Chapter 50

The Pediatric Patient

 Learning Objectives

1. Describe the specialty of pediatric dentistry.

2. Discuss the use of a caries risk assessment tool to
identify an individual patient’s risk and preventive factors.
3. Identify age-appropriate anticipatory guidance/
counseling factors to educate parents/caregivers of
toddlers, schoo laged children, and adolescents.
4. Identify age and caries risk level appropriate preventive
and therapeutic oral healthcare interventions for
children.
5. Discuss oral health home care needs, adjunct aids, and
continuing care recommendations for children.
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 Pediatric Dentistry

I. The Specialty of Pediatric Dentistry

II. The American Academy of Pediatric Dentistry
(AAPD)

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 The Child as a Patient

I. The Dental Home

II. Barriers to Dental Care
III. Child Dental Visits

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 Patient Management Considerations

I. Toddlers (1–2 Years of Age)

II. Preschoolers (3–5 Years of Age)
III. School Age Children (6–11 Years of Age
IV. Adolescents (12–18 Years of Age)

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 Components of The Dental Hygiene Visit

I. Initial Interview/New Patient Visit

II. Child and Family Medical/Dental History
III. Intra- and Extra-Oral Examination
IV. Developing Dentition, Occlusion, and TMJ
V. Radiographic Assessment

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 Components of The Dental
Hygiene Visit con’t

VI. Dietary Assessment

VII.Oral Prophylaxis
VIII.Prevention

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 Periodontal Risk Assessment

I. Gingival and Periodontal Evaluation

II. Periodontal Infections

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 Caries-risk Assessment

I. Purpose
II. Principles
III. Steps
IV. Classification of Caries Risk
V. Early Childhood Caries (ECC)

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FIGURE 50-4 Visualize the Caries Balance

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FIGURE 50-5 Progression of ECC

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FIGURE 50-6 White-Spot Lesions

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FIGURE 50-7 Cavitation of White Lesion
Areas

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 Anticipatory Guidance

I. Dietary and Feeding Pattern Recommendations

II. Oral Health Considerations for
Toddlers/Preschoolers
III. Speech and Language Development
IV. Digit Habits
V. Accident and Injury Prevention

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 Anticipatory Guidance Con‘t

VI. Oral Malodor

VII. Oral Health Considerations for
Adolescents
VIII. Tobacco/Piercings/Substance Abuse
IX. Referral

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FIGURE 50–8 Dentifrice for a Child

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FIGURE 50-9 Effects of Prolonged Thumb
Sucking on Teeth

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 Treatment Planning and Consent

• DH diagnosis to develop care plan

• Discuss
• Inform
• Signed consent
• Medical clearance
• Parent approval

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 Documentation

• Overall appraisal of physical status and key

health history findings.
• Existing pathology: soft tissue, gingiva, caries,
occlusal status.
• Oral hygiene status and caries-risk assessment.

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 Factors to Teach the Patient

• Parent’s health affect child’s

• Bacteria transferral
• Fluoride benefits
• Methods for prevention
• Parent examination
• Rationale for maintenance
• Preparation for dental visits

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