Caries In Children

Question 1

definition of dental caries

Answer 1

chronic process by which bacterial processes procure acid, resulting in demineralisation of dental hard tissues

Question 2

Methodology of Vipeholm Study

Answer 2

Different consistencies of fermentable carbohydrates introduced at varying intervals

Question 3

Conclusion from turku study

Answer 3

sucrose is the most cariogenic sugar as it forms a thicker plaque that sticks on

Question 4

what is the critical pH

Answer 4

5.5

Question 5

what are the bacteria associated with caries

Answer 5

strep mutans

lactobacillus

Question 6

definition of early childhood caries

Answer 6

presence of one or more decayed (non cavitated/cavitated) lesions, missing due to caries, or filled tooth surfaces in primary tooth in child under age of 6

Question 7

definition of severe early childhood caries

Answer 7

from ages 3-5m one or more cavitated, missing due to caries, filled smooth surface caries in primary maxillary anterior teeth OR

Decayed, missing, filled score ≥4 at age 3, ≥5 at age 4, ≥6 at age 5

Question 8

% of children 18-48 months old with ECC

Answer 8

42% had incipient lesions

31% had cavitated lesions

Question 9

Causes of early childhood caries

Answer 9

Breastfeeding
Diet
Oral hygiene practices
Genetic

Question 10

What are the recommendations by American Academy of Pediatrics regarding breastfeeding

Answer 10

Recommend exclusive breastfeeding for 6 months. After 6 months, start to introduce complementary foods with continued breastfeeding.

Breastfeeding is protective below 1 year old

On demand breastfeeding after 1 year old contributory to caries

Question 11

Recommendations regarding bottle feeding

Answer 11

Infants should not be put to bed with bottle containing fermentable carbohydrates

Should start to drink from cup as they approach age 1

Question 12

What % of ECC is attributed to genetics

Answer 12

35-40%

Question 13

Consequences of ECC

Answer 13

Pain and infection

Growth and development, affect development/eruption of permanent successors

Cost

Aesthetics

Function

Question 14

How to mitigate ECC

Answer 14

Mitigate by seeing children at a younger age. Recommend child to see dentist by age 1 —> communicate with parents how to brush, oral health education

Question 15

How to clean child’s gums from 0-6 months

Answer 15

Use cloth or finger rubber to brush gums

Question 16

How to clean child’s teeth from 6 months to 3 years old

Answer 16

Smear/rice grain size of tooth paste (avoid fluorosis). Toothpaste >1000ppm
Toothbrush

Question 17

How to clean child’s teeth from 3 years old onwards

Answer 17

From 3 years old, child is able to spit
Pea sized amount of toothpaste

Child can start brushing on their own when they have the manual dexterity and motivation

Question 18

Sensitivity vs specificity

Answer 18

Sensitivity: correctly identify patient WITH disease

Specificity: correctly identify patient WITHOUT DISEASE

Question 19

What are the reasoning models for CRA

Answer 19

AAPD, CAMBRA

Question 20

Sensitivity and specificity of CAMBRA

Answer 20

Reasoning model

High sensitivity, low specificity

Question 21

Which are the algorithm based models of CRA

Answer 21

Cariogram, NUS CRA

There are screening and comprehensive models. NUS CRA is a comprehensive model

Question 22

Risk factors in AAPD

Answer 22

Biological: primary caregiver has active caries, child has special health care needs, child put to bed with bottle containing natural/added sugar

Protective: brush daily with fluoride toothpaste, child receives optimally fluoridated drinking water, child has regular dental care

Clinical findings: child has plaque on teeth, child has active wsl or enamel defects