The Toddler and Dental ConsiderationsThe dental hygienist’s role….

The Dental Hygienist’s Role

• Important to partner with the parent(s)

• Partners…..engage in a working relationship and provide motivation to work toward established goal

• What other principles of empathy and motivational interviewing can be applied?

The Dental Hygienist’s Role

• Parents are role models for their children….▫ Oral hygiene habits

▫ Nutritional habits

▫ Behavior

• Partnering also means sharing your knowledge!

• Encourage parents to research oral health topics

• Guide them to patient-centered websites or other resources

• Encourage questions

Topics to Discuss With Parents

• Importance of primary dentition

• Parental role in child’s oral health

• Tooth eruption times

• Homecare routine

• Nutrition

• Dental Visits

Value of Primary Teeth

• Easy chewing

• Gaining food nutrients

• Developing proper speech patterns

• Guiding permanent teeth to proper alignment

• Building self-esteem .

The Dental Visit

• 50-85% of people with dental anxiety reported the onset in childhood or adolescence-make it fun!

• Morning appointments before or after naps

How are you going to explain these to a child???

• Air syringe-

• Water syringe-

• Suction-

• Saliva ejector-

• Explorer-

• Caries-

Dental Visits

• Parental guidance-1st visit then re-assess

• Advise parents not to use words like “hurt”, “pain”“do not be scared”

• Tell-show-do

Pediatric Health History

General growth and health•Chief complaint, such as pain

•Extraoral soft tissue and temporomandibular joint evaluation

•Intraoral soft tissue

•Oral hygiene and periodontal health

•Intraoral hard tissue

•Developing occlusion

•Caries risk

•Behavior

Extra-Oral Exam

• Observe : gait, appearance, size

• Hands: The dentist may first detect an elevated temperature by holding the patient's hand. Cold, clammy hands or bitten fingernails may be the first indication of abnormal anxiety in the child. A callused or unusually clean digit suggests a persistent sucking habit. Clubbing of the fingers or a bluish color in the nail beds suggests congenital heart disease that may require special precautions during dental treatment.

• Head: observe for signs of lice

• TMJ: most observations seen in adolescents

Extraoral exam

Intra-Oral Exam

• Examine soft tissues: mucosa, tongue, saliva, gingiva, lips, palate and tonsils

• Usually a PSR can be done after the eruption of the first permanent molars.

• Evaluate: occlusion, facial profile, molar and canine relationships, midline

• Look for: carious lesions, tooth anomalies

Explain differences between primary and permanent anterior teeth.

Explain differences between primary and permanent posterior teeth.

Nutrition

• Growth rate is decreased=appetite decreased

• Warn against empty calories: sugary liquids, cookies, chips, crackers etc.

• Caries process-limit sugary snack to mealtimes only

• Juice is only 4-6 oz a day=1 juice box/day

• Set a good example

• Allow them to serve themselves

Nutrition

• Encourage help in the kitchen

• Allow children to help plan and pick meals

• Make meals stress free time

• Give choices for meals and stick to regularly scheduled snack and meal times

• Encourage tasting of new foods

Instead of... Choose

Regular cheese Low-fat cheese

Sweetened yogurt Plain yogurt plus fruit

Whole milk Fat-free or low-fat milk

Sweetened breakfast cereals Cereals with little or no added sugar

Cookies Graham crackers

Fried chicken or fried fish Baked chicken or fish

French fries Oven-baked fries

Ice cream or frozen yogurt Frozen fruits or frozen 100% fruit bars

Soft drinks or fruit punch Water

Potato chips Baked chips or whole grain crackers

Butter or margarine Trans fat-free tub margarine

Jam or jelly 100% Fruit spread

Nutritional Deficiency Manifestations

• Iron deficiency: seen in underweight and overweight toddlers

• Zinc

• Vitamin B12 deficiency

• Vitamin D deficiency

Nutrition Practice

• Make a healthy menu for a toddler for one day

• Include healthy snacks and drinks

• Make sure that snacks are easily prepared and portable

• http://www.choosemyplate.gov/downloads/PatternA1000cals.pdf

Homecare Routine

• Toothbrushing:▫ Selection of toothbrush

▫ When to brush

▫ Demonstration of how to brush

▫ Parental guidance

Homecare Routine

• Flossing demonstration with appropriate tools for children