Medical Care and Your 13- to 18-Year-Old

What to Expect at the Doctor's Office

Teens should visit their doctors annually. At least three of these visits should include a complete physical examination:

• one performed during early adolescence (ages 11 to 14)
• one during middle adolescence (ages 15 to 17)
• one during late adolescence (ages 18 to 21)

If your child has a chronic medical condition or if certain clinical signs or symptoms are present, more frequent exams might be needed.

Medical care should include screenings for high blood pressure, obesity, eating disorders, and, if indicated, hyperlipidemia (an excess of cholesterol and/or other fats in the blood). A tuberculin (PPD) test may be done if your teen is at risk for tuberculosis.

Your teen's doctor will also check his or her teeth for tooth decay, abnormal tooth development, malocclusion (abnormal bite), dental injuries, and other problems. Your teen should also continue to have regular checkups with your dentist.

Vision and hearing will be checked. Teens are also checked for scoliosis (curvature of the spine).

Immunizations

By the age of 13, teens should have already completed the following immunizations:

• varicella (if they have not had chickenpox)
• measles, mumps, and rubella (MMR)
• hepatitis B series (hep B)
• meningococcal meningitis (MCV4)
• HPV (human papillomavirus) vaccine
• diptheria, tetanus, and acellular pertussis booster (Tdap)

Doctors recommend administering the Tdap booster at 11-12 years of age, with a tetanus and diptheria booster (Td) every 10 years thereafter. The flu vaccine, given before flu season each year, also is recommended.

As kids go through puberty, issues of sexual health will be addressed. Your doctor will teach your daughter how to perform a monthly breast exam. The doctor also might perform (or refer her to a gynecologist for) a gynecologic exam. Males will be checked for hernias and testicular cancer and taught to perform a testicular self-exam.

Teens should be asked about behaviors or emotional problems that may indicate depression or the risk of suicide. The doctor also should provide counseling about risky behaviors and other issues, including:

• sexual activities that may result in unintended pregnancy and sexually transmitted diseases (STDs), including HIV
• emotional, physical, and sexual abuse
• use of alcohol and other substances, including anabolic steroids
• use of tobacco products, including cigarettes and smokeless tobacco
• drinking and driving
• use of safety devices, including bicycle helmets, seat belts, and protective sports gear
• how to resolve conflicts without violence, including how to avoid the use of weapons
• learning problems or difficulties at school
• appropriate warm-ups before exercise and importance of regular physical activity

If You Suspect a Medical Problem

Parents or other caregivers should receive health guidance at least once during early, middle, and late adolescence from their teen's doctor. During these sessions, the doctor will provide information about normal development, including signs and symptoms of illness or emotional distress and methods to monitor and manage potentially harmful behaviors.

If you suspect that your teen has a physical disorder, a psychological problem, or a problem with drugs or alcohol, contact your doctor immediately.

Common Medical Problems

Issues involving puberty and sexual development are typical concerns for this age group. Doctors who establish a policy of confidentiality can serve as a valuable resource for a teen by answering questions and providing guidance during this period of physical and emotional changes.

Teens should be reassured that anything they discuss with their doctor will be kept confidential, unless their health or the health of others is endangered by the situation.

Sports injuries are common concerns. Osgood-Schlatter disease, a painful inflammation of the area just below the front of the knee, is particularly common in the early teen years. Knee pain is also a frequent complaint. Your teen's doctor should evaluate any severe or persistent pain of the joints, muscles, or other areas of the body.

Reviewed by: Steven Dowshen, MD
Date reviewed: September 2011