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Summary of Medical History
* Seasonal allergies
* Meds: Albuterol PRN; NKDA
* Was pt ever hospitalized?
* Expand on any "yes"
Summary of Dental History
* Radiographs ever taken?
* Previous dental tx completed?
* Any behavior guidance used?
Extra and Intraoral Exam
* Examine the mouth before taking radiographs
* What radiographs would you order? * Why?
* What are the AAPD guidelines for radiographs?
* What are the indications for PA's?
What is the patient's Caries Risk Assessment?
What would be your treatment plan?
Child has active white spot lesions or enamel defects
Child has >1 decayed/missing/filled surfaces (dmfs)
* Caregiver has decay
* Low SES
* >3 snacks between meals
What caries do you see?
A: Check M K: MB
B: D L: DO
D: M N:
E: MB O:
F: DB P:
G: M Q:
I: F demin S: DO
J: M incip. T: M
A: Check M/Seal K: SSC/MO comp
B: SSC/DO comp L: SSC
D: Strip crown N:
E: Strip crown O:
F: Strip crown P:
G: Strip crown Q:
I: Seal S: SSC
J: Seal T: SSC
* Refer for mesiodens extraction
Child weighs 35lbs; max dose is 2mg/lb
* 2x35=70 mg for max dose
* 1.7 ml per carpule --> 34 mg of lidocaine per carpule
* To calculate the number of carpules, divide the max dose by 34mg/carpule
Treatment Plan Sequence
* First visit: #S and T
* Second visit: #K and L
* Third visit: #B
* Fourth visit: #D, E, F, G
Refer for Mesiodens extraction
Post Operative Instructions
* anesthetized tissues
* Tylenol PRN
* emergency contact