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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