Exam 4 Flashcards
A child’s first visit to a dental office should occur when?
After the eruption of the first primary tooth and no later than age 1; recommended that infants be seen every 6 months
Best fluoride for white spot lesions in primary teeth
Varnish
Which primary teeth are affected first for caries?
Max. anteriors & primary molars
Lesions develop in all but mand. anteriors
Mand. incisors & canines are protected
Dental History of the Parents and Children:
Frequent visits for the parents and children
Caries & perio experience of parents and children
Tooth eruption patterns
Parents OH habits
Teeth problems
Deep pits & fissures in primary molars
No spacing
Feeding pattern Infant (birth- 1 year):
Breast/ bottle fed Formula used/ Fluoride content in water Problems in feeding Problems with sleeping Pacifier, thumb, or finger in mouth Other liquids
Feeding pattern Toddler (1-3 years) and Preschool Child (3-5 years):
Number of snacks per day and time period Types of snacks Amount of juice consumed Eating snacks without supervision Problems with eating
Pedo Oral Care: Fluoride Exposure
History of exposure Fluoride level of eater supply Well water Nonfluoridated bottle water Type of toothpaste (Training until they know how to spit, after they can spit.. use regular) Fluoride supplementation
Pedo Oral Care: Personal Oral Care Habits
Parents/Caregivers- wipe the inside of infants mouth with wet guaze daily
Brush teeth with water until age 2
Frequency and time of day
Positioning of child for access to pral cavity
Lift lip to brush anterior teeth
Child’s behavior
Pedo Oral Care: Barriers to Dental Care
Lack of belief in prevention Language Cost Fear No dental home Dentist does not see children under 3 years Dentist's hours do not fit into parents schedule Dentist does not accept dental insurance Transportation
Early Childhood Caries: Do not use these terms anymore…
Nursing caries
Baby bottle caries
Rampant caries
Pedo Oral Care: Microbiology- Strep mutans and Lactobacilli
High levels of Streptococcus mutans from saliva and dental biofilm
Transfer from parents or caregiver’s mouth to child
Lactobacilli in large numbers in the dental biofilm
Pedo Oral Care: Predisposing Factors
Place child in bed with bottle
Bottle contains sweetened milk
Prolonged breast or bottle feedings
Ineffective or no daily biofilm removal from teeth
Pedo Oral Care: Effects
Max. anterior teeth and primary molars are first to be affected
While the sucking is active, the liquid passes beyond the teeth
The nippe covers the mand. anterior teeth, so they are rarely affected
Recognition of ECC:
Demineralization on cervical 1/3 of max. anteriors and proximal surfaces
Remineralization can occur with use of fluoride paste and topical application
At later stage- lesions appear dark brown (This is decay)
Eventually the crown of the tooth may be destroyed, abcess can occur
Wiping Prior Tooth Eruption:
Need to remove biofilm daily by wiping gums, inside cheeks, lips, and tongue with clean wet cloth
Should be done daily
Bath time is a great time to remove it
Brushing Pedo Patients:
Recommend soft toothbrush
Emphasize brushing breakfast, morning, and night
Replace every 3 months
Diet and Health for Pedo Patients:
Healthy snacks between meals
Limit intake of retentive carbohydrates
Teach relationship between frequent and large amounts sweetened beverage intake and caries and obesity
What is the regular dental visit for children?
Every 6mo
When is the best time to schedule dental visits?
Early morning or after naps (when child is not tired he is more apt to cooperate
Purpose of Oral Prophy for Pedo Patients:
Provide positive experience
Remove biofilm, stain, calculus, and do exam
Educate patients
Child Management:
Show, Tell, and Do…..
Always explain everything you use bf doing so
Use fun names: tooth feeler, slurpy straw, elevator chair, sugar bugs
Keep explainations brief and do procedure quick
Let them watch you with hand mirror (eliminates fear)
What do you do when the child cries?
Stop procedure
Comfort
Avoid raising voice
If crying ceases ask if they are ready to begin again
No/little history of carious lesions; extractions, or restorations; no risk factors indicated; adequate protective factors
Low caries risk
History of carious lesions; extractions, or restorations, some risk factors but show no signs of continuing caries; could easily move to high risk; some protective factors
Moderate caries risk
Observable and/or radiographic carious lesions present; more than two risk factors; inadequate protective factors
High caries risk
High caries risk plus dry mouth or special needs
Extreme caries risk
Provide information to parents and caregivers on what to expect in a child’s current and next developmental stage so that the child’s needs can be anticipated and properly managed
Anticipatory guidance
Acronym that refers to the phrase “caries management by risk assessment”
CAMBRA
Child younger than 1 year of age
Infant
Sucking fingers, thumb, pacifier, or other objects for comfort
Nonnutritive sucking
Eating or drinking at will throughout the day or evening
Grazing
Discrimination toward/against the older adult population
Ageism
A form of irreversible dementia, usually occurring in older adulthood, characterized by gradual deterioration of memory, disorientation, and other features of dementia
Alzheimer’s disease
The anatomic or physiologic age of a person as determined by changes in organismic structure and function
Biologic age
The actual measure of time elapsed since a person’s birth
Chronological age
Severe mental deterioration involving impairment of mental ability; organic loss of intellectual function
Dementia
Difficulty in swallowing
Dysphagia
Low bone mass resulting from an excess of bone resorption over bone formation, with resultant bone fragility and increased risk of fracture
Osteoporosis
The age of a person as determined by his or her feelings, attitudes, and life perspective
Psychological age
An immunological disorder characterized by in sufficient production of the lacrimal gland to produce tears and the salivary glands to produce saliva that results in abnormally dry eyes and mouth
Sjogren’s syndrome
Ringing, buzzing, tinkling, or hissing sounds in the ear
Tinnitus
Older population
55 and older
Elderly
65 and older
Aged
75 and older
Very old
85 and older
Physiologic Aging: Musculoskeletal System
Skeletal Integrity: Influenced by intake of Ca, Phosphorus, Fluoride
Bone Volume: Decrease gradually after age 40, depending on diet, nutrition, exercise
Osteoporosis: Common in individuals older than age 60, increases with age
Loss of Muscle Function: Tremors
Osteoarthritis: Major cause of disability, affects the weight-bearing joints. AKA Degenerative Joint Disease
Physiologic Aging: Skin
- Thin, wrinkled, and dry with pigmented spots
- Loss of tone and atrophy of sweat glands
- Reduced tolerance to temperature extremes and solar exposure
Physiologic Aging: Cardiovascular System
- Decrease in cardiac output; increase in size of left ventricle
- Blood vessels become less elastic
- Some atherosclerosis is considered normal with aging
- Changes in cardio vasculature do affect function under normal, unstressful conditions
Bone disease involving loss of mineral content and bone mass; common in pts. older than 60 years of age
Bone is soft
Osteoporosis
What causes osteoporosis?
Depletion of estrogen after menopause, or calcium deficiency
How do you treat osteoporosis?
- Bisphosphonates- inhibit bone resorption
- Selective estrogen receptor modulators (SERMs)
- Calcitonin
- Parathyroid hormone (PTH)- stimulates bone formation
Pro-long use of bisphosphonates causes:
Osteonecrosis
What kind of oral changes occur in aging?
Lip Changes Oral Mucosa Tongue Changes Xerostomia Oral Candidiasis
