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Clinical Practice of the Dental Hygienist (Twelfth Edition) Lesson Plans Chapter 50 — The Pediatric Patient Goals of the Lesson: Cognitive: Students will identify considerations and techniques of pediatric oral hygiene and care, including preventative care and parental education. Motor: Students will practice proper care habits as well as the social and professional considerations involved in caring for young patients and effectively instructing their parents. Affective: Students will understand the importance of oral health for young patients and the role they personally play in establishing proper routines and achieving efficient and regular dental appointments. Learning Objectives: The lesson plan for each objective starts on the page shown below. 50-1 Describe the specialty of pediatric dentistry ................................................................................................................ 2 50-2 Discuss the use of a caries risk assessment tool to identify an individual patient’s risk and prevention factors .......................................................................................................................................................................... 4 50-3 Identify age-appropriate anticipatory guidance/counseling factors to educate parents/caregivers of toddlers, schoolaged children, and adolescents .......................................................................................................................... 6 50-4 Identify preventive and therapeutic oral healthcare interventions based on age and caries risk assessment. .............. 9 50-5 Discuss oral health home care needs, adjunct aids, and contin;uing care recommendations for children ................... 11 You Will Need: Gather the following materials and teaching aids for the following lessons: 50-1 Computer with internet 50-3 Provide a case study for the students and include pertinent information about the home environment, health history of the child, and current home care and feeding patterns. Legend: SG: Study Guide (Wyche, Active Learning Workbook for Clinical Practice of the Dental Hygienist, 12e); PPt: PowerPoint; SR: student resource, available online; NA: not applicable; Note: Electronic ancillary assets can be found on the book’s companion website at thePoint.lww.com/Wilkins12e. Page 1 Copyright © 2017 Wolters Kluwer Selected Key Terms Adolescent Anticipatory guidance CAMBRA Dental home Grazing Infant Interim therapeutic restoration (ITR) Main caregiver Nonnutritive sucking Preschooler PSR School-age Sippy cup Tooth germination Toddler Wean Clinical Practice of the Dental Hygienist (Twelfth Edition) Chapter 50—The Pediatric Patient Objective 50-1 Describe the specialty of pediatric dentistry. Date: Lecture Outline Content Pediatric health care Primarily dependent on parental intervention Parents largely informed by healthcare providers Key terms See Box 50-1: Key words: Pediatric oral health care Pediatric dentistry ♦ The specialty ♦ American Academy of Pediatric Dentistry The child as a patient ♦ Age classifications ♦ The dental home: first visit no later than 12 months of age ♦ Referral as necessary ♦ Early intervention Barriers to dental care Lack of knowledge about prevention Language Cost Fear No dental home Dentist does not see children under age 3 years Page 2 Copyright © 2017 Wolters Kluwer Text page 856857 PPt slide 1-4 Figures, Tables, and Features Boxes 50-1: Key words: Pediatric oral health care p. 856 Resources and In-Class Activities In-Class Activities Web exercise: Have students research for pediatric dentists in their hometown. Discuss if one is available, their office hours, and the recommended age for the patient’s first visit. Outside Assignments Evaluation Outside Assignments SR: Have students review the audio pronunciations and definitions for Chapter 50. Knowledge Exercises, SG, pp. 295-297 Competency Exercises, SG, p. 297 Instructor’s Notes Clinical Practice of the Dental Hygienist (Twelfth Edition) Chapter 50—The Pediatric Patient Dentist’s hours Insurance Transporation Child dental visits ♦ Purposes ♦ Frequency of continuing care ♦ Scheduling Legend: SG: Study Guide (Wyche, Active Learning Workbook for Clinical Practice of the Dental Hygienist, 12e); PPt: PowerPoint; SR: student resource, available online; NA: not applicable; Note: Electronic ancillary assets can be found on the book’s companion website at thePoint.lww.com/Wilkins12e. Page 3 Copyright © 2017 Wolters Kluwer Clinical Practice of the Dental Hygienist (Twelfth Edition) Chapter 50—The Pediatric Patient Objective 50-2 Discuss the use of a caries risk assessment tool to identify an individual patient’s risk and preventive factors. Date: Lecture Outline Content Caries risk assessment CAMBRA: caries management by risk assessment o Purpose o Principles o Steps o Classification by caries risk o ECC Prevalence Microbiology Risk factors Predisposing factors Effects Recognition Text page PPt slide 865870 10-14 Figures, Tables, and Features Tables 50-5: Caries risks and protective factors to assess at each dental visit p. 866 50-6: Caries management based on risk levels for patients up to age 5 years old p. 868 Figures 50-4: Visualize the caries balance p. 867, PPt 11 50-5: Progession of ECC p. 870, PPt 12 50-6: White spot lesions p. 870, PPt 13 50-7: Cavitation of white spot lesions p. 870, PPt 14 Boxes 50-4: Caries risk levels p. 867, PPt 8 Page 4 Copyright © 2017 Wolters Kluwer Resources and In-Class Activities In-Class Activities Have students review and discuss Factors to teach the parents in textbook p. 875. Outside Assignments Evaluation Outside Assignments Knowledge Exercises, SG, pp. 295-297 Competency Exercises, SG, p. 297 Instructor’s Notes Clinical Practice of the Dental Hygienist (Twelfth Edition) Chapter 50—The Pediatric Patient Legend: SG: Study Guide (Wyche, Active Learning Workbook for Clinical Practice of the Dental Hygienist, 12e); PPt: PowerPoint; SR: student resource, available online; NA: not applicable; Note: Electronic ancillary assets can be found on the book’s companion website at thePoint.lww.com/Wilkins12e. Page 5 Copyright © 2017 Wolters Kluwer Clinical Practice of the Dental Hygienist (Twelfth Edition) Chapter 50—The Pediatric Patient Objective 50-3 Identify age-appropriate anticipatory guidance/counseling factors to educate parents/caregivers of toddlers, schoolaged children, and adolescents. Date: Lecture Outline Content Anticipatory guidance For parents, caregivers, and providers Expectations during stages of development Individualized information on child’s needs Verbal Written Dietary and feeding pattern recommendations Toddlers and preschoolers School aged Adolescent Oral health considerations toddlers/preschools ♦ Gaining cooperation ♦ Brushing and flossing ♦ Parental involvement ♦ Toothpaste ♦ Instructions for parents Speech and language development Digit habits Accident and injury prevention ♦ School aged children ♦ Adolescents Oral malodor Page 6 Copyright © 2017 Wolters Kluwer Text page 870875 PPt slide 15-16 Figures, Tables, and Features Tables 50-7: Anticipatory guidance: 12 months to 6 years of age p. 869 50-8: Anticipatory guidance: Age 6 to Adolescence p. 871 Figures 50-8: Dentifrice for a child p. 873 50-9: Effects of prolonged thumb sucking on teeth p. 873 Resources and In-Class Activities In-Class Activities Students who will provide dental hygiene care for mothers and their young children will need to know how to interview the mother in order to gain necessary information to establish an effective dental hygiene treatment plan for the child. Provide a case study for the students and include pertinent information about the home environment, health history of the child, and current home care and feeding patterns. (Suggested case study: A child of three years and 2 months is seen for the initial dental visit. Health history reveals frequent ear infections and placement of two sets of tubes. The child currently is taking no medications. Oral examination reveals Outside Assignments Evaluation Outside Assignments Knowledge Exercises, SG, pp. 295-297 Competency Exercises, SG, p. 297 Instructor’s Notes Clinical Practice of the Dental Hygienist (Twelfth Edition) Chapter 50—The Pediatric Patient ♦ Causes ♦ What to teach parents Oral health considerations for adolescents Tobacco/piercings/substance abuse Referral multiple caries, five mandibular anterior teeth with one tooth wider than usual, and cervical plaque throughout. Family and feeding history indicates late weaning and frequent snacking on fermentable carbohydrates. Mother began brushing teeth at 2 years and currently brushes her child's teeth in the morning with fluoride toothpaste.) Divide class into pairs. Provide the case study to the students. One student will role-play the dental hygienist and one the parent. The dental hygienist will interview the parent in front of the class and use anticipatory guidance as part of the discussion with the treatment plan. Before the role playing moves to the treatment plan discussion, the class will be asked to identify the pertinent information derived from the interview and how the facts will be used to determine an effective dental hygiene treatment plan, for the parent and child. After that, students will peer evaluate the interviewing techniques used by the dental Page 7 Copyright © 2017 Wolters Kluwer Clinical Practice of the Dental Hygienist (Twelfth Edition) Chapter 50—The Pediatric Patient hygienist in the interview session. They will be asked to provide suggestions and rationale for how questions could be better formulated to obtain information. Additionally: Wrap up: Have students describe the proper office environment for conducting interviews with parents, examining the infant, and providing demonstrations, using anticipatory guidance for the parent in proper preventive oral health techniques. Legend: SG: Study Guide (Wyche, Active Learning Workbook for Clinical Practice of the Dental Hygienist, 12e); PPt: PowerPoint; SR: student resource, available online; NA: not applicable; Note: Electronic ancillary assets can be found on the book’s companion website at thePoint.lww.com/Wilkins12e. Page 8 Copyright © 2017 Wolters Kluwer Clinical Practice of the Dental Hygienist (Twelfth Edition) Chapter 50—The Pediatric Patient Objective 50-4 Identify preventive and therapeutic oral healthcare inteventions based on age and caries risk assessment. Date: Lecture Outline Content Patient management considerations ♦ nonverbal communication Toddlers (1 to 2 years of age) ♦ Primary teeth vunerable to tooth decay ♦ Use child friendly terms ♦ Oral examination ♦ Examination sequence Preschoolers (3 to 5 years of age) ♦ Preparing for the dental visit ♦ Positioning ♦ Parental involvement School age children (6 to 11) Adolescents (12 to 18) Components of the dental hygiene visit ♦ Initial interview/new patient ♦ Child and family medical/dental history o Family configuration o Medical history of the child Page 9 Copyright © 2017 Wolters Kluwer Text page 857865 PPt slide 5-9 Figures, Tables, and Features Tables 50-1: Oral and soft tissue conditions/pathology in children approximately 6 months to 5 years p. 858 50-2: Milestones in child development: 12 months to 5 years p. 859 50-3: Psychosocial development of adolescents p. 861 Resources and In-Class Activities In-Class Activities (Continued from obj. 503): Have students write an appropriate dental hygiene treatment plan for the case and to provide the rationale for their decisions in writing. This exercise will be followed by presentations and class discussion. Have students describe the proper office environment for conducting interviews with parents, examining the 50-4: Tooth development infant, and providing and eruption: primary teeth demonstrations for the p. 862 parent in proper preventive oral health techniques. Boxes 50-2: Child friendly substitution words for dental terminology p. 857 50-3: Use of xylitol: AAPD recommendations for children p. 864 Outside Assignments Evaluation Outside Assignments Knowledge Exercises, SG, pp. 295-297 Competency Exercises, SG, p. 297 Instructor’s Notes Clinical Practice of the Dental Hygienist (Twelfth Edition) Chapter 50—The Pediatric Patient ♦ Intra-extra oral examination ♦ Developing dentition, occlusion, TMJ ♦ ♦ o Evaluation o Referral ♦ 50-3: Premature loss of second primary molar p. 863 Radiographic assessment o Radiographic needs o Cooperation Dietary assessment o ♦ Figures Diet instruction suggestions Dental hygiene treatment o Purpose o Types of dental hygiene treatment o Instrumentation Prevention o Fluoride o Dental sealants o Xylitol o Antibacterial agents Periodontal risk assessment ♦ Gingival and periodontal evaluation ♦ Periodontal infections o Biofilm induced gingivitis o Risk factors for periodontitits Legend: SG: Study Guide (Wyche, Active Learning Workbook for Clinical Practice of the Dental Hygienist, 12e); PPt: PowerPoint; SR: student resource, available online; NA: not applicable; Note: Electronic ancillary assets can be found on the book’s companion website at thePoint.lww.com/Wilkins12e. Page 10 Copyright © 2017 Wolters Kluwer Clinical Practice of the Dental Hygienist (Twelfth Edition) Chapter 50—The Pediatric Patient Objective 50-5 Discuss oral health home care needs, adjunct aids, and continuing care recommendations for children. Date: Lecture Outline Content Text page 872876 Oral health considerations toddlers/preschools ♦ Gaining cooperation ♦ Brushing and flossing ♦ Parental involvement ♦ Toothpaste ♦ Instructions for parents Speech and language development Digit habits Accident and injury prevention ♦ School aged children ♦ Adolescents Oral malodor ♦ Causes ♦ What to teach parents Oral health considerations for adolescents Tobacco/piercings/substance abuse Referral PPt slide 15-21 Figures, Tables, and Features Boxes 50-5: Example documentation: preventive dental hygiene visit by child patient p. 875 Features Factors to teach the parents p. 875, SG, p. 298 Everyday Ethics p. 874, SG, p. 297 Resources and In-Class Activities In-Class Activities Have students form groups and conduct Internet searches for pacifiers and other teething products. Ask the group to select an ideal pacifier and one they feel is problematic. Next, have them explain their choices to the class. Outside Assignments Evaluation Outside Assignments SR: Have students take the quiz for Chapter 50. Knowledge Exercises, SG, pp. 295-297 Competency Exercises, SG, p. 297 Evaluation Create an exam for Chapter 50 using Test Generator. Treatment planning and consent Documentation Legend: SG: Study Guide (Wyche, Active Learning Workbook for Clinical Practice of the Dental Hygienist, 12e); PPt: PowerPoint; SR: student resource, available online; NA: not applicable; Note: Electronic ancillary assets can be found on the book’s companion website at thePoint.lww.com/Wilkins12e. Page 11 Copyright © 2017 Wolters Kluwer Instructor’s Notes