- To establish good rapport and effective communication with the child and their
parents. - To determine the family and social circumstances, whether other siblings are
affected by the same or similar condition and the ability of the parents to cope with
attendance for dental appointments given the added burden of medical appointments
and their wish to ensure adequate continued schooling. - To facilitate communication with medical colleagues.
- To satisfy medico-legal requirements.
Many dental practitioners use standard questionnaires to obtain a medical history; it
has been found that one of the most effective methods is to use a questionnaire
followed by a pertinent personal interview with the child and their parent or guardian.
Key Points
Key medical questions⎯ask about:
- cardiovascular disorders;
- bleeding disorders;
- respiratory/chest problems;
- epilepsy;
- hepatitis/jaundice;
- diabetes;
- hospitalization or hospital investigation for any reason;
- previous general anaesthetic experience/any further general anaesthetic procedures
planned? - allergies;
- illness in other family members;
- medication.
16.1.2 The general examination
General observation of the child is invaluable and can provide vital information.
The child's demeanour is important in assessing their potential co-operation for dental
treatment, but assessment of general outward appearance can also be helpful in
determining their state of health. An impression of height (are they as tall as their
peers?) and weight (undernourished or obese?) can give clues not only about nutrition
but also somatic growth and dental development. Visually accessible areas, such as
skin and nails, can reveal cyanosis, jaundice, and petechiae from bleeding disorders.
The hands particularly are worthy of inspection and can also show alterations in the
fingernails such as finger-clubbing from chronic cardiopulmonary disorders, as well
as infections and splinter haemorrhages. Overall shape and symmetry of the face may
be significant and there may be characteristic facies that are diagnostic of some
congenital abnormalities and syndromes.
16.2 CARDIOVASCULAR DISORDERS