Implications of dental disease in children Flashcards
What is the prevalence of dental caries?
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
What are the 4 implications of caries?
Pain
infection
General health
Psychosocial
What is pain
An unpleasant and emotional response to actual or potential tissue damage
it is purely subjective
Who can use the McGill pain questionaire?
Adults, childern dont use the same words, or dont know them
What is the prevalence of pain?
in 50% of children with caries.
When is pain more likely/
If caries are present: at young age
2 or more surfaces
Disease in lower molars
What are the signs of caries in very young children?
Pain on brushing
During eating
Surprisingly, NOT crying at night
What are the signs of chronic infection
Buccal sinus
Hypoplasia of permanent successor
What are the signs of acute infection
Facial swelling
Pyrexia
May require hospitalisation
How can health be affected by having caries?
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
How can having caries affect iron levels
Children who required high number of extractions had lower haemoglobin
80% suffered iron deficiency
What do oral health related quality of life measures assess?
Oral symptoms
Functional limitations
Social well-being
Emotional well-being
what is the oral impact of caries?
Difficulty eating and lower self-confidence
What is the impact on smiling of caries?
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
What are the implications for treating children with caries?
Short attention span
Fear of the unknown
How many children have dental anxiety?
1/5 children
Varies with age and gender - more in females
What is children anxiety associated with?
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
What are the communication problems as described by the children?
Less information provided than required
Problems understanding the language
Lack of opportunities to participate
What do the children want?
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
What is used in conscious sedation and when is it used?
In children who may require pharmacological behaviour management
Most commonly nitrous oxide/oxygen
How can conscious sedation be delivered?
Oral, transmucosal, IV
What is the impact of GA on children?
Pre-op: hunger, being scared/worried
Post-op: discomfort from the IV cannula, nausea, bleeding, tiredness, disturbed eating
What are the risks of GA?
Major risks: mortality rate 1:250,000-1.2million
highest in infants and >70 yrs
What guidance is there for reducing risk of death from GA?
Only done in hospital
A conscious decision
GA services are modernised
