Emergency care, relief of pain Preventive care Surgical treatment Restorative treatment Orthodontic treatment Extensive restorative, further

rther surgical management Recall and review

Collect general observations: Child/parent interactions, behavior Address reason for presenting FIRST Start with history: Medical, dental, family, social Record past dental care

Conduct head and neck exam Perform a complete oral examination Use a thorough and detailed form Establish a provisional diagnosis Obtain any additional tests: Radiographs, study models, medical consults, etc..

Finalize diagnosis and treatment plsn Present case to patient/parents Outline recommended treatment plan Involve parents in planning Secure parental consent

Treat existing problems Prevent progression of existing problems Prevent anticipated future problems Plan periodic exams, preventive care and treatment

Consider behavior (eg. Desensitizing app/procedure, modeling) Involve parent in treatment choices, but dont be dictated to! Incorporate prevention

Plan efficient use of LA (QUADRANT THERAPY) Treat comprehensively with definitive treatment, not patchwork Consider full coverage if using GA

Establish a follow up/review/recall plan based on established criteria (eg. AAPD) Make referrals in writing and expect a written report back

First visit: Examination, Diagnosis and treatment planning, Prophylaxis, OHI, dietary advice Second visit: Quadrant 1 Third visit: Quadrant 2 Fourth visit: Quadrant 3 Fifth visit: Quadrant 4, Fluoride application

Review and recall SPACE MANAGEMENT IF EXTRACTION IS DONE

Initials DOB Initial exam Age at exam Parents Marital status Siblings Residence

NH 13/11/1999 23/05/2003 3 years AO, AH Married No siblings Melbourne

CVS Endocrine GIT Bleeding UGS Respiratory CNS Allergies Past surgery Immunization up to date

NORMAL

Birth Speech Locomotion Weight Height

Full term, Normal delivery Normal Normal 100.8 cm, (50th) 15 kg, (50th)

Recently moved from Eritrea Non-English speaking family Single child Goes to Kinder Good social development Bottle-feeding at night

Past dental history First dental visit Referral Referred from North Yarra community health services for management of dental caries

Spontaneous pain in upper anterior teeth Pain disturbing sleep Pain interfering with eating

Use of systemic F Water Fluoridation Use of topical F Fluoridated toothpaste

Facial symmetry Eyes Skin colour Nails Hair TMJ Lymph nodes

Symmetrical Brown Dark complexion Normal Normal Normal Normal

SOFT TISSUES Gingiva Alveolar mucosa Palate Buccal mucosa Tongue Sublingual area Soft palate Oropharynx

NORMAL

Periodontal tissues Oral hygiene

Normal Fair

HARD TISSUES Primary dentition stage Extensive dental caries Hypoplastic upper and lower central incisors

SOFT TISSUES

Facial profile Lip line Lip seal Habits

TRANSVERSE RELATIONSHIP

Slightly convex Normal lip line Incompetent lips Everted lips None Normal

A-P RELATION Primary Is Class I Primary Ms Flush terminal 2mm Overjet VERTICAL RELATION Facial type Mesiofacial Overbite 3mm SPACING Primate spaces

EDCBA
EDCBA

ABCDE
ABCDE

EARLY CHILDHOOD CARIES Behaviour Frankle ( - )

PREVENTIVE PHASE Oral hygiene instructions Dietary counselling Dental prophylaxis Topical fluoride application Antimicrobial therapy (CHX) RESTORATIVE PHASE Under GA

Oral hygiene instructions, Dietary advice, Prophylaxis, Fluoride application Quadrant 1: Exo 51,52buccal, 54 MOD, 55 occlusal Review OH and diet changes Quadrant 2: Exo 61, 64 MOD, 65 occlusal Quadrant 3: 74 MOD, 75 occlusal Quadrant 4: 84 DO, 85 occlusal Review 3/12 for Fluoride application, OHI and monitoring

Oral hygiene instructions ( Brushing and Flossing) Diet analysis Parent education regarding feeding habits

Pre-operative Rt & Lt BW Prophylaxis 52 Buccal- GIC 54 MOD- Formocresol pulpotomy, IRM, SSC, Ketac cement 55 Occlusal- vitrebond liner, GIC base, Amalgam restoration

84 DO- vitrebond liner, GIC, SSC, Ketac cement 85 Occlusal- vitrebond liner, GIC, SSC, Ketac cement

64 MOD-vitrebond liner, GIC, SSC, Ketac cement 65 Occlusal- vitrebond liner, Amalgam restoration

74 MOD- vitrebond liner, GIC, SSC, Ketac cement 75 Occlusal- Formocresol pulpotomy, IRM, SSC, Ketac cement

Extraction of 51, 61 Duraphat application Post-operative Rt & Lt BW.

Good oral hygiene Diet modified Improved feeding and sleeping Overall improvement in the quality of life Prescribed CHX Gel

Very good prognosis Excellent patient and parents compliance

Review 3/12 BW, OH and Diet monitoring, Topical Fluoride application Monitor growth changes