You asked Donna not to feed him breakfast and if he must have something then only to give Tyler a light breakfast preferably liquid no later than 5 AM. This is just in case you need to give oral medication for anxiolysis.

Donna returns the next day at 11:00 AM with Tyler. You have prepared everything for his arrival including the television and iPad. Donna reports he has had nothing to eat since last night. Today Tyler goes readily back to the operatory and sits in the treatment chair. He begins to flap his hands for about 15-20 seconds. You ignore this behavior and do not allow it to interrupt you from showing him a picture board about what is going to happen today. After a few minutes Tyler appears to be calm and receptive to the picture board. Utilizing the concepts of “tell-show-do” and “one voice” you are able to look in his mouth. Tyler even permits bitewing radiographs (which show no radiographic caries) and a periapical radiograph of the chipped tooth as well as a clinical examination for caries and trauma on the chipped tooth. You attempt to complete an oral prophylaxis using a cavitron and prophy angle but Tyler will not permit it. You then brush his teeth using a regular toothbrush dipped in Peridex while counting to 5. He allows you to repeat the process and you are able to brush all four quadrants of his mouth. Soon after Tyler lets you know he has had enough and tries to get out of the chair. You sit him up and congratulate him on his excellent behavior and allow him to pick a prize of his choice from a selection of age appropriate gifts.

Your radiographic and clinical exam indicate that Tyler does not need to return for 6 more months. You are pleased with how your first visit went and want to continue working towards establishing a dental home for Tyler but know that Donna has been having difficulty caring for Tyler’s oral health.

Review the following information on home care techniques to help provide Donna with suggestions on how to care for Tyler’s teeth: Home Care Techniques