Implication of Dental Disease

Question 1

What is the level of caries experience in the UK?

Answer 1

1/3 children aged 5 years have experience

50% of 8 year olds

Question 2

General implications of caries?

Answer 2

P PIG
Psychosocial
Pain
Infection
General health

Question 3

What is pain?

Answer 3

Unpleasant sensory and emotional response to actual or potential tissue damage
Is subjective

Question 4

When is the McGill pain questionnaire useful?

Answer 4

In adults - children don’t use these words/ know them

Question 5

How may children describe pain?

Answer 5

Stabbing, burning, dull, pressing, weird

Pulp test: uncomfortable, sore, hitting, dizzy

Question 6

What is the prevalence of pain?

Answer 6

Approx 50% children with caries

More likely if: young, 2+ surface, disease in lower molars

Question 7

Signs children are in pain?

Answer 7

Crying, not playing, changes eating/ sleeping, grumpy

Pain on toothbrushing or eating

Question 8

Give examples of acute and chronic infection?

Answer 8

Chronic: buccal sinus, hypoplasisa permanent successor (turners tooth)
Acute: facial swelling, pyrexia

Question 9

What effects can dental disease have on general health?

Answer 9

1. Weight - may be lower in weight
2. Height - mean height between 10th-25th percentiles in group w/ caries (should be 50th-75th)
3. Iron deficiency - children require XLA had lower haemoglobin

Question 10

What is the psychosocial impacts?

Answer 10

Oral health related quality of life measures
Reduced self-confidence - embarrassed to smile/ laugh

Measure: oral symptoms, functional limitations, social and emotional well-being

Question 11

How many children suffer from anxiety and what are the impacts?

Answer 11

1/5th (increased in females)

Impact

1. OH status, OH related QoL
2. Dental professional: occupational stress, time-consuming
3. Dental services: financial impact, referrals, cancelled appt

Question 12

How can communication reduce dental anxiety?

Answer 12

Evidence communication reduces dental anxiety
Tell what will happen at vist
Age-appropriate, non-patronising manner

Question 13

What do children think barriers in communication?

Answer 13

Less information provided
Problems understanding language
Lack opportunities to participate

Question 14

What are the different types of anaesthesia available?

Answer 14

1. Conscious sedation
2. General anaesthesia
3. Local anaesthesia

Question 15

Why may conscious sedation be used?

Answer 15

Anxious children who require pharmacological behavioural management

Nitrous oxide/ oxygen

Question 16

Why are general anaesthesia used and the implication?

Answer 16

Dental caries most common reason for hospital admission
Minor risk: nausea, vomit, headache
Major risk: mortality

Benefit: one vist w/ multiple procedures
less pain –> improve oral health QoL

Question 17

How to minimise impact of dental caries?

Answer 17

Prevention
Community oral health promotion
Reduce dental anxiety

Question 18

How can community oral health promotion help?

Answer 18

Targeted community based e.g F varnish programmes/ toothbrushing
Supervised toothbrushing nurseries/ school
Healthy food/drink
F- of public water

Question 19

How can self-help CBT resources help?

Answer 19

Evidence based - child-centred approach

• Resource for children w/ extra for parents and dental professionals
• Help challenge unhelpful thoughts - normalise anxiety
• Enhance control - message dentist/ stop signals
• Reflect and plan rewards