Clinical assessment

Clinical assessment

For each child, a comprehensive clinical assessment that includes a full extra- and intra-oral examination should be carried out, including consideration of a radiographic examination (see Assessing carious lesions). Some children will not cope with a full assessment initially but this should be introduced as early as possible. 

For the majority of children, dental caries is the most common cause of oral health problems. Early detection can greatly improve treatment outcomes for the child. Although there is a poor correlation between plaque levels and dental caries, assessing plaque levels over time provides valuable information about the child’s oral hygiene behaviour and compliance with toothbrushing using fluoride toothpaste, which is one of the most effective preventive interventions. Regular and systematic assessment of the dentition is required to accurately diagnose, manage and then monitor carious lesions over time. A number of devices and systems are available to assist with caries detection but there is uncertainty about their performance and added value. Some devices are not applicable to general practice while others may be useful adjuncts to visual examinations.²⁶ Because primary teeth are shed, the clinician’s priorities when managing carious primary teeth differ from those when managing the carious permanent dentition. This needs to be taken into account when planning care.