clinic theory III pediatric radiographic techniques and infant to adolesent

radiographic needs

• medical/dental history and clinical findings

• explain radiographs for accurate diagnosis

• only necessary images exposed

• see the entire tooth : “inside”, root, bone

• address safety concerns with speed, digital lower exposure, or type of radiograph (periapical vs panoramic)

frequency of radiographs

• radiographs not taken routinely: age? number of images? caries risk?

• review previous radiographs (or obtain if possible)

• ALARA guidelines

• adjustment of brightness, contracts, and negative/positive image

• magnification use

• digital/phosphor plates/films

radiographs necessary/ types

• bitewing: horizontal vs vertical, extraoral BWX /w panoramic

• periapical or occlusal

• panoramic: primary eruption patterns, permanent: 3rd molars

• cephalometric: for extractions and orthodontics

• positioning

• aids: hemostats, snap a ray

• appropriate size sensor (0 or 1)

patient management/ compliance

• for diagnostic quality:

• parent holding

• desensitization techniques

  • letting them feel, allowing for autonomy, putting in in their mouth their selves

  • “tell, show, do” with child friendly terms

• allow to touch

• use mirror

• distraction

lead apron

• heavy space blanket

• super hero cape

x ray machine

• tooth camera

  • giant flashlight

sensor

• electric tooth picture

  • special tooth cracker

taking image

• im going to take a picture of your tooths roots (the part that hides under your gums like a tree)

interprofessional education

• is when students from two or more profession and learn about, from, and with each other to enable effective collaboration and improve health outcomes

interprofessional collaborative practice

• occurs when multiple health workers form different professional backgrounds work together with patients, families, and communities to deliver the highest quality of care

early childhood caries

• presence of one or more decayed, missing, or filled tooth surface in a primary tooth in children younger than 71 months

• caused by prolonged and repeated exposure of tooth to fermentable carbohydrates

• strive for the appointment to be fun and stress free!

infant oral care

• oral structures begin to develop in third and fourth weeks of embryonic development

• around 20-30 months, eruption of all primary teeth has occurred

• during eruption of primary teeth, infants and toddlers can become uncomfortable

• health feeding/eating habits and oral habits must be practiced

third and foruth

• oral structures begin to develop during __ and __ weeks of embryonic development

dental caries vertical bacterial transmission

• source of initial infection is through mother

• occurs through saliva

dental caries horizontal bacterial transmission

• occurs indirectly of exposure to saliva

herpetic infections symptoms

• fever, crying, oral pain, and unwillingness to eat or drink

• gingiva may appear red and painful; blisters on tongue and lips

pacifier use

• continued pacifier use after age 2 can push teeth forward, change bite, narrow the palate, and affect speech

toddler to preschool (2-6 years) oral health

• by 2 years old, a dental home should be well established

• anticipatory guidelines should include dietary habits, homecare, and growth and development

• during this age most susceptible to dental trauma

  • age appropriate injury prevention counseling

  • non nutritive oral habits should be discussed (pacifier, thumb sucking, bruxism)

stretegies to decreased indidence of early childhood caries

• using a small amount of fluoridated toothpaste inhibits decay and minimized chane of developing fluorosis when used after age 2-3

• candies and gums should be given only to children who can manage them properly

• educate children on limiting highly refined carbohydrates

• encourage child to discuss fears about oral health visits

school age (6-12) children and oral health

• as child enters primary school, primary teeth will begin to exfoliate

• obtain preventive dental services at minimum twice a year

• sports involvement

  • 31% of all orofacial injuries are related to sports

  • ensure child has properly fitted mouth guard

  • inquire about dental sealants once first permanent molars erupt

adolescent stages and oral health (13-18)

• potential high caries incidence

• traumatic injury

• periodontal disease, gingivitis, anemia (hormone changes, puberty, menses, and more freedom)

• poor nutritional habits

• esthetic appearance and desire

• orthodontic and restorative care

• exposure to tobacco, drugs, and alcohol

• social and psychologic needs

older adolescents

• 3rd molars

• vaping/nicotine/tobacco

• HPV

• energy drinks

• oral piercings

  • people with tongue piercings risk developing gaps between their front teeth as a result of playing with stud

age ranges

• infant

• toddler

• preschooler

• child

• adolescent

water and fluoride

• community water fluoridation has benefited US citizens for approximately 70 years

• public health service recommends optimal fluoride concentration of 0.7 mg/L be used in drinking water

• use of water fluoridation is cost-effective mechanisms that benefits all individuals regardless of demographic background

fluoride toxicity

• can occur if recommended doses for fluoride additives are not followed

• while most us communities have water fluoridation, there are still communities without a water fluoridation system

  • providers can recommend fluoride supplements

  • dietary fluoride supplements in the US are available only in prescription form

toical fluoride gels and varnishes

• in 2000s, fluoride varnish progressively replaced acidulated phosphate fluoride gels and foam

• APF gels with a fluoride concentration of 1.23% or 12,300 ppm benefit children and adolescents in reducing incidence of dental caries in primary and permanent teeth

• fluoride varnish is used for caries prevention in clinical setting

DMFT

• decayed, missing, filled teeth

• used for permanent dentition; expressed in total number of teeth decayed, missing, or filled in an individual

decayed teeth include (D)

• carious tooth

• filled tooth with recurrent decay

• only the roots are left

• defect filling with caries

• temporary filling

• filled tooth surface with other surface decayed

behavioral management of pediatric patients durign dental hygiene care

• during assessment phase, hygienist collects info about child health and dental history

• AAPD guidelines recommends documentation in dental record of:

  • informed consent

  • instructions and information provided to parent

  • health history, vital signs, and oral assessment

  • object observations of pediatric patients behaviors

  • time based record that includes name, route, site, time, dosage, and patient effect of administered drugs

  • adverse effects (if any) and their treatment