Implications of Dental Disease in Children Flashcards
How many children have caries in the UK?
1/3 aged 5, 1/2 of 8 yr olds
Affects 621 million children globally, 10th most common disease
Implications of caries?
Pain
Infec
General health
Psychosocial
Define pain
Unpleasant sensory and emotional response to actual or potential tissue damage
Purely subjective
How common is dental pain in children?
We don’t know how children describe dental pain
Few researchers have asked children
How do children describe dental pain?
Effects of dental pain on children?
Stabbing, burning, dull, pressing, weird
Crying, stops them from playing, miss schools
Words used to describe pulp testing?
Uncomfortable
Sore
Hitting
Dizzy
Prevalence of caries in children?
50% of children with caries
When is pain more likely if caries is present?
At young age
2 or more surfaces
Disease in lower molars
Signs of caries in very young children?
Pain on toothbrushing
During eating
Not crying at night
Types of dental infection in children?
Chronic infec
- Buccal sinus
- Hypoplasia of permanent successor
Acute infection:
- Facial swelling
- Pyrexia
Effects of caries on general health?
Poor diet
Pain when eating
Weight lowered
Mean height between 10th-25th percentiles in group with caries, caries free = 50-75th percentile
Iron deficiency in 80% of children who required a higher number of extractions
Psychosocial - what does oral health related quality of life measure?
Oral symptoms
Functional limitations
Social well being
Emotional well being
What psychological effects can caries have in children?
In 12yr olds - lower self confidence
Feel sad about teeth
Embarrassed and ashamed to smile or laugh
What are the implications of treating caries in children?
Short attention span
Fear of unknown
Child dental anxiety - 1/5 (higher in females)
Communication difficult
What is the impact of dental anxiety?
Children:
- OH status and QoL
- Waiting lists
- Travel
Dental professionals:
- Cause of occupational stress
- Time consuming
Dental services:
- Financial implications
- Higher rates of missed/cancelled appointments
- Referrals to specialist service demand
What communication problems are described by children?
Less information provided than required
Problems understanding language
Lack of opportunities for children to participate
How to give LA to children?
Topical
Explain how it might feel to be numb
Small amounts of treatment
What is most commonly used for conscious sedation?
How can it be given?
Nitrous oxide/oxygen
Oral, transmucosal, intravenous
What are the minor and major risks of GA?
Minor:
Nausea
Vomiting
Headache
Major:
Mortality rate 1:2 million
Highest in infants and >70yrs
Impact of GA on children?
Pre-op: hunger, scared
Post op: discomfort from IV cannula, nausea, bleeding, tired, disturbed eating
Benefits of treatment under GA?
One visit
Multiple procedures
Cost effective
What occurs when caries treatment is successful in children?
Less pain
Eating more
Sleeping better
Improved OH QoL
How to minimise the impact of dental caries?
Prevention
Community OH promotion
Reducing child dental anxiety
How to prevent caries in children 0-3yrs old?
Breast feed 1yr+ bottle feeding stopped No added sugar Parents brush/supervise children Brush last thing at night, once another time in day 1000ppm F Smear of toothpaste Sugar free medication
How to prevent caries in children 3-6yrs old?
Brush x2 daily Supervised 1350-1500 + Spit do not rinse Decrease freq and amount of sugar Apply fluoride varnish to teeth x2 a yr
How to prevent caries in children 7+ and young adults?
Fluoride varnish x2 yearly
Brush x2, spit
1500ppmF
8yrs+ with caries = prescribe fluoride rinse
What F to prescribe children 10+ with active caries?
2800ppm F
What F to prescribe children 16+ with active caries?
2800 or 5000ppm F
What is community oral health promotion?
F varnish programmes in schools or care homes
Supervise brushing in schools
Fluoridation of water
Healthy food and drink
What is CBT?
Cognitive behavioural therapy to help reduce dental anxiety by:
Challenging unhelpful thoughts - normalises dental anxiety, provides info
Enhancing control - message to dentist, stop signal
Reflect and plan reward
