Early Childhood Oral Health Flashcards
Define ECC
presence of one or more decayed (noncavitated or cavitated lesions), missing (due to caries), or filled tooth surfaces in any primary tooth in a child under 6yrs
pg 71 guidelines
Define S-ECC
- <3yrs: any sign of smooth-surface caries in a child;
- 3-5yrs: one or more cavitated, missing (due to caries), or filled smooth surfaces in primary maxillary anterior teeth OR a DMFT score of their age +1 (so score of 4 for a 3yr old, score of 5 for 4yo, and score of 6 for 5yo)
pg 71 guidelines
What are the main microbial risk markers for ECC?
MS and lactobacillus sp.
pg 71 guidelines
What is vertical transmission? Horizontal transmission?
Vertical transmission: from caregiver to child through salivary contact, affected by frequency and amount of exposure.
**Therefore, infants whose mothers have high levels of MS are at greater risk of acquiring MS earlier than children whose mothers have low levels.
Horizontal transmission: occurs between other members of family or children in daycare.
pg. 71 guidelines
T or F. Frequent night-time bottle-feeding with milk and ad libitum breast-feeding will lead to ECC.
False.
Frequent night-time bottle-feeding with milk and ad libitum breast-feeding are associated with, but not consistently implicated in, ECC.
pg. 71-72 guidelines
Why does frequent consumption of between-meal snacks and beverages containing sugars increase risk of caries?
due to prolonged contact between the sugars and the cariogenic bacteria
pg 72 guidelines
What is AAP’s recommendation for intake of 100% fruit juice per day?
1yo to 6yo: 4-6 oz/day
**also, newly erupted teeth (due to immature enamel) and hypoplastic enamel may be at higher risk for developing caries.
pg. 72 guidelines
What is the current at-home recommendation to reduce risk of ECC?
ALL children whether in optimally or sub-optimally fluoridated communities should brush 2x/day with fluoridated toothpaste.
pg. 72 guidelines
What is the recommended amount of fluoridated toothpaste for children?
<3yo: rice size/smear, approx 0.1mg fluoride ion
3-6yo: pea-size; approx. 0.25mg fluoride ion
**Keep rinsing after brushing to a minimum to maximize benefits of fluoride.
pg. 72 guidelines
What is the recommended professionally-applied fluoride treatment for children at risk for ECC, who are younger than 6yo?
5% NaF varnish (22,500 PPM of F-)
At what age is preventive intervention considered critical?
Evidence increasingly suggests that preventive interventions within the first year of life are critical.
pg. 72 guidelines
T or F. ECC is a chronic disease
True
pg. 72 guidelines
T or F. ECC results from an imbalance of multiple risk and protective factors over time.
True
pg. 72 guidelines
What age does AAPD encourage parents to avoid baby bottle use?
after 12-18 months of age.
pg. 72 guidelines
AAPD recommends establishing a dental home by what age?
within 6mo of eruption of first tooth and no later than 12mo of age
pg. 72 guidelines
What are some non-traditional methods that have started to gain more emphasis due to risk with restorative care in the pediatric population?
Because ECC management often requires use of sedation and GA with its associated costs and possible health risks, emphasis is placed on prevention and arrestment of disease processes:
- chronic disease management: parent engagement to facilitate preventive measures and temporary restorations to postpone advanced resto care.
- active surveillance: emphasizes careful monitoring of caries progression and prevention programs in children with incipient lesions
- ITR: temporarily restore teeth in young children until time when traditional cavity preparation and resto is possible.
pg. 74 guidelines
What are the objectives of CRA? (4)
Caries Risk Assessment:
- fosters treatment f disease process vs treating outcome of the disease
- allows understanding disease factors for a specific patient and aids in individualizing preventive discussions
- individualizes, selects, and determines frequency of preventive and restorative treatment for a patient
- anticipates caries progression or stabilization
pg. 220 guidelines
What factors does CRA take into account?
diet fluoride exposure susceptible host microflora social/cultural/behavioral factors
pg. 220 guidelines
What is the point of CRA?
To determine the likelihood of increased incidence of caries
What are some of the most common caries risk indicators? What are some protective factors?
Risk factors: presence of caries lesion* low salivary flow* visible plaque on teeth high frequency sugar consumption* presence of appliance in mouth health challenges socio-demographic factors* access to care cariogenic microflora
Protective factors: potimally-fluoridated water 2x/day brush with fluoridated toothpaste professionally applied F varnish regular dental care
pg. 220 guidelines
__% of children have caries by the time they reach kindergarten.
28%
pg. 228 guidelines
What is the perinatal period?
Period around the time of birth–beginning with completion of 20th week of gestation and ending 4 weeks after birth.
pg. 229 guidelines
pg 2 handbook
What is the optimum level for fluoridated water?
- 7PPM
pg. 229 guidelines
T or F. Transfer of drugs and therapeutics into breastmilk should be considered, especially in infants <6 months.
True.
pg. 230 guidelines
What is a term vs pre-term birth?
Term birth is anytime between 36 weeks to 41 weeks (and 6 days of gestation)
Pre-term birth is anytime between 20weeks to 36 weeks (and 6 days of gestation)
pg. 2 handbook
Define LBW.
Low Birth Weight: infants weighing less than 2.5kg at birth, regardless of gestational age.
pg. 2 handbook
What are some implications of oral health on pregnancy?
Poor OH is associated with decreased birth weight, growth restriction, preterm delivery, preeclampsia, early pregnancy loss, and intrauterine fetal demise
pg. 3 handbook
T or F. Pregnancy itself is not a reason to postpone routine and necessary dental treatment as treatment is safe throughout pregnancy.
True.
pg. 3 handbook
What is the best way to position pregnant women in the chair during dental treatment?
Maintain a semi-seated position is best to avoid aspiration; pillow placement under RIGHT hip to maintain the uterus off the vena cava.
pg. 3 handbook
When is the most comfortable time for treatment in a pregnant patient?
second trimester poses greatest comfort, since generally nausea has stopped and uterus is a size where lying down is not uncomfortable
pg. 3 handbook
T or F. Infants born via C-section colonize S. Mutans earlier than children born vaginally.
True.
pg. 6 handbook
For how long does the AAP and WHO recommend exclusive breastfeeding?
Exclusively breastfeeding for the first 6 months, continued through one year or longer as mutually desired by mother and infant.
What are the benefits of breastfeeding for the infant?
- bonding
- immunologic–decrease URI and LRI, otitis media, GI infections
- metabolic–decreased risk of celiac disease, IBD, obesity, DM
- decreased risk of CV disease in adulthood
- linked to decreased risk of SIDS
pg 6-7 handbook
What are the benefits of breastfeeding for the mother?
- reproductive–decreases postpartum blood loss, rapid involution of uterus, increased child spacing
- decreased later development of rheumatoid arthritis, CV disease, cancers of breast /ovary
- decreased risk of postpartum depression, child abuse
pg 7 handbook
When should non-nutritive sucking such as pacifiers be introduced?
AAP states pacifiers may be used during breastfeeding, but delay introduction until breastfeeding is well established (approx. one month)
pg 7 handbook
However, prolonged NNS can lead to dental malocclusion (anterior open bite, increased overjet, posterior crossbite).
Recommend cessation by age 3 or with establishment of terminal planes of occlusion.
Prolonged pacifier use (past 6mos) may increase incidence of otitis media and increased risk of oral candida and GI infections
pg 8 handbook
T or F. Pacifier is associated with a decrease in duration of breastfeeding.
False
pg 7 handbook
T or F. Pacifier use is protective for SIDS
True
pg 7 handbook
What is the age of peak incidence for primary dentition trauma?
occurs between 2-3 years of age, consistent with gross motor development
Ankyloglossia prevalence is estimated at five percent, with higher frequency in males. Fifty percent of babies with ankyloglossia who are breastfed have no feeding trouble.
- Both statements are true
- Both statements are false
- First statement is true, second is false
- First statement is false, second is true
- Both statements are true
pg 7 handbook
Which of the following is/are NOT protective for development of orofacial clefts?
- Use of folic acid
- avoiding tobacco
- avoiding alcohol
- B and C
- All the above are protective
- All the above are protective
pg 3 handbook
Introduce flossing when teeth are in contact (24-36 months). Little evidence supports benefits of flossing.
1 Both statements are true
2 Both statements are false
3 First statement is true, second statement is false
4 First statement is false, second statement is true
4 First statement is false, second statement is true
–> introduce flossing when teeth are in contact between 12-24 months.
What should you do to relieve discomfort for teething?
1 Use topical anesthetics
2 Use of over-the counter teething gels
3 Use of oral analgesics
3 Use of oral analgesics
pg 230 guidelines
Which of these is FALSE, regarding treatments during pregnancy:
1 Dental radiographs are safe during pregnancy
2 Dental radiographs are safe during pregnancy
3 Dental radiographs are safe during pregnancy
Dental radiographs are safe during pregnancy
pg 3 handbook
T or F. Professionally-applied fluoride varnish should be considered for every child.
False.
It should be considered for children at risk for caries.?????
pg 223 guidelines
T or F. The amount of fluoridated toothpaste to be used twice daily depends on the child’s risk.
False.
