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Paediatrics > Implications of dental disease in children > Flashcards

Implications of dental disease in children Flashcards

1
Q

What is the prevalence of dental caries?

A

Untreated dental caries 10th most prevalent disease worldwide
in the UK 1/3 of children aged 5 years have experienced caries, almost half of 8 yr olds

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2
Q

What are the 4 implications of caries?

A

Pain
infection
General health
Psychosocial

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3
Q

What is pain

A

An unpleasant and emotional response to actual or potential tissue damage
it is purely subjective

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4
Q

Who can use the McGill pain questionaire?

A

Adults, childern dont use the same words, or dont know them

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5
Q

What is the prevalence of pain?

A

in 50% of children with caries.

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6
Q

When is pain more likely/

A

If caries are present: at young age
2 or more surfaces
Disease in lower molars

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7
Q

What are the signs of caries in very young children?

A

Pain on brushing
During eating
Surprisingly, NOT crying at night

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8
Q

What are the signs of chronic infection

A

Buccal sinus

Hypoplasia of permanent successor

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9
Q

What are the signs of acute infection

A

Facial swelling
Pyrexia
May require hospitalisation

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10
Q

How can health be affected by having caries?

A

Weight lower than peers
Catch up in weight following dental treatment
Mean height between 10th and 25th percentiles compared to 50th and 75th in caries free
Iron deficiency

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11
Q

How can having caries affect iron levels

A

Children who required high number of extractions had lower haemoglobin
80% suffered iron deficiency

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12
Q

What do oral health related quality of life measures assess?

A

Oral symptoms
Functional limitations
Social well-being
Emotional well-being

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13
Q

what is the oral impact of caries?

A

Difficulty eating and lower self-confidence

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14
Q

What is the impact on smiling of caries?

A 
children feel sad about teeth
Embarrassed to smile or laugh
Rated smiles less positively 
Parents less positive about smiles 
Children showed less teeth when smiling
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15
Q

What are the implications for treating children with caries?

A

Short attention span

Fear of the unknown

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16
Q

How many children have dental anxiety?

A

1/5 children

Varies with age and gender - more in females

17
Q

What is children anxiety associated with?

A

Irregular attendance - poorer dental health and health-related quality of life, a continuation of dental anxiety into adulthood
Economic and service impacts
Cost: of sedation and GA and missed appointments
may contribute to occupational stress for the clinican

18
Q

What are the communication problems as described by the children?

A

Less information provided than required
Problems understanding the language
Lack of opportunities to participate

19
Q

What do the children want?

A

To be told what is going to happen at the visit
Information explaining in an age-appropriate and non-patronising manner
Intolerant to changes once a plan had been agreed

20
Q

What is used in conscious sedation and when is it used?

A

In children who may require pharmacological behaviour management
Most commonly nitrous oxide/oxygen

21
Q

How can conscious sedation be delivered?

A

Oral, transmucosal, IV

22
Q

What is the impact of GA on children?

A

Pre-op: hunger, being scared/worried

Post-op: discomfort from the IV cannula, nausea, bleeding, tiredness, disturbed eating

23
Q

What are the risks of GA?

A

Major risks: mortality rate 1:250,000-1.2million

highest in infants and >70 yrs

24
Q

What guidance is there for reducing risk of death from GA?

A

Only done in hospital
A conscious decision
GA services are modernised

25
Q

What are the benefits of treatment under GA?

A

One visit, all done at one sitting
Can do multiple procedures
Cost-effective `

26
Q

What is the success of the treatment?

A

less pain
Eating more
Sleeping better
Improved OH

27
Q

How can we minimise the impact of dental caries?

A

Prevention - DBOH
Community oral health promotion
Reducing child dental anxiety - better communication

28
Q

What is the DBOH advice or children up to 3 years?

A

Sugar not added to weaning foods or drinks
Parents/carers should brush or supervise brushing
As soon as teeth erupt in mouth need to brush twice daily with fluoridated toothpaste
Last thing at night and one other occasion
no less than 1000ppm fluoride
Smear of toothpaste
Frequency and amount of sugar reduced
Sugar free medicine

29
Q

DBOH advice for children 3-6?

A

Still should be supervised
toothpaste containing more than 1000ppm F, pea sized
spit dont rinse
apply fluoride varnish 2x a year 2.2%NaF-

30
Q

DBOH advice for children 3-6 showing concern/special needs?

A 
fluoridated toothpaste 1350-1500 F-
smear or pea
Sugar free medication
F varnish 2-3x a year 2.2%NaF
Reduce recall interval
Investigate diet - give dietary advice
31
Q

DBOH advice for all patients 7-young adult

A 
1350-1500ppm fluoride 
reduce amount and frequency sugar
spit dont rinse
twice a day
Fluoride varnish twice a year
32
Q

DBOH advice those giving concern - active caries, ortho appliances, dry mouth, special needs

8yrs
10yrs
16+

A

Use fluoride mouth rinse daily 0.05 NaF at different time to brushing
Fissure sealant on molars
F varnish 2-3x year
8+ fluoride rinse
10+ 2800 ppm toothpaste
16+ with active disease either 2800ppm or 5000ppm fluoride toothpaste
investigate diet - eatwell plate

33
Q

What are the different community health promotion schemes?

A

Targeted community-based fluoride varnish programmes in schools or care homes
Targeted provision of toothbrushes and toothpaste
Supervised tooth brushing in nurseries and schools
healthy food and drink policies in nurseries and schools
Fluoridation of public water supplies
Influencing local and nutritional government policies

34
Q

what ways can you reduce children dental anxiety?

A

Development of self-help CBT (cognitive behavioural therapy resources
uses child-centred approach
resources for children with accompanying rescources for parents and dental professionals

Paediatrics (6 decks)

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