Module 3: Oral Health Supervision
3.1 Family Interview
To provide appropriate care for CSHCN, oral health professionals need to gather key information from parents. Topics to discuss include the following:
- Perinatal history. Asking questions about perinatal history may help explain any dental abnormalities or motor reflex issues.
- Developmental history. Asking questions about the child’s development may help correlate dental growth and development with general developmental milestones.
- Medical history. Asking questions about history of illnesses, medications, surgeries, and other medical care can provide insight into the child’s oral health status and risk factors.
- Dental history. Asking questions about the child’s dental history can provide insight into teething problems, oral lesions or trauma, home care practices (e.g., use of fluoride or fluoride products), and dental visits. Review the child's list of medications to determine if they might impact the child’s oral health (e.g., reduce salivary flow, cause excessive bleeding, affect ability to fight infection).
- Nutritional history. Asking questions about feeding and eating practices and parents’ role in purchasing and preparing meals may help determine whether the child has feeding skill challenges or challenging behaviors; has difficulty eating; consumes nonfood items; requires a special diet or food restrictions or has feeding equipment needs; or has specific food likes, dislikes, or allergies. Asking such question can also help determine whether the family’s culture has dietary restrictions or practices or whether the child’s diet and eating behaviors place them at high risk for dental caries. Asking about who feeds the child during the day and in the evening can also be helpful.
Following are examples of questions that oral health professionals can consider asking. In addition to asking these or other interview questions, discuss any issues or concerns that parents have. (Also see Getting to Know Me questionnaire in module 2.)
- What oral health education and care did you receive during your pregnancy?
- Describe any problems you had with your teeth or gums during pregnancy and care that you received.
- Were you hospitalized during your pregnancy? If yes, for what reason?
- Describe any complications delivering your child.
- Was your child born prematurely?
- If your child has any developmental delays, please tell me about them.
- Describe any physical, sensory, social, emotional, or learning difficulties your child has.
- What grade in school is your child in? Does your child receive any special services at school? If yes, what kind of services are they? Is the classroom adapted for children with special health care needs?
- Describe any afternoon or evening programs that your child participates in.
- Who is on your child’s medical team?
- Does your child have a nurse care coordinator?
- Has your child been hospitalized? If yes, for what reasons?
- Does your child have medical and/or dental insurance for their special health care needs? What, if any, medication is your child taking for chronic illnesses or conditions?
- Does your child have asthma? If yes, has your child ever been hospitalized for asthma, or have they taken steroids? If your child has taken steroids, what are the names of the medications they have taken?
- Has your child ever had a seizure? If yes, when was the last seizure?
- Describe any food, environmental, or medication sensitivities or allergies that your child has. Explain the symptoms and severity
- Does your child fall frequently?
- When was the last time your child had a medical visit? Describe the visit, what was done, and how it went.
- Tell me about your child’s weight, physical abilities, and mobility.
- How old was your child when the first tooth appeared in their mouth?
- Has your child had any teething problems?
- Do you brush your child’s teeth, or does your child brush their own teeth? At what age did brushing begin? How often and when during the day? How has this been going?
- Describe or demonstrate how your child’s teeth are brushed.
- Does the toothpaste contain fluoride? If the toothpaste contains fluoride, at what age did you begin using it? How much toothpaste is placed on the brush?
- Do you know if your local (town/city or well water) supply has fluoride?
- Does your child have any oral habits, such as sucking on a finger, thumb, or pacifier or chewing on objects?
- Does your child grind their teeth?
- When was the last time your child had a dental visit? Describe the visit, what was done, and how it went.
- Do you or others in your household have cavities? Have the cavities been treated by a dentist?
- Is your child tube fed, or have they ever been tube fed? If your child is tube fed, do they take any food by mouth?
- Are you breastfeeding or bottle feeding your child, or both? How is feeding going?
- How long was your baby breastfed? How long was your baby bottle fed?
- If you bottle feed your child, what do you put in the bottle?
- Is your child put to bed with a bottle? Do you breastfeed at will during the night?
- At what age did your baby transition to drinking from a cup? What do you put in the cup?
- If your child uses a sippy cup, what do you put in the cup?
- Does your child carry the sippy cup around during the day?
- Are there any health conditions that limit the foods your child is able to eat?
- Does food stick or stay in your child’s mouth after eating?
- Does your child regurgitate food?
- Who provides the meals, snacks, and drinks to your child during the day? In the evening?
- Can you describe a typical day of meals and snacks for your child? Where are most of the meals eaten?