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Spring 2022 > Fluoride Tx > Flashcards

Fluoride Tx Flashcards

1
Q

What does ECC stand for? (dental)

A

Early Childhood Caries

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2
Q

What are ECC?

A

One or more decayed, missing, or repaired tooth surfaces in primary tooth of child <6 yo

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3
Q

What are the causes of ECC?

A

ECC is a chronic, infectious disease that is orally transmitted from family members to infants and young children
Caused by: bacteria (strep mutans), plaque (biofilm), fermentable CHO, poor oral hygiene
Results in demineralization of tooth

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4
Q

Why should NPs provide fluoride varnish?

A

Within scope of practice

Prevention: avoid primary tooth decay, avoid caries, avoid negative oral-systemic effects of dental caries

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5
Q

What is fluoride varnish?

A

Contains 5% fluoride concentrated at 22,600 ppm sodium fluoride
Cost per unit dose application: $0.55

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6
Q

What are fluoride’s mechanisms of action/effects?

A
  • Reduces demineralization of enamel
  • Inhibits bacterial metabolism
  • Inhibits acid production
  • Promotes enamel remineralization
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7
Q

What are the stages of the progression of dental caries?

A

Adhesion, colonization, de&remineralization, white spots, enamel lesion, dentin lesion, pulpal lesion

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8
Q

At what stages in dental caries progression can prevention occur?

A

Colonization and de/remineralization

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9
Q

At what stage in dental caries progression does a diagnosis occur?

A

The presence of white spots

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10
Q

At what stages in dental caries progression does restoration occur?

A

Enamel, dentin, and pulpal lesions

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11
Q

Prevention and early treatment of white spots

A
  • Remineralization with fluoride varnish (FV)
  • Proper home care
  • Decrease CHO consumption
  • Caregiver education
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12
Q

What do children with white spot lesions have and need?

A
  • Dental caries
  • ECC
  • Immediate referral to dentist
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13
Q

Healthy People 2020 goal for oral health

A
  • Reduce the proportion of children and adolescents who have dental caries in primary or permanent teeth
  • Reduce the proportion of children 3-5yo with dental caries in primary teeth
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14
Q

Healthy People 2030 oral health goal

A

Increase the use of the oral health care system

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15
Q

USPSTF Oral Health Recommendations Children <5yo

Category B

A

Children <5yo: PCPs Rx oral fluoride starting at 6mos for children with deficient fluoride in water supply
Children <5yo: PCPs apply FV to primary teeth of all infants/children with first tooth eruptions

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16
Q

USPSTF Oral Health Recommendations Children <5yo

Category I

A

Uncertain harm/benefit for routine screening/dental exams for dental caries performed by PCP for children <5yo

17
Q

What are the only proven strategies to reduce dental caries?

A

Fluorides and sealants

18
Q

Dental caries risk factors

A
  • 60-90% of people are affected by dental caries

- Lower socio-economic status increases r/f caries

19
Q

What are the risks associated with fluoride treatment?

A

Cosmetic: Dental fluorosis
No cosmetic risk demonstrated in FV research

Otherwise no known risks

20
Q

Supplies for FV application

A

Gloves, 2x2 gauze, FV, light source

21
Q

Steps for applying FV for pediatrics

A
  • Position child (knee to knee position for young children)
  • Inspect oral cavity, noting white spot lesions or advanced decay
  • Dry teeth with gauze
  • Paint on FV
  • Continue until all surfaces of teeth have been treated
22
Q

FV Education

A

After care: avoid sticky food, hot beverages on the day of tx

23
Q

Oral hygiene recommendations for children

A

Brush BID with soft brush
Toothpaste Smear < 3yo
Toothpaste Pea size > 3yo

24
Q

Diet modifications for optimal oral health peds

A

Avoid highly fermentable CHO, avoid grazing, avoid bottles in bed

25
Q

Health Promotion and Follow-Up for FV/Dental

A
  • Establish dental home
  • Refer to dentist for all white spot lesions
  • Continue FV application q3-6mos through age 5
26
Q

FV Billing

A

$30 reimbursement
CPT 99177
ICD10 Z41.8
Ages 0-6 or 7

Spring 2022 (14 decks)

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