as
risk of/from dental disease.
Caries Assessment Tool (CAT)
Thank You

Any Question ???

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