COMPONENTS OF ORAL HEALTH SUPERVISION

Screening (continued)

When performing the oral health screening, health professionals should

• Note whether the infant, child, or adolescent is currently in pain or has an abscess on the gums above or below the teeth. An abscess may look like a “gum boil” and may or may not have localized or generalized swelling with or without pus draining from the area. If the infant, child, or adolescent is in pain or has an abscess, refer to a dentist immediately.
• Check whether tooth eruption and loss are proceeding according to schedule (see Tooth Eruption Chart).
• Check the teeth for plaque and food debris.
• Note whether any teeth appear to have unusual color or shape.
• Note whether any teeth have untreated decay. Tooth decay may occur on any tooth surface. Tooth decay initially appears as a chalky white area on the enamel. More advanced tooth decay appears as cavities or stains. When decay is observed, refer the infant, child, or adolescent to a dentist. Discolored teeth may be difficult to attribute to tooth decay. When in doubt, refer to a dentist.
• Note whether any dental trauma has occurred. If the teeth are prematurely missing, refer the infant, child, or adolescent to a dentist for space management. If trauma may be the result of physical abuse, record observations and call the local social service agency.

Health professionals should document oral health history, clinical findings, and recommended follow-up in the infant’s, child’s, or adolescent’s permanent health record.