Description
INSTRUCTIONS
Submit a 4 page (approx.) template on the adolescent patient. The document attached should be downloaded and saved (see below) to your computer. Fill in all appropriate sections and include 2 references or sources for your information. Bullet points preferred.
The file name should be created like this: DH 113-B, JSmith-adol (your report needs your first initial and last name embedded in the name of the file). Confirm the type of document you submit is accessible on Canvas (Word or PDF) Google docs and Pages will not open within the rubric area.
The Wilkins text has excellent general information about each patient type however the template requires details about each heading area. Students should plan on 4-5 sentences per heading. Students will include at least two peer-reviewed references; typically these are journals and not websites (in addition to your required texts) in APA format, for this assignment.
If a student submits a report after the deadline, this will result in a loss of 10% off the final score for each day it is late OR if they turn in the report after 5 days, the student will receive a “0” for the report.
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ADOLESCENT SPECIAL PATIENT REPORT TEMPLATE
Caries risk & Nutrition (sugar level IN GRAMS of typical food):
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Sport drinks/juice/soda in weekly diet
Fluoride supplements (past or current, suggested by pediatric dentists?):
Growth & development (10-17 years):
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Hormonal challenges & bodily changes occurring (both male and female)
OHI challenges – TB, interdental cleaning
Referral to orthodontist (why & when), sports guards (how supplied)
3rd molar extraction (referral when?)
Typical schedules:
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Activities/hobbies/sports (importance of, why overscheduling can occur)
Personal interests (developing rapport)
Community involvement
Access to dental care:
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Family knowledge/history of dentistry
Past experience with dental care (very little or sufficient)
Access to dental care/insurance
Psychological/Health issues:
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Personal care (or lack thereof)
Body image
Anxiety/suicide
School/peer pressure/bullying (effects)
Family stress (divorce)
Birth control/STD’s
Drug abuse (signs and symptoms):
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Tobacco/vape use (effects)
Piercing and risk associated
Illicit/OTC drug abuse
Key approach to discuss:
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Listen and engage (how)
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Find common ground
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Avoid “talking down”
References
Textbook:
Wilkins, E. (2016). Clinical practice of the dental hygienist. 12th edition, Lippincott, Williams and Wilkins,
Philadelphia, PA.
Include pages used:
Journal Articles (2 required):
1
Child/Pediatric Patient Report
Adian Sahib
DH 113-B
September, 2023
2
Caries risk (sugar level IN GRAMS of A typical food):
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ECC/rampant decay (how does this affect future dentition and dental fear)
Early childhood caries is the presence of one or more decayed teeth in
children age 5 and younger. Worldwide, ECC has an impact on young children in
preschool. The incidence of ECC varies depending on the population being
studied, and it has been shown that for underprivileged communities, the
frequency might reach 85%. Early tooth decay can have an impact on children’s
life, such as having pain while drinking hot or cold drinks or difficulty chewing.
The most common source of sugar intake in children is sweetened beverages.
Less than 25 grams per day is recommended for children based on the American
Heart Association recommendations.
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Bottle-feeding with sugary drinks (in the past or current)
There is a correlation between bottle feeding with sugary drinks and an
increase in caries risk in children. A study that was done on the nutritional status
of children in rural El Salvador demonstrated that frequent feeding of infants with
bottled sugary drinks has been shown to increase the risk of developing
malnutrition and early childhood tooth decay. The study examined a sample of
797 children aged 6 months to 6 years living in rural El Salvador, and assessed the
risk of developing malnutrition, moderate to severe malnutrition, and severe tooth
decay in children. In particular, bottle-feeding sugar-sweetened beverages was
associated with risk of dental caries.
●
Sport drinks/juice/soda in weekly diet
Consuming sugary drinks reduces the quality of a child’s diet and leads to
poor oral health. Children who regularly consume sugary drinks such as soft
drinks and juices are at risk of developing tooth decay. The average of children’s
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consumption of sugary drinks such as juice is about 30 gallons each year. The
acidity of the sweetened beverages can lead to tooth erosion and cavities.
Children are encouraged to drink plain tap water throughout the day to maintain
oral health.
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Fluoride supplements (past or current, suggested by pediatric dentists?):
Some form of fluoride consumption every day is suggested to children
from age 6 months to 16 years by the The American Academy of Pediatric
Dentistry. A doctor or a dentist may prescribe a fluoride supplement if the child’s
tap water is not fluoridated. These are available as drops or tablets that are taken
orally. The amount of fluoride prescribed depends on the age of the child and the
amount of fluoride in the drinking water.
Growth & development:
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Eruption patterns (what are a few key factors before year 3 and through
year 8?)
There are some factors that can affect the eruption of baby teeth. Genetics
plays an important role when it comes to teething. If the parents had an early or
late-onset eruption of teeth, the child may experience a similar pattern. Nutrition
can also have an impact on teeth eruption, a child may have a late eruption due to
vitamin deficiencies. Medications or any chronic health condition may delay the
process of teething.
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OHI – interdental cleaning/TB techniques/manual dexterity challenges
Children may experience dexterity challenges while brushing and cleaning
the interdental areas in teeth. The Fones or circular method is an easy method to
teach children how to brush properly. To use the Fones method, place the
toothbrush at 90 degrees to the long axis of the teeth and move the bristles of the
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toothbrush in a circular motion several times in each area. Another method that is
easy to be taught to children is the Leonard’s or vertical method. The toothbrush
is placed at 90 degrees to the long axis the teeth and bristles move in an up and
down motion. Both methods should be used in approximately up to a total of two
minutes of brushing. Children are encouraged to floss by providing them a special
floss for kids that is colorful and shaped like characters that kids will like to
motivate them to floss.
● Referral to orthodontist due to occlusion/crowding (why & when)
Crowded teeth may occur when there is not enough space for teeth in the
jaw to erupt and it’s usually the main reason why dentists refer a patient to an
orthodontist. Crowding can affect the primary teeth (baby teeth) or adult teeth.
Crowded teeth may lower a child’s self-esteem and the quality of their life.
Crowded teeth can be prevented or fixed by braces or by the extraction of some
teeth.
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Sport guards (need for, how supplied)
Sports mouthguards can protect a child’s teeth, lips, tongue, and soft
tissue. They should be used while playing some kinds of sports such as softball,
baseball and soccer. They usually cover the top teeth only and they can
custom-made or boil and bite from any drugstore.
Typical schedules:
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Hobbies, sports, after school activities
Children’s hobbies or after school activities may distract them from
brushing. Most kids do not like to spend time brushing, so teaching them at a
young age and making brushing as a part of their daily routine would be
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beneficial. Playing music while brushing can make kids enjoy the task and it can
be used as a timer so kids will know when to stop brushing.
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Personal interests, peer pressure (evidence of?)
Creating a positive peer pressure around children can motivate them to
brush at least twice a day. For example, children at a young age like to imitate
parents so if everyone else in the family brushes twice a day, that will make them
want to do the same thing and will make tooth brushing as a part of their daily
routine.
Access to dental care:
●
Family knowledge/history of dentistry
Children’s oral hygiene care can be influenced by parental factors.
Children’s oral hygiene habits and conditions have been found to be related to
their parents’ income and education level. Several studies have found that children
from high-income households are less likely to have tooth decay. Furthermore,
higher levels of education were associated with higher incomes, which in turn led
to better employment and increased access to health education.
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Past experience with dental care (very little or sufficient)
Previous experience with dental care can have an impact on children’s
behavior in a dental clinic. If a child doesn’t visit the dentist regularly, they will
have more fear and anxiety than a kid who does visit the dental clinic more often.
Creating a positive experience for kids during their dental appointments is
important to maintain a lifetime of good oral health.
Psychological development:
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Bullying, pressure to fit in, eating disorders
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Having poor oral health can increase the risk of bullying among children.
Kids who experience dental caries and have an unsecure smile will have lower
self-confidence which can increase the likelihood of being bullied. Poor oral
hygiene can lead to infections and tooth loss. Cavities cause pain while chewing
food or while consuming something acidic or high in sugar, that can lead to eating
disorders among kids.
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Anxiety
Dental fear and anxiety is one of the biggest challenges in younger
patients. One way to reduce anxiety is to visit the dental clinic regularly to
overcome the fear. Another way is to talk to kids and explain what to expect at a
dental appointment. Also, maintaining good oral hygiene at home can reduce the
likelihood of getting dental procedures at a young age.
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Family stress, divorce
Family stress or divorce can have a negative impact on kids’ health. Children may
experience depression that inables them to do everyday tasks including toothbrushing
which can lead to bad oral health. Anxiety and depression can leave signs of oral neglect.
Mandatory reporter/abuse signs and symptoms:
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DH role
Children are hard to work with, hygienists should try to make the procedure fun to
reduce kids’ anxiety. Maintaining a positive environment will make kids feel safe and
willing to come in for dental treatment. Building a good relationship with pediatric
patients will make it easier to communicate with them and teach them proper ways to
brush their teeth and floss.
●
Define responsibilities
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One of the most important responsibilities of a dental hygienist while working
with a pediatric patient is to review their medical and make sure that there are no
contraindications to dental treatment. Another responsibility is to have a parent or
guardian with the child during the whole treatment period. Safety of a pediatric patient is
another important responsibility. To maintain safety, ensure that the patient has an
eyewear while being treated and a lead apron while taking x-rays.
Key approaches to discuss:
●
Speak directly to child (why)
Speaking directly to a child will make them feel safe and it helps to build a better
relationship with them. Ask questions about brushing and flossing to know their strengths
and weaknesses to maintain their oral health.
●
Alleviate fears through what behaviors?
To alleviate kids’ fear, give them a sticker or a reward after dental treatment.
Encourage and cheer them everytime they improve their oral hygiene. Ask kids before
doing anything to reassure them.
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Positive reinforcement (give 2 examples)
Give children positive feedback everytime they overcome a certain fear. Motivate
kids to brush and floss everyday by showing them the proper ways of brushing and
flossing on a puppet.
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Communication with appropriate words (child-like understanding)
Communicating with children in words that they can understand is important to
decrease their fears. Refer to the explorer as a “teeth counter” and try not to show kids
any sharp instruments during their first appointment. Name the saliva ejector as
“Mr.thirsty” and show them how it works. Place the polish brush on their fingernails and
show them that it will not hurt.
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References
Textbook:
Wilkins, E. (2016). Clinical practice of the dental hygienist. 12th edition, Lippincott,
Williams and Wilkins, Philadelphia, PA.
Include pages used:
pgs.443-444
Peer-reviewed Journal Articles (2 required):
Achalu, P., Bhatia, A., Turton, B., Luna, L., & Sokal-Gutierrez, K. (2020, December 31). Sugary
liquids in the baby bottle: Risk for child undernutrition and severe tooth decay in rural El
Salvador. International journal of environmental research and public health.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7795345/
Anil, S., & Anand, P. S. (2017, July 18). Early childhood caries: Prevalence, risk factors, and
prevention. Frontiers in pediatrics.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5514393/
CDHP Dental Health Project. (2023, August 17). Why does it take so long for baby teeth to
erupt? (explained).
Default – Stanford Medicine Children’s health. Stanford Medicine Children’s Health – Lucile
Packard Children’s Hospital Stanford. (n.d.).
https://www.stanfordchildrens.org/en/topic/default?id=fluoride-and-children-90-P01853#
:~:text=The%20American%20Academy%20of%20Pediatric,dentist%20may%20prescrib
e%20fluoride%20supplements.
9
Department of Health & Human Services. (2003, June 18). Soft Drinks, juice and sweet drinks children. Better Health Channel.
https://www.betterhealth.vic.gov.au/health/healthyliving/soft-drinks-juice-and-sweet-drinks-child
ren
The effects of sugary drinks on your child’s health – children’s health. (n.d.-b).
https://www.childrens.com/health-wellness/effects-of-sugary-drinks-on-your-childs-healt
h-infographic
Familydentistry. (2023, August 31). Ways to help dental anxiety in kids: Read more. Family
Dentistry of New Jersey.
https://familydentistryofnewjersey.com/blog/my-child-freaks-out-at-the-dentist-ways-to-h
elp-dental-anxiety-in-kids
Folayan, M. O., Oginni, O., Arowolo, O., & El Tantawi, M. (2020, July 11). Association between
adverse childhood experiences, bullying, self-esteem, resilience, social support, caries
and oral hygiene in children and adolescents in sub-urban Nigeria. BMC oral health.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7353770/#:~:text=Good%20oral%20hea
lth%20enables%20children,the%20risk%20for%20bully%20victimization.
Health, C. (n.d.). The effects of sugary drinks on your child’s Health Children’s health. Children’s
Health.
https://www.childrens.com/health-wellness/effects-of-sugary-drinks-on-your-childs-healt
h-infographic#:~:text=The%20American%20Heart%20Association%20recommends,to%
20children%20under%20age%201
10
Sugary drinks fast facts – voicesforhealthykids.org. (n.d.-a).
https://voicesforhealthykids.org/assets/resources/sugary-drink-fast-facts-3.24.20.pdf
Turner, S., Harrison, J. E., Sharif, F. N., Owens, D., & Millett, D. T. (2021, December 31).
Orthodontic treatment for crowded teeth in children. The Cochrane database of
systematic reviews. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8786262/
Why your young athlete needs to wear a mouthguard. Dentistry for Children MD. (2019,
September 27).
https://dentistry4childrenmd.com/blog/why-your-young-athlete-needs-to-wear-a-mouthgu
ard/#:~:text=DOES%20MY%20CHILD%20NEED%20A,(skateboarding%2C%20mount
ain%20biking).
Zhang, Y., Li, K. Y., Lo, E. C. M., & Wong, M. C. M. (2020, February 17). Structural equation
model for parental influence on children’s oral health practice and Status – BMC Oral
Health. BioMed Central.
https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-020-1048-2#:~:text=C
hildren%20whose%20mothers%20demonstrated%20less,affect%20their%20children%27
s%20oral%20health.
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