An initial exam should happen as early as six months of age, or six months after the first tooth erupts and no later that 12 months of age. Thorough medical histories of the infant and dental histories both of the mother/caregiver and infant should be recorded. It is important to ducate the caregivers in infant oral care, provide a caries risk assessment and determine an appropriate prevention plan. Referral to specialists should be evaluated, if needed.
The initial visit should consist of the following:
There are several techniques used for this initial exam. The one recommended is the lap-to-lap knee-to-knee where you will demonstrate oral hygiene and ask the parent to participate. Usually the child will cry and this will help in keeping the mouth open. Make sure the parent understands what you will be doing as they can be surprised.
Normal Clinical Findings in the Initial Exam:
Natal – present at birth.
Neonatal – within the first 30 days and erupts prior to three months of age.
Tx: monitor; removal/smoothening of tooth
Associated finding – Riga-Fede disease which often shows a sublingual traumatic ulceration