Reference no: EM133435433
Case study
A. Presenting Patient
• Seven year old African American male
• New patient screening and prophylaxis appointment
B. Chief Complaint
• Mother states, "The child has been complaining of a toothache for several days."
C. Social History
• Family of 5 children
• Medicaid coverage for medical and dental care (Healthy Kids Dental)
• No current transportation for the family
D. Medical History
• Review of medical history reveals no significant findings, no known food or drug allergies, no medications, vaccinations are up to date.
E. Dental History
• Child has never been to a dentist
• No dental home
• Other children in the family have been seen for extensive dental caries under general anesthesia
• Poor oral hygiene habits
• Cariogenic diet
• Brushes once a day with toothpaste with no supervision
• No history of trauma
F. Extraoral Exam
• Normal weight and height for age
•Examination was difficult because the child is extremely anxious and in pain
G. Intraoral Exam
• Mixed dentition
• Multiple carious lesions noted in primary molars
• Class 1 primary canines and class 2 permanent molars
Generalized severe plaque accumulation and calculus deposits on lingual surface on mandibular incisors.
H. Diagnosis and Problem List
• Dental pain
• Behavior management difficulties
• Untreated caries lesions in primary dentition
• Lack of dental home
• High caries risk (poor oral hygiene, cariogenic diet, extensive plaque accumulation)
I. Treatment Plan
• Emergency treatment for tooth causing current dental pain for child
• Comprehensive treatment of other carious lesions
• Establishment of caries prevention plan including appropriate recall
Please answer the following questions:
1. What are three risk factors of this patient to be indicative of an elevated susceptibility to dental caries?
2. Indicate the caries risk assessment and monthly recall required for this patient.
3. Provide behavior modifications that you would implement during the dental appointment and why.
4. Are dental sealants recommended for this patient? List the steps of sealant placement and provide a brief summary of the education you would provide to the child and mother regarding sealants.
5. What anticipatory guidance would you provide to the child and mother regarding oral hygiene habits and the cariogenic diet?