Lap to Lap Exam Procedure for Infants

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Questions and Answers

What is the primary indication for using SDF?

Patients without any access to dental care

High caries risk patients with active cavitated lesions (correct)

Patients with completely healthy teeth

Patients with pulp exposure due to cavities

Which of the following is a contraindication for SDF application?

Active cavitated lesions without pulp involvement

Multiple cavitated lesions

Difficulty in accessing dental care

Allergy to silver (correct)

What should be done before applying SDF to minimize potential irritation?

Isolate the affected area with a cotton roll (correct)

Apply a dental anesthetic

Remove all dental materials

Ensure that no staining occurs

How long should the area be isolated after SDF application to minimize systemic absorption?

3 minutes Signup and view all the answers

What should parents be made aware of regarding the appearance of the tooth after SDF treatment?

The tooth will become black due to decay within a week Signup and view all the answers

What is a possible adverse event that can result from SDF treatment?

Mucosal irritation from contact Signup and view all the answers

What is the recommended time frame for a second application of SDF after the first?

2-4 weeks Signup and view all the answers

What is one of the benefits of SDF regarding its effect on bond strength?

It has no adverse effect on bond strength Signup and view all the answers

What role do dentists play in addition to oral health?

Checking developmental milestones for potential delays Signup and view all the answers

When is the first dental exam for children recommended?

No later than 12 months old Signup and view all the answers

What is the relationship between caries in primary teeth and permanent teeth?

Primary caries predict future permanent caries Signup and view all the answers

Which factor is NOT taken into account in caries risk assessment models?

Historical dental records Signup and view all the answers

What is the maximum recommended amount of toothpaste for children under the age of 3?

A smear or rice-sized amount Signup and view all the answers

What is the maximum recommended amount of fruit juice for children up to age 6?

2-4 oz Signup and view all the answers

Why is it important for dental professionals to recognize signs of child abuse?

To fulfill legal reporting requirements Signup and view all the answers

When assessing caries risk, which psychological aspect is typically NOT considered?

Biological predisposition to dental issues Signup and view all the answers

What is the condition defined as having one or more decayed, missing, or filled surfaces in primary teeth for children under age 6?

Early Childhood Caries Signup and view all the answers

Which factor is most directly correlated with the vertical transmission of mutans streptococci (MS) to infants?

Caregiver's MS salivary levels Signup and view all the answers

What is a common dietary practice associated with an increased risk of Early Childhood Caries?

Frequent nighttime bottle feeding with juice Signup and view all the answers

What is the recommended maximum amount of fruit juice for children under 6 years old?

No fruit juice allowed Signup and view all the answers

Which of the following is NOT a consequence of Early Childhood Caries?

Improved oral health-related quality of life Signup and view all the answers

Which treatment option involves the usage of a desensitizing agent containing silver and fluoride?

Silver diamine fluoride (SDF) Signup and view all the answers

What is the primary reason for the high rates of early childhood caries in low-income children in the US?

Access to dental care Signup and view all the answers

At what age does severe Early Childhood Caries (S-ECC) become a concern, according to the diagnostic criteria?

Under 3 years old Signup and view all the answers

What clinical examination method is primarily used to diagnose Early Childhood Caries?

Visual examination Signup and view all the answers

What is a characteristic of mutans streptococci (MS) colonization in infants?

It can start from birth. Signup and view all the answers

What is one of the primary goals of treating Early Childhood Caries?

Return oral cavity to health Signup and view all the answers

What percent of cavitated lesions demonstrated arrested caries lesions 2 years after SDF application?

81% Signup and view all the answers

What type of recommendation is provided for the use of SDF in treating cavitated lesions in primary teeth?

Strong recommendation, moderate quality evidence Signup and view all the answers

What is the weight/volume percentage of silver and fluoride in SDF?

5-6; 33-36 Signup and view all the answers

What part of skin does SDF not penetrate, making pigmentation temporary?

Epidermis Signup and view all the answers

After how many days does skin pigmentation induced by SDF typically resolve?

14 days Signup and view all the answers

What consideration is important when choosing restorative treatments for children?

Patient compliance and oral hygiene Signup and view all the answers

What is the main focus of educating parents and patients in managing Early Childhood Caries?

Promoting good oral hygiene and diet Signup and view all the answers

What is the primary purpose of the lap to lap exam for infants?

To secure the infant's head and limbs for a smooth examination Signup and view all the answers

When should a parent start brushing their child's teeth?

As soon as the first tooth erupts Signup and view all the answers

What is the recommended fluoride concentration in community water systems as of 2015?

0.7ppm Signup and view all the answers

What is a common recommendation for preventing early childhood caries (ECC)?

Limit nighttime feeding with cow's milk Signup and view all the answers

Which of the following behaviors is NOT recommended regarding bottle and sippy cup usage?

Allow the child to use a bottle throughout the day Signup and view all the answers

What should be used to apply fluoride for children under 2 years old?

A smear of fluoride toothpaste Signup and view all the answers

Why should parents avoid licking pacifiers clean?

It increases the risk of vertical transmission of mutans streptococci Signup and view all the answers

At what age is it recommended for children to stop using a pacifier to prevent skeletal changes?

By age 3 Signup and view all the answers

Which of the following is a sign of teething in infants?

Low-grade fever and irritability Signup and view all the answers

What should parents be counseled about regarding their child's diet?

Limiting sugary snacks and drinks Signup and view all the answers

What is NOT a key topic for parental counseling during infant dental visits?

Sports physicals Signup and view all the answers

How often should infants be evaluated for their oral health?

Every 6 months Signup and view all the answers

Which of the following practices can increase the risk of caries in children?

Frequent drinking of milk in a bottle between meals Signup and view all the answers

What is the recommended fluoride supplement for children aged 6 months to 3 years?

0.25mg Signup and view all the answers

Study Notes

Lap to Lap Exam

It's normal for infants to cry and be uncooperative during dental exams; parents should be prepared.
Hold the child in a hugging position, laying them back in the parent's lap.
The parent secures the child's arms and legs while the clinician secures the head.
Complete dental exams, prophylaxis, and fluoride application quickly, ideally under 5 minutes.
Use a toothbrush to help open the mouth and serve as a bite block.
Educate parents on proper brushing and flossing techniques during the exam.

Parental Counseling Topics

Discuss essential topics such as oral hygiene, diet, habits, transmission of Mutans streptococci (MS), and fluoride.

Anticipatory Guidance Topics

Provide information on the eruption sequence of teeth, trauma prevention, future dental visits, and changes in oral hygiene, diet, and habits.

Oral Hygiene Counseling

Begin brushing as soon as the first tooth erupts, using a soft toothbrush.
Brush twice daily and floss when contacts are closed.
Recommended patient positioning: Brush from behind the child for stability, using the lap-to-lap technique, or have the child stand/sit for older children.

Diet Counseling

Breast milk is preferable to cow's milk; nighttime cow's milk feeding is linked to increased caries risk.
Limit sugary foods and beverages; no more than 4 oz of juice daily.
Introduce sugar in children’s diets only after age 2 and provide water in between meals.

Oral Habit Counseling

Discourage prolonged use of bottles/sippy cups due to caries risk; aim to stop as soon as possible.
Discuss stopping digit-sucking and pacifier habits by age 3 to avoid skeletal changes.

MS Transmission Counseling

Educate on vertical transmission of MS; avoid sharing utensils and saliva.
Discuss caregiver factors influencing bacterial levels and transmission risks.

Fluoride Counseling

Assess fluoride intake from various sources such as tap water, formula, and toothpaste.
Community fluoridation is a cost-effective method to reduce caries risk.
Recommend fluoride supplements for specific age groups with caution, considering factors like ongoing dental development.

Eruption Sequence

Discuss upcoming tooth eruptions and associated discomfort; recommend supportive measures like pain relief or teething rings.
Warn against topical anesthetics due to safety concerns.

Trauma Prevention

Discuss potential hazards related to falls, play objects, electric cords, and car seat safety.

Future Dental Visits

Emphasize the importance of dental check-ups every 6 months.
Children may be uncooperative until around 3-4 years of age.

Caries Risk Assessment

Conduct on all patients to create preventative and restorative care plans.
Note trends associating increased caries risk in early school age and adolescence.

Early Childhood Caries (ECC)

Defined as the presence of decay in primary teeth for children under 6 years.
Severe ECC (S-ECC) includes caries in children younger than 3 and cavitated lesions in maxillary anterior teeth ages 3-5.

ECC Statistics and Etiology

High prevalence in low-income preschoolers, often untreated in children under 3.
Caused by a mix of bacterial, dietary, and behavioral factors.

MS Colonization

Can begin at birth, with levels increasing post-eruption; associated with practices like saliva sharing.

Dietary Influence on ECC

Notable factors include nighttime bottle feeding and sugary snacks between meals.

Diagnosis and Treatment of ECC

Diagnosis primarily through visual examination; radiographs may be used for extent assessment.
Treatment options range from interim restorations to silver diamine fluoride (SDF) application.
General anesthesia may be necessary for extensive treatments or difficult cases.

Silver Diamine Fluoride (SDF)

SDF is a desensitizing agent that can arrest caries; consists of silver and fluoride at specific concentrations.
Application requires careful preparation and informed consent due to potential discoloration.

Treatment Goals in ECC

Stabilize dental disease, maintain oral health, educate parents and children about good oral hygiene and diet.

Additional Notes

Dentists have broader roles in dietary counseling and developmental monitoring.
A smear of fluoride toothpaste is appropriate for children under age 2, and maximum juice intake for children is 4 oz per day.

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Description

This quiz covers the procedure for performing a Lap to Lap exam on infants. It includes instructions for parents and guidelines for securing the child while conducting the exam efficiently. Test your knowledge on the steps involved and the recommended techniques for this procedure.