FIRST SMILES: DENTAL HEALTH BEGINS AT BIRTH …

                    FIRST SMILES: DENTAL HEALTH BEGINS AT BIRTH




   Oral Health Assessment: 6 Steps for the Medical Team

1. Interview/Anticipatory Guidance
   Ask the following questions:
        · Does your family drink fluoridated wa-
           ter or do your children take fluoride
           supplements?
        · Have you started cleaning your child's
           teeth with a fluoride toothpaste?
        · Have you taken your child to a dentist
           yet? When was the last visit?
        · Have you or any of your other children
           had many cavities?
        · Does your child take a bottle or sippy cup to bed at night or frequently
           walk around with a bottle or sippy cup throughout the day?
        · How often does your child snack throughout the day? On what?

  As the caregiver answers the questions, the provider offers appropriate AG.

                      AG is provided throughout the 6 Steps.

2. Position the child
   Assume the knee-to-knee position with the child sitting in the caregivers lap and
   lowering the child's head onto your lap. Some medical team members may prefer
   having the child lying on one end of the exam table, positioning themselves be-
   hind the child's head, or just sitting on the exam table.

3. Toothbrush Prophylaxis (optional)
   Demonstrate how to brush a child's teeth, showing the caregiver how to do the
   same at home. This is a good time to remind the family about the importance of
   using a small dab of fluoride toothpaste daily.

4. Oral Assessment
   "Count" the child's teeth aloud, using a toothbrush or tongue depressor to keep
   the mouth propped open and to avoid getting bit. Assess the child's oral condi-
   tion, looking for chalky white spots, obvious tooth decay, or tooth defects.

   Based on your interview with the caregiver and your assessment, decide if the
   child is at low or high risk for tooth decay. (See "Caries Risk Assessment Chart")

5. Fluoride Varnish Treatment
   Provide a fluoride varnish treatment if the child is at high risk for tooth decay.
   Apply the varnish to all surfaces of all of the teeth.

6. Summarize and Review Anticipatory Guidance and Counseling
   Discuss your findings and recommendations for follow-up, anticipatory guidance
   and home care.