• Before bringing the patient back ask the parent:
  • Any problems/concerns with patient’s teeth?
  • Any changes in patient’s prescription medications?
  • Are they ok with x-rays (when recommended) and/or the fluoride varnish 
• Children under 4 years old we try to take back the child without the parent, but if the patient refuses, that is ok as they are still very young.
• Children 4 years old & older we always try to take the patient back without the parent. 
• Some young children will refuse to go back without the parent, in these cases try to talk the patient into going back by themselves. 
• If they completely refuse let the patient and the parent know that we can have the parent come back this one time.
• When a parent tries to come back with the patient for a prophy appt., inform the parent that we always bring the patient back by themselves and we will come get them for the exam portion of the appt. with the Doctor.
• If a parent insists that they will NOT allow their child to go back for any appts. by themselves, inform the parent that we bring patients back without the parent so we can build a rapport with the patient. 
• This allows us to get to know the patient and for the patient to get to know us. 

1. Seat patient & Introduce yourself. Go over the procedure as well as what the patient should expect. Explain everything you are doing as you go to help patient understand. ie. Today we are going to clean your teeth, take pictures of your teeth (if they are due) and then Doctor will come and check your teeth to see if you have any cavities. Some kids may have lots of questions and that is good, try to answer them the best that you can. The questions that you aren’t sure of the answer, try to remember them and ask the doctor the question for patient when the doctor is doing the exam. 
2. Place bib on patient, open up everything, prepare for the procedure. Inform the patient of the available prophy paste flavors, so they can pick their flavor. Ask patient how often they brush & floss, use open ended questions to encourage the patient to talk more. i.e. “How often do your brush your teeth?” Asking a patient “Do your brush your teeth twice a day,” will only get you yes or no answers. 
3. Take Bitewing Radiographs or Pano if pt. is due for them. 
4. Polish patients teeth adding more prophy paste as needed. Stop occasionally to suction pt.’s saliva. Some patients will prefer to rinse more often and that’s ok. Floss patients teeth, as you go explain to the patient why you are flossing and how you are flossing. 
5. For parents that prefer to be in the exam room for the exam with the doctor, now is the time to get them from reception.
6. Notify the Doctor that the patient is ready for their exam, of any concerns the patient/parent has and any other pertinent information.
7. Chart appointment in patient’s chart. Make any changes or adjustments to the patient’s appointment. Add your name in the assistant field if not already there & Complete the appt.
8. At the end of the appt. ask if the patient and parent has any questions, and then escort them to the front desk so they can check out.

Child Prophy Charting

Pre-op

Chief complaint – 

Medical history and medications reviewed – 

D0120 Periodic oral evaluation – established patient

Intraoral cancer screening – normal

Radiographs – 

Occlusion – 

D1120 Prophylaxis Child

Polished and flossed.

Polish flavor – 

Plaque – 

Supragingival calculus – 

Subgingival calculus – 

Hand scaling needed – 

D120.1 Head and Neck Cancer Screening 

Completed, no significant findings.

D1206 Topical fluoride varnish; therapeutic application for moderate to high caries risk patients 

Varnish applied and instructions given. 

Flavor – 

D1310 Nutritional counseling for control of dental disease 

Frequency of snacking – 

Frequency of sugary food and beverages – 

Reinforced the role of sugary food and beverages as a risk factor for dental disease.

D1330 Oral Hygiene Instructions 

Daily brushing twice a day – 

Flossing daily – 

Electric toothbrush – 

Reinforced oral hygiene instructions, including brushing and flossing techniques, to brush for at least 2-3 minutes at least twice a day and to floss at least once a day.

Patient handled visit today (1-4, 4 being best) – 

NV –