Caries Prevention Flashcards
Describe early childhood caries
Also known as nursing caries
Typically affects the upper anterior and molar teeth
What is the typical cause of nursing caries
Inappropriate use of feeding cups and bottles
What are the main methods of caries prevention
Diet
Fluoride
Oral hygiene
What benefit is there of pregnant women taking fluoride supplementation
None
What should be recommended in terms of feeding bottles
Use a free-flow spout cup rather than bottle from 6 months
Drinks containing free sugars should never be put in a feeder bottle
Children should not be put to bed with a feeder bottle
Soya milk formulation is potentially cariogenic and should only be used when medically indicated
What is recommended in terms of sweetened drinks
The use should not be advocated but where there is a strong suspicion they are begin used:
- mealtimes only
- dilute as much as possible
- take through a straw which should be held at the back of the mouth
What drinks are safe to have between meals
Water and milk
What is recommended in terms of sugar free medicines
Should be requested when available, where not, doses should be given at mealtimes and never after tooth-brushing at night
Describe cheese as a snack
Good, high energy, non-cariogenic and may actively protect against caries
What are safe snacks
Milk/water Fruit Savoury sandwiches Crackers and cheese Bread sticks
What are the different sources of fluoride
Water
Toothpaste
Supplementary self-delivered - mouthwash
Professionally delivered - varnishes and slow/release devices
Describe ideal tooth brushing in children
Should be started as soon as the first primary teeth erupt
Children under 8 lack the dexterity to brush their own teeth effectively
Young children should have their teeth brushed by an adult before bed and one other time in the day
Older children unable to brush their teeth effectively should be assisted
What fluoride strengths are found in different toothpastes
Child formulations (not recommended) - 450-600 ppm
Child formulations - 1000ppm
Standard fluoride - 1400-1500 ppm
Enhanced fluoride (dura-hat) - 2800ppm
What toothpaste strength recommendations should be given
First tooth eruption - 3 years - 1000 ppm
4-16 years - 1000-1500 ppm
High risk children under 10 - 1500ppm
High risk 10 and over - 2800 ppm (prescription only)
High risk 16 and over - 5000ppm (prescription only)
How should fluoride toxicity be managed
By dosage
<5mg/kg - give calcium orally (milk) and observe for a few hours
5-15mg/kg - give calcium orally (milk, calcium gluconate, calcium lactate) and admit to hospital
>15mg/kg - admit to hospital immediately, cardiac monitoring and life support, IV calcium gluconate
How should dental floss be used
In combination with brushing with fluoride toothpaste
For those with ortho/fixed pros, gingival recession - interdental cleaning may be a better option
How can fluoride supplementation be given
Drops - from spoon Tablets: 6m - 3y - 0.25mg/d 3y - 6y - 0.5mg/d 6y+ - 1mg/d
What is recommended for fluoride mouthwash
Not recommended for children under 6
Even over 6, need to assess the child’s ability to properly expectorate
Describe practice based prevention
Topical fluoride varnish should be applied to the dentition at least twice yearly for pre-school children assessed as being at increased risk of caries
Floss between contact areas
Fluoride varnish can be administered for high risk adults
Describe health education
A process that results in individuals or groups having increased knowledge related to health
Describe health promotion
Supports individuals into translating their health knowledge into positive behaviours and lifestyles
Describe oral health promotion programmes
Aim to reduce the risk of early childhood caries, should be available for parents during pregnancy and postnatal
For young children should be initiated before the age of 3
Should address environmental, public and social policy changes in order to support behavioural change
Help of lay persons and non-dental health professionals
How should radiographs be used in caries prevention
Bitewings every 6 months for high risk children
Every 12-18 months for low risk
60% of interproximal caries are missed if you do not take bitewings
