Caries Prevention & Management

Question 1

How is caries risk assessed?

Answer 1

1. Clinical evidence
2. Diet
3. SH
4. F use
5. Plaque control
6. Saliva
7. MH

Question 2

Which teeth affected in nursing bottle caries?

Answer 2

Upper anterior and molar teeth

Question 3

What advice should be given in regards to feeding bottles/ cups?

Answer 3

• Recommended for 6 months onwards
• Never use for drinks containing sugar
• Should not put children to bed with bottle
• Soya milk potentially cariogenic, only use if medically indicated to do so

Question 4

What is the optimum level of fluoride in water supplies?

Answer 4

1ppm

Question 5

What are the toothpaste strength recommendations for <3, 4-16 and 16+ yrs?

Answer 5

NORMAL CR
<3yrs = 1,000ppm
4-16yrs = 1,000 - 1,500ppm
16+yrs = 1,500ppm

HIGH CR
<10yrs = 1,500ppm
10+yrs = 2,800ppm (duraphat toothpaste)

Question 6

What is the toxic dose of fluoride ingestion?

Answer 6

5mg/kg

Question 7

What is the management for children who are suspected to have ingested fluoride?

Answer 7

<5mg/kg = milk and observe for few hours

5-15mg/kg = calcium orally (milk, calcium gluconate/ lactate) and admite to hospital

> 15mg/kg = immediate admission to hospital for cardiac monitoring and life support, IV calcium gluconate

Question 8

What are the concentration of fluoride supplements (excluding toothpaste)?

Answer 8

• Tablets = 1mg F
• Mouthwash = 250ppm
• Varnish = 22,600ppm

Question 9

What is the management strategies for caries in the primary dentition?

Answer 9

OCCLUSAL: non-cavitated

• Complete caries removal and restoration
• Partial caries removal and restoration
• Fissure seal caries
• Prevention alone* (only when no other alt feasible)

OCCLUSAL: cavitated

• Complete caries removal and restoration
• Partial caries removal and restoration
• Seal with Hall crown technique
• Self-cleansing and prevention*
• Prevention alone*

INTERPROXIMAL: early dentine

• Complete caries removal and restoration
• Partial caries removal and restoration
• Hall crown
• Prevention alone*

INTERPOXIMAL: advanced lesion

• Complete caries removal and restoration
• Partial caries removal and restoration
• Hall crown
• Self-cleansing and prevention*
• Prevention alone*

ANTERIOR: cavitated

• Complete caries removal and restoration
• Partial caries removal and restoration
• Prevention alone*

GROSSLY CARIOUS: unrestorable, no signs/symps

• Prevention alone
• Extraction