Pedodontics Lecture 4: Mouth Examination

Study Notes

Successful dental treatment for children requires a detailed history, clinical examination, appropriate investigations, diagnosis, and a treatment plan.
Essential to gather all relevant patient and family information and obtain informed consent prior to treatment.
The first dental examination is recommended at the eruption of the first tooth or by 12 months of age to detect and manage oral health issues early.
Accurate data collection from children is challenging due to parental involvement, behavioral differences in clinic settings, and potential inaccuracies in reports from caregivers and teachers.

Treatment planning arranges patient treatment needs to maximize overall benefit, targeting existing problems and preventing future issues.
Should include comprehensive information from parents about the child’s dental needs, anticipated treatment time, and costs.
Advantages of treatment planning include avoiding re-diagnosis at each visit, scheduling efficient appointments, and preparing necessary instruments in advance.
Plans may need adjustments based on patient cooperation, oral condition assessment, and treatment requirements.

Accurate diagnosis relies on thorough history, examination, and evaluation of patient concerns and potential underlying issues.
Immediate signs (e.g., gingival swelling linked to a carious molar) may allow for quick diagnosis, though complex cases may require postponed assessments.
Clinical examination includes assessment of general growth, health, oral hygiene, intraoral hard and soft tissues, developing occlusion, and caries risk.

History Recording: Collect comprehensive details about vital statistics, chief complaints, and present illness history.
General Examination: Includes assessing head, hair, face, neck, hands, temporomandibular joint, lymph nodes, lips, chin, and tongue.
Head and Neck Observations: Abnormalities may reveal syndromes related to oral health. Signs of conditions like head lice or ringworm should prompt referrals.
Temporomandibular Joint (TMJ) Evaluation: Assess TMJ function for abnormalities such as deviations or crepitus, which may indicate associated issues requiring treatment.

Address any abnormalities in temperature, signs of anxiety, or habits (e.g., thumb-sucking) via physical examinations of hands.
Lymph Node Evaluation: Note any tenderness or enlargement during palpation; further tests may be necessary based on findings.
Assessment of Lips and Tongue: Evaluate speech and positions of lips and tongue to gather diagnostic clues about oral functionality.

Comprehensive examination and treatment strategies are vital in pediatric dentistry to support optimal oral health and overall well-being in children.