COMPREHENSIVE PEDIATRIC EXAM TOOTH DIAGNOSIS
- TOOTH DEVELOPMENT
- Proper size, shape and color
- Proper number of teeth
- TOOTH MINERALIZATION
- Normal vs. hypomineralization
- DECAY DEVELOPMENT
- Primary decay: new decay
- Secondary decay: decay which occurs around an existing filling
- Decay patterns:
- Front vs. back teeth
- Contra-lateral teeth
- Decay clusters
- Decay Risk Assessment
- C1 – Slight or no decay risk
- C2 – Moderate decay risk
- C3 – High decay risk
JAW DEVELOPMENT DIAGNOSIS
- TEETH ALIGNMENT
- a.Primary (Baby) Teeth
- Frenum preventing tongue or alignment development
- Spaces between all front teeth
- Normal bite relationship
- Normal (myofacial) tongue swallow pattern (necessary for palatal expansion)
- b.Secondary (adult) teeth
- Lower front teeth alignment
- Upper front teeth alignment
- Bite analysis (Normal, open or deep bite)
- Back teeth analysis (Normal vs. cross-bite, bite relationship)
- Myofacial analysis (Tongue swallow pattern)
- Palatal arch development (Normal vs. need for palatal expansion)
- a.Primary (Baby) Teeth
- JAW DEVELOPMENT
- a.Arch development of the upper jaw (maxilla) and the lower jaw (mandible)
- Proper arch placement vs. “gummy” smile
- Skeletal development (no protrusion or retrusion of jaw bones)
- b.Facial development
- Proper facial symmetry
- Proper facial bone (cheek bone) development
- Proper cranial development
- a.Arch development of the upper jaw (maxilla) and the lower jaw (mandible)
PERIODONTAL DIAGNOSIS (TEEN GINGIVITIS)
- Probing depths (indicates bone loss)
- Gingival assessment (indicates the presence of gum infection of inflammation)
- Tooth mobility (indicates tooth looseness as a result of bone loss or bite stress/grinding)
- Gum recession (indicates whether the gums are receding)
TREATMENT PLAN (initial) A consultation is provided to address the findings from the tooth , jaw development and periodontal (gingivitis) examinations. The risk (slight/moderate/severe) for disease progression is also mentioned in order for preventive measures to be planned. DENTAL NUTRITION AND SYSTEMIC ASSESSMENT The mouth and body interact in a two-way relationship (mouth to body and body to mouth). In order to determine the cause of one’s dental problems, a systemic assessment is necessary and consists of the following:
- Dietary Analysis
- Mineral and trace mineral intake
- Fat-soluble vitamin intake
- Protein (quality and quantity) intake
- Sugar assessment
- Nutritional Status
- Mineral balance
- Hard and soft tissue health
- Bio-terrain analysis for Redox status, pH (acid-alkaline) and osmolarity
- Immune System
- Oral biofilm analysis (Normal vs. pathogenic)
- Systemic (chronic infections or inflammation)
- Dental material selection (biocompatibility testing options)
- Hormone (endocrine-tooth axis) Analysis
- Hypothalamus – Parotid-tooth axis
- Sex hormone – oral cavity axis
- Blood test (if necessary)
- Calcium/phosphate ratio
- Calcium levels (parathyroid)
This assessment is critical to determine your child’s risk of developing any dental disease and the odds of it progressing. Counter-measures will be discussed and a treatment plan can be finalized to include treatment of causes and a plan for prevention and maintenance.