caries risk and prevention planning Flashcards
what is the definition of dental caries?
> Is a multifactorial, dynamic process caused primarily by the complex interaction of cariogenic bacteria with fermentable carbohydrates on a tooth surface over time
when does dental caries occurs?
> Caries occurs when the net demineralising flux prevails over the net remineralisation flux
what are caries risk factors?
> Caries risk factors are anything that affects this balance
what are the pathological factors that cause demineralisation?
> acid producing bacteria
> sub normal saliva flow and or function
> frequent eating/ drinking of fermentable carbohydrates
> poor oral hygiene
what are the protective factors that cause remineralisation?
> saliva flow and components
> remineralization (fluoride, calcium, phosphate)
> antibacterials (fluoride, chlorhexidine, xylitol)
> good oral hygiene
what is the caries risk in NI relative to England based CDHS 2013?
> obvious decay at 5years - England = 31%, NI = 40%
> obvious decay at 12 years - England = 32%, NI = 57%
> obvious decay at 15 years - England = 44%, NI = 72%
what was the impact of caries based on the CDHS 2013?
> 22 % of 12 year olds and 19% of 15 year olds respectively reported experiencing difficulty eating in the past three months.
> 35% of 12 year olds and 28% of 15 year olds reported being embarrassed to smile or laugh due to the condition of their teeth.
> 35% of the parents of 15 year olds reported that their child’s oral health had impacted on family life in the last six months
> 23% of the parents of 15 year olds took time off work because of their child’s oral health in that period.
when is a Childs first dental assessment?
> First assessment is when the first tooth erupts or by one year of age
what does comprehensive assessment of a patient social, medical, dental status allow you to determine?
> risk of developing caries
> also predicts rate of disease disease progression
what are some evidence based risk indicators based on the SDCEP 2018?
> Previous Caries experience (any decayed, missing or filled teeth)
> Visible plaque on maxillary incisors is excellent predictor in young children
> Caries in primary teeth increases caries risk in permanent teeth
> Resident in an area of deprivation
> Caries/restorations in anterior teeth
> Healthcare worker’s opinion
when should you carry out a caries risk assessment?
> Should be done regularly as can change/ is non static
> Caries risk assessment is undertaken as part of the history and examination and
> Determination of caries risk assessment should be undertaken before formulating a treatment plan
based on a history, what are some caries risk factors you should consider?
> Previous and current caries experience
> Significant Medical History e.g. Special needs, chronic ill health (increased risk of developing disease or increased risks associated with management of disease), regular sugar containing medication.
> Salivary flow, xerostomia, previous radiation
> Diet
> Drinks- Use of sweetened drinks regularly/bottle in bed
> Poor oral hygiene
> Fluoride usage
> Family caries experience (consider parents, siblings)
> SES and mother’s education
> Regular dental attendance
based on a dental exam, what are some caries risk factors you should consider?
> Visible plaque
> Gingivitis
> Hypomineralisation/ hypoplasia of enamel
> Deep pits/ fissures
> Defective restorations
> radiographic caries
When a child is too small for the dental chair, what is the solution for a dental exam?
> knee to knee exam
what are the principles of treatment planning in paediatric dentistry?
> Must be individualised
> Should foster a positive dental attitude
> Whilst aiming for adulthood with optimal dental health
> Realistic and flexible and achievable
> Must show empathy and focus on motivating parents and patients SCDEP 2010
