Non fluoride prevention methods

Question 1

What are the 6 types of non fluoride prevention?

Answer 1

1. Diet modification
2. OH and dental health education
3. FS
4. Sugar free meds
5. Chewing gum
6. CHX

Question 2

Where are intrinsic sugars found?

Answer 2

Inside cell, e.g. raw fruits

Question 3

Where are extrinsic sugars found?

Answer 3

Not inside the cell - Non-milk sugars, e.g. fruit juices, pulp purees, honey, added sugar, table sugar (discretionary sugar) AND milk sugars

Question 4

What did the COMA report of 1989 find?

Answer 4

Caries is positively related to non milk extrinsic sugars

Question 5

What are the delivering better oral health guidelines on sugar?

Answer 5

1. Frequency and amount of sugars should be reduced. Consumption of sugary foods should be restricted to mealtimes.
2. Limit consumption of foods and drinks with added sugars to a maximum of 4x/day
3. Sugars (excluding those naturally present in whole fruit) should provide less that 10% total energy in the diet or less than 60g/person/day. (Young children = 33g/day)

Question 6

What are diet dairies used for?

Answer 6

1. Both dental decay and erosion require an investigation of diet diary
2. 3 day diet dairy, 1 weekend day
3. Clear instructions to record everything eaten or drunk, when and amount

Question 7

What are you analysing in a diet diary?

Answer 7

Amount of sugar intake
Frequency of sugar intake
Frequency of snack intakes
How food and drink are consumed

Question 8

Name some non cariogenic, non sugar sweeteners

Answer 8

Sorbitol, mannitol, xylitol, maltitol, lactitol, isomalt, hydrogenated glucose syrup

Question 9

Name some non cariogenic intense sweeteners

Answer 9

Saccharin
Aspartame
Acesulfame K
Thaumatin

Question 10

OH for children

Answer 10

Teach all children about OH
Use disclosing tablets
2x brush/day using fluoride toothpaste containing 1000ppm
Spit not rinse
Children up to 7 years, small pea sized toothpaste

Question 11

Toothpaste for under 2 years

Answer 11

Smear, 0.1ml vol size of an uncooked grain of rice, none swallowed

Question 12

Toothpaste 2-3 years +

Answer 12

Pea sized

Question 13

Who should have FS?

Answer 13

1. Children and young people with impairments and caries in primary teeth
2. Deep fissure susceptible to caries
3. IF teeth erupted sufficiently for moisture control
4. If occlusal caries in one permanent molar then seal the other permanent molars.

Question 14

Which teeth should be sealed?

Answer 14

1. 6s
2. Palatal pits of 2s
3. 7s, 4s, 5s

Question 15

How to FS

Answer 15

Etch with 30-40% phosphoric acid for 20-40s

Wash and dry tooth

Cure for 20s

Question 16

How much does FS reduce decay by?

Answer 16

78% on occlusal surfaces after 2y
60% after 4-4.5 years

Superior to fluoride varnish

Question 17

Remember about FS

Answer 17

Check radiographically any stains
Check FS after with radiographs to see if there are any caries underneath the sealant
Defective sealants should be replaced

Question 18

Name 4 materials used for FS

Answer 18

resins
gif
compomer
fluoride containing sealants

Question 19

When to use a GIC sealant

Answer 19

1. Useful in high caries individuals as temporary sealants
2. PE teeth where isolation is an issue

Question 20

What non cariogenic sugars do chewing gums have?

Answer 20

Xylitol and sorbitol - anti caries properties through salivary stimulation (xylitol more effective than sorbitol in caries reduction)

Question 21

CHX uses

Answer 21

Prophylaxis in the form of a rinse, gel or paste can achieve a substantial (46%) reduction in caries

CHX varnish considered as an option