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MCG School of Dentistry Quality Assurance Manual

Pediatric Dentistry

General Guidelines
The following section on quality assessment of pediatric dentistry treatment includes specific features of this discipline. Also included are references to other sections of the manual, where appropriate, since many of those are for adult patient care.

Services necessary for the preservation of the dentition and supporting structures should be provided through the age of 18. All of these services are necessary for comprehensive dental care and are listed. It must be understood that adequate diagnosis is a necessary prerequisite to treatment rendered.

  1. Preventive services and treatment of acute conditions to include plaque control, patient education, prophylaxis and emergency treatment for the relief of pain and infection.

  2. Restoration of the primary and permanent teeth to adequate form and function, with careful consideration given to the health of the pulp and the supporting structures.

  3. Maintenance and restoration of space in the dental arch to achieve or retain normal functions, esthetics and occlusion.

  4. Treatment of malocclusion with priority given to interceptive services.

Pediatric Dentistry - Quality Evaluation Criteria

ITEM

RATING AND EXPLANATION

 

ACCEPTABLE

NOT ACCEPTABLE

Dental and medical history and patient examination

1.        An interview with parent or responsible person and child, including history of health problems and medical treatment, past dental experience.

2.        Clinical charting of the existing condition of the oral and facial structures.

Radiographic survey with films sufficient in number and quality to detect anomalies and diseases and to evaluate development with the age and mental development of the child as consideration. Adequate radiation protection measures taken (i.e., lead apron for patient.)

1.        No dental-medical history taken and noted in records.

2.        No chart record of existing conditions.

3.        Radiographic survey inadequate. (Refer also to item  “Radiographic Examination.”) No radiation protection of patient.

Patient and parent counseling, motivation and preventive procedures

1.        Plaque control: Parents instructed in toothbrushing and expected to cleanse the mouth of the very young child, involving the child in the process to the extent practical but maintaining direct responsibility for mouth cleanliness. With maturity educational efforts directed primarily to the child whose dexterity will increase. The older child is expected to assume responsibility for his own oral hygiene, encouraged and supported by parents and reinforced by dental office personnel at periodic recall visits.

2.        Oral prophylaxis and use of fluorides applied topically at least annually and more frequently when necessary.

3.        When appropriate, review of dietary patterns of the child including appropriate counseling.

4.        Fluorides for systemic use prescribed when indicated by lack of availability through water supply in accordance with 1994 revised supplemental guidelines.  

1.        Parents not instructed or involved in home care procedures. Responsibility not directed to parent when child is very young. As child matures, educational efforts and responsibility not redirected. No reinforcement by office personnel at periodic recall visits.

2.        Inadequate prophylaxis, topically applied fluoride not used as indicated.

3.        No review of dietary patterns evident, no nutritional counseling.

4.        Fluorides for systemic use not prescribed when indicated by lack of availability through water supply or exceeding recommended levels for prescription of systemic fluoride.

Diagnosis and plan of treatment

1.        Identification of anomalies, disease and other significant deviations from normal for treatment or referral.

2.        Formation of an organized approach to a plan to a plan for treatment consistent with the needs of the patient and the level of patient acceptance and compliance. Priority given to the elimination of oral problems listed below:

a.        Pain and acute infection.

b.        Major and minor deformities.

c.        Carious lesions.

d.        Periodontal conditions.

e.        Prostheses or appliances for guidance of growth, space maintenance, correction of anomalies.

3.        Presentation of proposed plan of treatment to patient, parent or responsible party, with clear explanation of need, possible consequences of nonacceptance of proposed treatment or acceptance of partial treatment.

1.        Anomalies, disease and other deviations from normal not identified and/or not treated or referred for treatment.

2.        Incomplete diagnosis and inadequate sequential treatment plan.

3.        Treatment plan not discussed, alternatives not indicated, consequences of nontreatment or partial treatment not explained.

Control of pain and apprehension

Proper methods of apprehension and pain control utilized to assure that child does not experience unnecessary pain or discomfort. Child properly prepared for dental treatment.

No attempt made to control apprehension and pain or to prepare child for dental treatment.

The Medical College of Georgia is an Equal Opportunity Educational Institution.


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Patient Services
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December 19, 2005