Ch 47 The Pediatric Patient Flashcards
One out of __ toddlers already has one or more dental caries
10
Barriers to Dental Care (5)
- Availability of dental providers
-insurance, area, office hours, and/or willing to see children - Financial
- Lack of prenatal oral health literacy and importance of
- Language
- Transportation
Common appt plan for children with little or no oral disease
every 4 to 6 months
Children who wait until 2 or 3 for first dental visits are more likely to require
Restorative and emergency visits
Having a parent present is no longer needed once the child is __ ____ ___ ____ (generally)
In school full time
6-11 years even if no bone loss a periodontal assess should be completed
Yes
Indications for Referral
Severe crowding, malposed, congenitally missing teeth
Overbite, jet, cross tie or other malocclusions requiring intervention
Early loss of primary molars
-if left untreated will disrupt eruption and alignment of perm molars and premolars
Patients age is not an indicator for ____
Determined by DDS after review of medical and dental history, clinic exam, and vulnerability to environment factors
Radiographs
Frequency of appt depends on
Assessment of caries risks and periodontal health
Can an ultrasonic scaler be used on primary teeth?
NO, never on primary only permanent!
effective for localized mod to heavy calc and ortho pts
Fluoride used for what
Prevention, inhibition and reversal of caries
When should children receive a pro fluoride application and how often
Moderate caries risk
Every 6 months
High risk at 3-6 mos
Supplements may be considered when exposure is not optimal
Example ?
Prescription toothpaste for high risk or numerous lesions on proximal surfaces
Rinse, For children older than 6 yrs with moderate caries risk a supplement to daily brushing
90% of dental caries in school aged children occur in
Pits and fissures
Younger than 6 years should of use
Mouthrinse, unless directed by DDS
Parent/caregiver can rinse with .12% chlorhexidne to prevent vertical transmission of cariogenic bacteria. How long
1 week
Perio screening and probing is indicated following eruption of
Permanent incisors and first molars
Most common perio disease among children
Biofilm induced gingivitis
Presence of one or more decayed, missing, or filled tooth surfaces in any primary tooth in a child younger than 6
Early childhood caries
Child younger than 3 years with any smooth surface caries (white spot or cavitated)
Several early childhood caries
(SECC)
SECC is usually seen in children who have
Been given a bottle when going to slow containing cariogenic liquid (formula, milk, juice)
Or prolonged at will breast feeding
Tooth decay affects children in US more than any other chronic infections disease
Affects 1/4 children who live in poverty
True
What is the primary tooth adherent specific bacteria
Can it colonize be free tooth eruption as early as birth?
MS
Lactobacilli in large numbers are also in dental biofilm
Yes!
What teeth are the first to be effected by ECC
Max anteriors and primary molars
The nipple usually covers mand anteriors (rarely affected)
How often should sweetened foods and drinks be given per day at the max?
No grazing or sipping at will
3 or less and provided at mealtimes rather than in between meals
Primary beverages?
No more than _ to _ oz of juice per day
Milk and water
4-6 oz
Adolescent is the highest time for caries risk in males
- exceeded only during pregnancy for females
Children’s toothpaste in the US contains the same amount of fluoride as adult toothpaste whereas other countries reduce the amount in children’s
True!
Can any amount of fluoridated toothpaste be used as soon as first tooth comes?
Younger than 3yrs use
3 and older use
Yes just decrease the amount put on toothbrush
Smear of toothpaste grain of rice)
Pea size
What is associated with narrow max arch, anterior open bite, posterior cross bite, increased over jet and decreased overbite
Thumb sucking and finger sucking
When does the greatest incidence of injury to primary dentition occur
2-3 years
True or false
Tele dentistry is not as reliable as visual clinical exam for screenings, ortho, indications for oral surgery and managing odontogenic infections
False. Just as reliable and is encouraged for those with special healthcare needs
What do you need parents consent for medical clearance for ?
Local anesthesia
Antibiotic coverage
Other meds for or under age
Document
Overall appraisal
Pathology
Hygiene status
Anticipatory guidance provided
Procedures completed
Child behavior and cooperation
Tx planned
