28 | 2017 | Issue 7 S upporting Y our P ractice First Dental Exam Both CDA and the Canadian Academy of Pediatric Dentistry recommend that the first dental visit occur by age one or within six months after the eruption of the first tooth. Dr. Nouri refers to the ATP of the first oral exam: A ssessment : Perform a thorough assessment including a detailed medical history, extra-oral hard and soft tissue examination, and intra-oral soft tissue and hard tissue examination. T reatment: Provide any treatment that is necessary, including the application of fluoride varnish or Silver Diamine Fluoride (SDF) in an attempt to arrest caries. ( ➊ ) Discuss diet modifications, oral hygiene improvements, use of fluoridated toothpaste when indicated and xylitol consumption or application as needed with the parents. P revention: Consider any extensive preventive measure that could be applied including fluoride supplementation when indicated. Anticipatory guidance may be used here to inform parents of what to look for in light of any history of systemic involvement. When examining young patients, Dr. Nouri recommends using the knee-to-knee technique, which may be combined with the “show, tell, do” technique. ( ➋ - ➍ ) InterceptiveMeasures The prevalence of early childhood caries (ECC) is an important concern in dentistry. “We have a professional duty to see children early on or at least provide routes through which they can have a dentist look after their teeth and well-being,” stresses Dr. Nouri. “It’s important to mention that ECC is a progressive disease,” adds Dr. Nouri. “And amazingly, we don’t see many symptoms in young children. Their bones are very soft, allowing for any abscess to expand ( ➎ - ➑ ), and their pain pathways are not as well developed yet. Children are also highly adaptive, putting up with pain and discomfort as a way of life. Dental caries in children can go unnoticed for years, with unfortunate results.” ➋ ➌ ➊ ➎ ➏ ➐ ➑ ➍ We have a professional duty to see children early on or at least provide routes through which they can have a dentist look after their teeth and well-being.