ICP19 - Prevention of dental disease in children and adolescents

Question 1

What is a stephan curve

Answer 1

Graph showing ph change after taking a sucrose drink/carbs there is a pH drop and after about 20mins the pH begins to rise again due to saliva and dat

Question 2

What do you need to do when carrying out a caries risk assessment

Answer 2

• think about the disease
• List aetiological factors in the order of importance
• Identify risk category

Question 3

What are the risk factors for a patient developing dental caries

Answer 3

• Clinical evidence - new lesions, dmft
• Dietary habits
• Use of fluoride
• Plaque control
• Saliva
• Social history
• Medical history

Question 4

Name some factors that put someone at low risk of developing caries

Answer 4

• No caries
• Favourable family history
• Good diet
• good oral hygiene
• Well motivated parents/carers

Question 5

Name some factors that put someone at moderate risk of developing caries

Answer 5

New lesions every 2 years

Question 6

Name some factors that put someone at high risk of developing caries

Answer 6

• Presence of lesions each year
• Orthodontic treatment
• Chronic illness/ medically/ physically compromised
• Social risk factors

Question 7

What is the difference between primary, secondary and tertiary prevention

Answer 7

• Primary - stop disease starting in the first place
• Secondary - detecting disease and preventing further development of the disease
• Tertiary - treating disease, restoring to function and prevent further development of the disease

Question 8

Name ways in which the patient can adhere to primary prevention

Answer 8

• Brush twice daily
• Brush last thing at night and on one other occasion
• Use fluoridated toothpaste (1350-1500 ppm or above depending on age and caries risk)
• Spit out after brushing and don’t rinse
• Frequency and amount of sugary food and drinks should be limited to mealtimes, not ore than 4 time a day

Question 9

How can we carry out secondary prevention once caries have presented in the patient

Answer 9

• Bitewing radiographs
• Occlusal caries: if into dentine - repair
• If in fissure system or enamel: PRR
• Approximal/smooth surface caries confined to enamel: use fluoride, reduce sugar intake and increase brushing if needed

Question 10

What advice do you give the patient in order to improve their oral hygiene

Answer 10

• Advise and encourage an effective oral hygiene regimen
• Advise/demonstrate tooth brushing methods
• Manual dexterity? - manual -> electric
• Supervised brushing for <7 year olds
• Spit not rinse

Question 11

What ways can fluoride be incorporated into a patients oral hygiene regimen

Answer 11

• Professional topical fluoride application at intervals depending on caries risk category
• Daily use of fluoridated toothpaste
• Mouth rinses for >8 y/o for high risk
• Children > 10 y/o can have 2800 ppm
• Children > 16 y/o can have 5000ppm

Question 12

What teeth do we normally fissure seal

Answer 12

Usually first permanent molars

• Other permanent molars and premolars depending on tooth anatomy/caries risk
• Occasionally primary molars depending on caries risk and anatomy or behaviour