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Pediatric Dentistry > Early Childhood Caries + Fluoride > Flashcards

Early Childhood Caries + Fluoride Flashcards

1
Q

ECC (according to AAPD)

A

presence of 1 or more decayed (cavitated or non-cavitated), missing (due to caries), filled tooth surfaces in any primary tooth in a child 71 months of age or younger

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2
Q

types of ECC

A
  • Type I: mild to moderate
  • Type II: moderate to severe
  • Type III: severe
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3
Q

severe ECC: 3 years and younger

A

any signs of smooth surface caries

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4
Q

severe ECC: ages 3-5 years old

A
  • 1 or more cavitated, missing, filled smooth surface in primary dentition
  • DMFT score greater than or = to 4 (age 3), >/= 5 (age 4), >/= 6 (age 5)
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5
Q

modes of transmission of cariogenic microorganisms

A
  • vertical transmission
  • horizontal transmission
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6
Q

modes of transmission: vertical

A

mother/primary caregiver to child

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7
Q

modes of transmission: horizontal

A
  • child/other person via things to the patient
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8
Q

2 types of dental caries

A
  • active
  • inactive/arrested
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9
Q

active vs inactive caries: location

A

active - plaque retentive areas (pit and fissure, proximal, gingival)

inactive - not in plaque retentive areas

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10
Q

active vs inactive caries: plaque over the lesion

A

active - thick and/or sticky

inactive - not thick/sticky

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11
Q

active vs inactive caries: surface appearance

A

active - matte/opaque

inactive - shiny

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12
Q

active vs inactive caries: tactile feeling

A

active - rough enamel/soft dentin

inactive - smooth enamel/hard dentin

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13
Q

active vs inactive caries: gingival status

A

active - inflammation/BOP

inactive - no inflammation/no BOP

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14
Q

why do we need to classify active and inactive caries

A
  • to know what should be prioritized when treating
  • to assess if it will progress or not
  • to know what type of treatment to do
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15
Q

associated risk factors for ECC

A
  • bottle feeding
  • breastfeeding
  • free sugars
  • oral hygiene
  • fluoride
  • socioeconomic factors
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16
Q

previous name for ECC

A

nursing bottle caries

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17
Q

why milk causes caries

A

sugar content

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18
Q

breastfeeding age (WHO)

A

until 24 months

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19
Q

breastfeeding age (ADA)

A

soon after child’s 1st birthday

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20
Q

WHO recommendation for free sugars

A

(strong recommendation) reduce intake of sugar to less than 10% of total energy intake

(conditional recommendation) further reduction of free sugar intake to below 5% of total energy intake

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21
Q

2 factors for free sugars

A
  1. age
  2. frequency of consumption
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22
Q

most cariogenic carbohydrate

A

sucrose

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23
Q

why sucrose is the most cariogenic carbohydrate

A
  • combination of glucose + fructose
  • small molecule; easily enters biofilm
  • produces extracellular polysaccharide (dextran)
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24
Q

purpose of dextran

A

helps biofilm stick to the tooth surface, making it more difficult to remove

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25
Q

acid produced by energy production induced by sucrose

A

lactic acid

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26
Q

why children who do not have their teeth cleaned at night have higher risk of ECC

A

less saliva production at night = less protection from cariogenic microorganisms

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27
Q

minimum amount of recommended fluoride concentration

A

1000 ppm

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28
Q

professionally applied fluoride should be done…

A

every 6 months

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29
Q

best age for first dental visit

A

1 year old

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30
Q

children from low income families tend to:

A
  • make first visit to dentist at older age
  • less frequent dental visits
  • visit only when there is an established dental problem
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31
Q

consequences of non-treatment of ECC

A
  • cellulitis
  • abscess
  • dental problems
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32
Q

T or F: ECC is a preventable disease.

A

True

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33
Q

ways on preventing ECC

A

parent education

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34
Q

how to clean infant teeth as soon as they erupt

A
  • washcloth
  • soft bristle brush
35
Q

recommended brushing for children

A

brush 2x a day with fluoride toothpaste and soft age-appropriate toothbrush

36
Q

toothpaste amount: 2 years below

A

smear amount

37
Q

toothpaste amount: 2 years and up

A

pea size amount

38
Q

regular removal and prevention of its accumulation on teeth and adjacent gingival surfaces

A

plaque control

39
Q

cornerstone of non-operative treatment

A

plaque control

40
Q

T or F: Plaque can be washed away by action of saliva or by rinsing with fluids.

A

False; it cannot

41
Q

T or F: Plaque re-attaches within minutes after cleaning of tooth surface

A

True

42
Q

duration of time for plaque to form and become visible

A

24-48 hours

43
Q

duration of time it takes for plaque to produce signs of gingival inflammation

A

48 hours

44
Q

only practical means for improving oral health

A

daily mechanical removal of plaque

45
Q

oral hygiene index and patient education: what patient should be instructed on

A
  • objectives and goals of plaque control
  • OH devices: toothbrush, toothpaste, fluoride, floss, etc.
  • brushing technique
46
Q

when brushing habits should start

A

as soon as 1st deciduous tooth erupts

47
Q

age when potential brushing is needed

A

up to 6 years of age

48
Q

age when children should still be supervised by an adult when brushing

A

up to 12 years of age

49
Q

recommended brushing frequency

A

2-3x a day for 2-3 minutes

50
Q

recommended toothpaste

A

fluoridated toothpaste (not less than 1000ppm)

51
Q

age for smear (grain) amount of toothpaste

A

6 months to 2 years old

52
Q

age for pea size amount of toothpaste

A

2-6 years old

53
Q

toothbrush recommendation for pedia patients

A
  • soft bristle toothbrush
  • small head
  • broad handle
54
Q

toothbrushing methods

A
  1. roll - roll method/modified Stillman technique
  2. vibratory - Stillman, bass techniques
  3. circular - Fones technique
  4. vertical - Leonard technique
  5. horizontal - Scrub technique
55
Q

toothbrushing method: roll

A

roll method, modified Stillman technique

56
Q

toothbrushing method: vibratory

A

Stillman, Bass techniques

57
Q

toothbrushing method: circular

A

Fones technique

58
Q

toothbrushing method: vertical

A

Leonard technique

59
Q

toothbrushing method: horizontal

A

Scrub technique

60
Q

other toothbrushing methods

A
  • Charters
  • Bass
  • Modified Bass
  • Stillman
  • Modified Stillman
61
Q

bristles on cervical crown obliquely pointing
coronally, horizontal motion with rotations

A

Charters

62
Q

bristles in sulcus 45 degree pointing apically, horizontal back and forward motion

A

Bass

63
Q

bristles in sulcus 45 degrees pointing apically, horizontal motion with rotations to occlusal

A

Modified Bass

64
Q

bristles in gingival margin obliquely towards the
apex; vibratory movements without moving the brush

A

Stillman

65
Q

bristles in gingival margin obliquely towards the apex; vibratory movements with rotations towards occlusal

A

Modified Stillman

66
Q

2 types of fluoride mouthrinse

A
  • 0.05% NaF
  • 0.2% NaF
67
Q

frequency of rinse: 0.05% NaF

A

rinse once daily

68
Q

frequency of rinse: 0.2% NaF

A

rinse once weekly

69
Q

order of treatment plan

A
  1. Plaque control
  2. Chief complaint
  3. Preventive/Restorative procedures
  4. Pulp therapy
  5. Extraction
  6. Orthodontic/Prosthodontic care
  7. Recall
70
Q

last step before patient can go after charting

A

fluoride application

71
Q

3 types if professionally applied fluoride

A
  • 2% sodium fluoride (gel)
  • 1.23% acidulated phosphate fluoride (gel)
  • 8-10% stannous fluoride
72
Q

most common professionally applied fluoride

A

2% sodium fluoride (gel)

73
Q

2% sodium fluoride: ppm and pH

A

8% 9,050 ppm fluoride ion

pH 7 (neutral)

74
Q

1.23% acidulated phosphate fluoride: ppm and pH

A

12,330 ppm fluoride ion

pH 3.2

75
Q

8-10% stannous fluoride: ppm and pH

A

19,500 ppm fluoride ion

pH 2.4-2.8

76
Q

why 8-10% stannous fluoride is not used anymore

A

causes tooth discoloration

77
Q

steps in fluoride gel application

A
  1. Correct sized trays to fit UL arches of
    the patient
  2. Minimal amount of gel that will permit
    complete coverage of the tooth surfaces
    (5ml per arch)
  3. Px should sit upright
  4. Teeth must be cleaned and dried
  5. After UL trays are positioned, small
    saliva ejector should be placed between
    trays or in the vestibule
  6. Instruct the patient not to swallow the gel
  7. Fluid gel should be left in the mouth for
    4 mins
  8. After trays are removed, excess saliva
    and gel should be evacuated
  9. Tell the patient to spit the remaining oral
    fluid
  10. Instruct the patient not to eat, drink or
    rinse for 30 mins
  11. Repeat every 6 months
78
Q

fluoride varnish: %NaF

A

50 mg/ml NaF

79
Q

fluoride varnish: ppm and pH

A

2.2% fluoride ion; 22,600 ppm

pH 7

80
Q

where fluoride varnish is applied

A

clean, dry tooth surface

81
Q

when fluoride varnish sets

A

in presence of moisture

82
Q

duration of time fluoride varnish remains on tooth surface

A

12 hours

83
Q

steps in applying fluoride varnish

A
  • oral prophylaxis
  • isolate
  • dry
  • apply
  • patient instruction
84
Q

post-op instructions after fluoride application

A
  • no food/drinks (hard, sticky, abrasive food and hot beverages)
  • no rinsing with water
  • brush teeth after 12 hours
  • repeat every 3 months/6 months

Pediatric Dentistry (10 decks)

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