Non Fluoride Prevention Methods Flashcards
What are intrinsic sugars?
Sugars that are within the cell structure eg raw fruit
List the non fluoride prevention methods?
Diet modification OHI and dental health education Fissure sealants Sugar free medicine Chewing gum Chlorhexidine
What are extrinsic sugars and give examples?
Extrinsic sugars are not inside the cell, therefore more accessible to be metabolised by cariogenic bacteria in the mouth.
Milk sugars - those found in milk
Non milk sugars - fruit juice/purée, honey, added in recipes or added at the table
What dietary advice can you give to help prevent caries?
Reduce the frequency of sugar consumption
Restrict it to meal times
Foods with added sugar should only be eaten a maximum of 4x daily
Most sugars are hidden within manufactured and processed food so check labelling
Drink only water and milk (not from a bottle at night)
Sugar free snacks
Don’t eat or drink after brushing
List some cariogenic food and drinks
Confectionary, cakes, biscuits, ice cream and puddings
Sugared breakfast cereal
Jams and honey
Fresh fruit juice, fruit in syrup, dried fruit
Sugared soft drinks and milk based beverages
Summarise the Vipeholm study
In a Swedish mental institute (1945-1953) patients were used as subjects to test the relationship between caries and frequency and the type of sugar (sticky or not).
Conclusions were: positive correlation between sugar intake and caries
Sugar between meals had more of an effect than during meals
What did the study at Hopewood house find?
Hopewood house was a children’s home in Australia, the children there lived on a lacto-vegetarian diet which had no refined carbohydrates.
The children there had a much lower incidence of caries compared to other children of a similar age not on that diet showing that diet has a significant impact on caries
When would the use of a diet diary be appropriate and how would you analyse it?
Children with caries or erosion require investigation into their diet
Include 2 weekdays and either sat/sun
Instruct parent to record everything including times
Circle all the sugar containing foods and drinks and look at their frequency and whether or not they are during meals or between.
Ask parent to identify problem areas and suggest alternatives to fit with family lifestyle
May not always be accurate!!!
What OHI would you give to a child?
Toothpaste at least 1000ppm fluoride then adult concentration after 3years
Use a smear at first then pea sized after 3 years old
Brush before bedtime and one other time of day
Start as soon as teeth have erupted
Apply Duraphat 2x year
What is fissure sealant and who should receive it?
Placement of a material into the pits and fissures of teeth to prevent caries on the occlusal surfaces of the teeth.
Children at high caries risk should be treated with fissure sealants
Cochrane review said that sealing teeth is an effective caries prevention method
Which teeth should have fissure sealant placed??
Pre molars and molars
Palatal pits of 2s
Primary posterior teeth in high risk children
All teeth considered should be radiographed before to check for existing caries!!!!
If the sealant becomes defected it should be replaced and they should be continually monitored once they have been placed
Name the different types of sealant
Resin, GIC, compomer, fluoride containing sealant
Why are xylitol chewing gum effective at preventing caries?
Salivary stimulation
Must be sugar free
How would you manage a high caries risk child?
Toothpaste 1350-1500 ppm and 3-4x yearly Duraphat
Also add mouthwash or prescribe a high fluoride toothpaste depending on whether the child can rinse and spit
If mouthwash appropriate then NaF 0.05% 10ml daily or 0.2% 10ml weekly
Not mouthwash appropriate then prescribe Duraphat toothpaste
10+ 2800ppm
16+ 5000ppm
