4 Prevention of dental caries Flashcards
What is caries?
Is it preventable?
a disease of the dental hard tissues caused by the action of microorganisms, found in plaque, on fermentable carbohydrates
yes at an individual level
what is the impact of caries on pre-school children
aesthetic problems
loss of function
pain
infection - abscess
What is the distribution of caries related to in scotland
poverty - ‘hard to reach children’
25% of scottish children have 75% of the disease
What are risk indicators in children
- oral hygiene
- diet
- bacterial exposure
- socioeconomic status
- breast/bottle feeding
- fluoride exposure
- parental smoking
- parental oral health status
what is early childhood caries also known as
nursing caries
where does early childhood caries typically effect
upper anterior and molar teeth
what is the typical cause of nursing caries
inappropriate use of feeding cups and bottles
how can you prevent caries?
- diet
- fluoride
- oral hygiene
Are there benefits to taking fluoride during pregnancy?
no, fluoride goes through placenta but not enough to do anything
focus is on topical use of fluoride rather than systemic
What should the dental teams stance on breastfeeding be?
should support and promote breastfeeding
BUT
on demand overnight breastfeeding will cause caries
WHO recommends breastfeed til 2
but really should be stopped after about a year cause of effects on teeth
A lot of crying gets blamed on teeth, probably isn’t that
What should the dental teams stance on feeding cups be
use of a feeding cup rather than a bottle should be recommeded from 6 months (free flow spout)
drinks containing free sugars should never be put in a feeder bottle
children should not be put to bed with a feeder bottle or cup
soya milk formula is potentially cariogenic and should only be used when medically indicated
What should the dental teams stance on sweetened food and drinks be
The use of sweetened drinks should not be advocated but where there is a strong suspicion that they are being used:
- meal times only
- dilute as much as possible
- take through a straw which should be held at the back of the mouth
- encourage the use of non-sugar sweeteners in particular xylitol in food and drink
- use sugar free chewing gum, particularly containing xylitol
- clinicians should prescribe sugar-free medicines wherever possible
what are the only safe drinks to have between meal times
milk and water
What medicines should be prescribed
sugar free
dose given at mealtimes where not available
never after tooth brushing at night
what are safe snacks to recommend
milk/water fruit savour sandwiches crackers and cheese bread sticks crisps (although sugar molecules help shaped crisps maintain their shape e.g. hula hoops)
