pediatric dental assessments

Pediatric Dental

Assessments

Medical History-Considerations

Noonan syndrome

Down syndrome

William’s syndrome

Fragile X syndrome-

Treacher-Collins syndrome

Osteogenesis imperfecta

Genetic disorders affecting tooth

development

Van der Woude: Lower lip pits; cleft lip/palate; cleft uvula;

hypodontia

Amelogenesis imperfecta: Enamel defects that affect both

dentitions; appearance is yellow-brown to orange depending on

subtype; teeth are sensitive, susceptible to wear, and may also have

taurodontism in molars

Dentinogenesis imperfecta: Both primary and permanent teeth are

affected; teeth are blue-gray or brown; susceptible to extreme

wear; pulpal obliteration and dental abscesses

Hypophosphatasia

Ectodermal dysplasia

Cleidocranial dysplasia

Noonan Syndrome- Research the

following condition and describe

Down’s Syndrome- Research the

following condition and describe

Fragile X Syndrome- Research the

following condition and describe

Research the following conditions and

describe

Cleidocranial dysplasia

Treacher- Collins syndrome

William’s Syndrome- Research the

following condition and describe

Ectodermal Dysplasia- Research the

following condition and describe

Components of the dental exam

Medical history

Behavioral assessment and general appraisal

Extra-oral exam: head, neck, face, hands

Intra-oral exam

Caries risk assessment (CRA)

Radiographic examination

General Appraisal

Extra-oral exam

Hair: be aware of thickness or amount for ectodermal dysplasia

Scalp: look for abuse, dermatitis

Ears: malformed ears as in Treacher collins syndrome, hearing loss

Eyes: position of eyes including upward or downward slanting of

fissures, stellate pattern in iris is for William’s syndrome

Nose: misshapen=ectodermal dysplasia, asthma, allergies, clefts

Extra-oral exam

Lymph nodes: The examination must involve evaluation of the head and neck. Palpation to identify enlarged and fixed lymph nodes or other swellings is critical. Many children of this age have swollen nodes, but the nodes are usually movable and confined to the lower face and jaws and are indicative of minor infection. Swollen nodes in the neck and clavicular region are more rare and may indicate more serious ailments.

Thyroid: increased size=goiter, tumor

Lip: through visualization, should have absence of lesions, poor closure lip incompetence, clefting, asymmetry/bell’s palsy or cranial nerve damage, ulceration or herpes infection

Skin: edema or cellulitis=renal disorder, redness=allergies? Dryness or dehydration=ectodermal dysplasia, ulcerations=abuse?

Chin: scars=trauma?

Extra oral palpation on pedo exam

Extra-oral Exam: Facial Profile

A: Class I skeletal relationship is characterized by a well-balanced profile in the

anteroposterior dimension. These relationships can be judged by mentally connecting the

points of the bridge of the nose, the base of the upper lip (maxilla), and the soft tissue

chin (mandible). This line should be slightly convex.

B: Class II skeletal relationship is characterized by a truly convex profile.

C: Class III skeletal relationship is characterized by a straight or concave profile.

Describe

Intra Oral exam

Palate: clefts, ulcerations or lesions=herpes, abuse petechiae=abuse

Pharynx-normal tonsils

Tongue-redness=glossitis, ulceration/herpes, apthous ulcer, trauma, limited movement=celebral palsy, ankyloglossia

Floor of mouth: swelling, mucocele, apthous ulcers, abuse

Buccal mucosa: ulceration/ cheek biting, abuse, swelling=salivary gland infection, mumps

Teeth: absence/delayed eruption/congenital absence(genetic syndromes), extra teeth or supernumerary teeth=cleidocranial dysplasia, microdontia, macrodontia, fusion, abnormal color: amelogenesis imperfecta, caries, mobility=periapical infection

Maxillary lateral incisor is the most common missing tooth in primary dentition

Intraoral findings:

Describe each photo

Intra-oral findings

Describe each photo

Intra-oral findings

Describe each photo

Define each of the following:

Anomalies of Dentition

Hyperdontia

Hypodontia

Microdontia

Macrodontia

Fusion

Gemination

Dens in dente

Taurodont