COMPREHENSIVE PEDIATRIC EXAM TOOTH DIAGNOSIS

  1. TOOTH DEVELOPMENT
    • Proper size, shape and color
    • Proper number of teeth
  2. TOOTH MINERALIZATION
    • Normal vs. hypomineralization
  3. 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

  1. 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)
  2. 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

PERIODONTAL DIAGNOSIS (TEEN GINGIVITIS)

  1. Probing depths (indicates bone loss)
  2. Gingival assessment (indicates the presence of gum infection of inflammation)
  3. Tooth mobility (indicates tooth looseness as a result of bone loss or bite stress/grinding)
  4. 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:

  1. Dietary Analysis
    • Mineral and trace mineral intake
    • Fat-soluble vitamin intake
    • Protein (quality and quantity) intake
    • Sugar assessment
  2. Nutritional Status
    • Mineral balance
    • Hard and soft tissue health
    • Bio-terrain analysis for Redox status, pH (acid-alkaline) and osmolarity
  3. Immune System
    • Oral biofilm analysis (Normal vs. pathogenic)
    • Systemic (chronic infections or inflammation)
    • Dental material selection (biocompatibility testing options)
  4. Hormone (endocrine-tooth axis) Analysis
    • Hypothalamus – Parotid-tooth axis
    • Sex hormone – oral cavity axis
  5. 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.