Infant Oral Examination is vital that you are well informed from the start when it comes to your baby’s oral care. Although the first teeth that come in are temporary, they may still develop infection and decay. Understanding the proper way to approach oral care for every stage of an infant’s development will help you to give the best oral care you can to your baby.
The U.S. CDC reports that the most common infectious disease in children is dental caries. Over forty percent of children have cavities before they are five years old. Early childhood cavities can be particularly difficult, and start very soon after a tooth erupts.
The cavities can develop on smooth surfaces and progress rapidly, having a long lasting negative effect upon your child’s teeth.While pediatric patients may be small, they often can be as intimidating to us as we are to them. The factors that add to this anxiety are relative inexperience with children compared to adult patients, and the inability of younger patients to communicate or cooperate with the physical exam. While each physician may vary with style points and favorite tricks, here are a few tips for the pediatric physical exam to improve your interaction and comfort level. One of the first tasks as an emergency physician is to put the patient at ease.
Talk to the child as well as the parents. For older children, introduce yourself to them first before the parents and sit down on the bed or chair as to not tower over them. Try to facilitate the relationship and open up communication by noticing something cool about them (light-up shoes, Dora T-shirt or fun toy). While doing the actual physical exam, try to use the parent’s lap as much as possible as the child is most comfortable there.
To distract and calm them, consider telling them a story throughout the exam or try to make the physical exam a game – play with the instruments. Finally, consider having something fun in your pocket such as stickers or a bubble-blowing pen to make the experience more enjoyable. In general, when evaluating any child, observation is the best initial diagnostic tool. The degree of alertness and interaction, responsiveness to parents and respiratory status are all valuable measures of illness that may either suggest or eliminate concerns of toxicity.
After observation, it is important to begin the exam with auscultation of the heart and lungs as this is usually when the child is calm, quiet and most cooperative. Do not forget that a negative lung auscultation is not sufficient to rule out significant pulmonary disease; the appearance of the patient (tachypnea, respiratory distress) is much more predictive.