-dentists mandated by law to report any suspected child abuse or neglect
-proof of abuse/neglect NOT necessary -failure to report suspected abuse/neglect may result in legal ramifications (fine, jail, civil liability) -types: 1) Physical: intentional abuse -common injuries include bruises, welts, lacerations, burns, and fractures -50% of abuse in craniofacial region, w/ 25% in oral region 2) Emotional: denial of affection, isolation, extreme threats, corruption 3) Sexual: any type of sexual activity, exhibitionism, and pornography 4) Neglect: willful negligence to provide for basic needs of child (food, shelter, clothing, medical care, supervision, protection, guidance) -willful failure of parent to seek and follow through w/ txt necessary to endure a level of oral health for adequate fxn and freedom from pain and infxn Pit and Fissure Sealants 1) Indications a) deep pits/fissures b) caries-free surface or incipient lesion 2) Contraindications a) rampant caries b) interproximal caries c) well-coalesced grooves d) inability to maintain dry field 3) Technique: a) obtain clean pit/fissures -pumice, air polishing device, toothbrush, 3% H2O2, enameloplasty b) isolation (rubber dam, cotton rolls, dry angles, etc w/ high-volume suction c) acid etch (37% phosphoric acid) for 20-30 seconds, rinse 30 seconds, dry w/ air 15 seconds -check for frosty enamel appearance d) bonding agent e) place sealant in all occlusal, buccal, and lingual grooves -avoid excessive sealant and check occlusion 4) Types of sealants a) resin-based sealants are most common and have superior retention compared to glass ionomer sealants Cleft Palate -combined cleft lip and palate more common than cleft palate alone -isolated cleft palate more common in females -4 classes: 1) Class I: only soft palate 2) Class II: soft and hard palates but not alveolar process 3) Class III: soft and hard palate and involves alveolar process on one side of premaxilla 4) Class IV: soft palate and continues through alveolus on both sides of premaxilla Cleft Lip -more common in males -more common on left side than right -4 classes: 1) Class I: unilateral notching of vermilion not extending to lip 2) Class II: unilateral notching that extends into lip but not to floor of nose 3) Class III: unilateral notching that extends into floor of nose 4) Class IV: any bilateral clefting of lip