Caries prevention

Question 1

what are the impacts of caries on pre-school children?

5

Answer 1

• aesthetic problems
• loss of function
• pain
• infection
• poor growth

Question 2

what are the risk indicators in children for caries?

Answer 2

• oral hygiene
• diet
• bacterial exposure
• socioeconomic status
• breast/bottle feeding
• fluoride exposure
• parental smoking
• parental oral health status

Question 3

what is nursing caries? what teeth does it affect?

Answer 3

tooth decay caused by inappropriate use of feeding cups and bottles
* typically affects upper anterior and molar teeth
* saliva cannot remineralise carises on upper teeth due to gravity

Question 4

give prevention advice for diet and nutrition

9

Answer 4

• Use of feeding cup rather than a bottle should be recommended 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
• The use of sweetened drinks should not be advocated but at mealtimes only, dilute as much as possible, through a straw
• Food and confectionary containing free sugar should be minimised and restricted to mealtimes only
• Plain water or milk are the only safe drinks to have between meals
• Sugar free medicines should be requested where available, where not available doses should be given at mealtimes and never after tooth-brushing at night
• Cheese is a good high energy food for toddlers, it is non-cariogenic and may actively protect against caries

Question 5

what are safe foods for children to snack on?

5

Answer 5

• milk / water
• fruit
• savoury sandwiches
• crakers and cheese
• bread sticks

Question 6

give examples of fluoride prevention for caries

4

Answer 6

• water
• toothpaste
• supplementary self-delivered - drops, tablets, mouthwash
• professionally delivered - APF gels, varnishes, slow-release devices

Question 7

when should children start brushing their teeth?

Answer 7

as soon as the first primary tooth erupts

Question 8

what size of toothpaste should be used for children under 3 and 3+?

Answer 8

children <3 = smear of paste
children >=3 = pea sized

Question 9

what strength of toothpaste should be used for children around 3 years?

Answer 9

1000ppmF

Question 10

what strength toothpaste should be used for children 4-16 years?

Answer 10

1000-1500ppmF

Question 11

what strength toothpaste should be used for high risk children under 10 years?

Answer 11

1500ppmF

Question 12

what strength of toothpaste should be used in high risk children 10-15 years?

Answer 12

2800ppmF

Question 13

what strength of toothpaste should be used in high risk children 16+ years?

Answer 13

5000ppmF

Question 14

what modifications for individuals for autism/neurodiversity are available when brushing teeth?

5

Answer 14

• use softer brush
• set a predictable routine, use a timer
• sing a song/play app for more engagement
• change location - less overwhelming
• use incentives and rewards to encourage cooperation

Question 15

what is the amount of toothpaste that can be a probable toxic dose?

Answer 15

5mg/kg body weight

Question 16

what is the amount of fluoride in a 90g 1000ppm toothpaste?

Answer 16

90mgF

Question 17

what should you give if somone ingested <5mg/kg fluoride?

Answer 17

give calcium orally (milk) and abserve for a few hours

Question 18

what should you give if someone ingested 5-15mg/kg fluoride?

Answer 18

give calcium orally and admit to hospital

Question 19

what should you give if someone ingested >15mg/kg fluoride?

Answer 19

admit to hospital immediately, cardiac monitoring and life support, intravenous calcium gluconate

Question 20

how often should you take radiographs for high and low risk children?

Answer 20

high risk - every 6 months
low risk - every 12-18 months