NURS 330 - Peds quiz 2

Question 1

What is the most chronic disease of childhood

Answer 1

Tooth decay
5x more common than asthma
7x more common than allergies

Question 2

Early Childhood Carries (ECC)

Answer 2

Tooth decay

Question 3

Early Childhood Carries (ECC) Complications

Answer 3

Pain/Infection
Malnutrition
Loss of sleep
Missed school days

Question 4

How many Canadian children have tooth decay?

Answer 4

2/3 of all Canadians aged 6-11 have tooth decay
1 in 3 kids entering grade 1 have tooth decay

Question 5

Access to oral healthcare in Canada

Answer 5

85% of Canadians report that they have good oral health
75% have visited the dentist within the last year
32% have no dental insurance
53% between ages 60&79 have no dental insurance
50% of low income families have no dental insurance

Question 6

Serious Complications of Poor Oral Health

Answer 6

Diabetes (from mouth yeast infection), Cardiovascular disease, Pre-term LBW babies, Obesity, Cognitive Function, Aspiration pneumonia

Question 7

Bacterial cause of Dental Carries

Answer 7

Streptococcus Mutans:
- Gram positive coccus
- commonly found in the oral cavity

Question 8

Process of tooth decay

Answer 8

Bacteria + Sugar = ACID
Acid + tooth = CAVITY

Question 9

Primary modifying factors of tooth decay

Answer 9

Tooth anatomy, saliva, biofilm pH, use of fluoride, diet specifics, oral hygiene, immune system, genetic factors

Question 10

Secondary modifying factors of tooth decay

Answer 10

socioeconomic status, education, lifestyle, environment, age, ethnic group, occupation

Question 11

Non-disease state of teeth

Answer 11

Normal equilibrium between demineralization and remineralization

Question 12

Pathological factors of tooth decay

Answer 12

Cariogenic bacteria, subnormal salivary function and diet

Question 13

Protective factors of tooth decay

Answer 13

Salivary flow & components, Fluoride/Calcium/Phosphate
Antibacterials & chemotherapeutics

Question 14

Where are dental carries usually found?

Answer 14

Smooth surfaces (near gumline) just at or below where 2 teeth touch, pits and fissures, exposed root surfaces, underneath existing fillings, teeth which hold dentures or other dental work in place

Question 15

Clinical appearance of dental carries: early lesions

Answer 15

White, chalky appearance, often seen at gumline or where ortho brackets were placed

Question 16

Clinical appearance of dental carries: Progressing/advanced lesions

Answer 16

Light brown, wet appearance
Caviated

Question 17

Clinical appearance of dental carries: Inactive/Arrested lesions

Answer 17

Dark brown or black, leathery appearance
Feel hard with probing

Question 18

Periodontal Disease

Answer 18

Inflammation of the supporting tissue of the teeth
Progressive destructive change leading to loss of bone and periodontal ligament

Question 19

Periodontitis increase the risk for…

Answer 19

Cardiovascular disease, diabetes, respiratory diseases, adverse pregnancy outcomes

Question 20

Risk factors for ECC

Answer 20

Fluoride exposure, diet, sleep time routine, oral hygiene, habits, special health needs, previous carries, oral bacteria, poor family oral health, socioeconomic status

Question 21

Fluoride Exposure (risk for ECC)

Answer 21

GOOD when it is in water - prevents tooth decay (should not use too much)

Question 22

Dietary habits (risk for ECC)

Answer 22

Consistent bottle use
Types, consistency and frequency of food and liquid intake

Question 23

Sleeping habits (risk for ECC)

Answer 23

Sleeping with a bottle increases risk for tooth decay

Question 24

Oral Hygiene (risk for ECC)

Answer 24

Starting brushing teeth as soon as they have them
wipe gums with clean cloth if they do not have teeth
Child should go to dentist by age 1 to increase comfort

Question 25

Poor family oral health (risk for ECC)

Answer 25

Carries experience of the primary caregiver
Transmission of bacteria
Parental attitude toward oral hygiene (did parent group up with dental insurance?)

Question 26

Socioeconomic Status (risk for ECC)

Answer 26

Disparities in dental disease by income
Access to care (insurance, clinic close by, ability to book appointment)
Low-income children suffer twice as much for untreated dental disease

Question 27

High Risk Biologically if…

Answer 27

Mother/primary caregiver has cavities
Parent/caregiver has low socioeconomic status
Child has > 3 meal sugar-containing snacks or beverages per day
Child is put to bed with a bottle containing natural or added sugar
Child is a recent immigrant
Child has special healthcare needs

Question 28

High risk Protectively if…

Answer 28

Child receives no fluoride in drinking water/supplements
Child does not brush teeth daily with fluoride toothpaste
Child does not receive topical fluoride from health professional
Child has no dental home/regular dental care

Question 29

High risk Clinically if…

Answer 29

Child has white spot lesions or enamel defects
Child has visible cavities or fillings
Child has plaque on teeth

Question 30

Oral health screening

Answer 30

Medical Hx and allergies
When did you last see dentist? (if > 1 years, ask about access)
How often are teeth brushed/flossed? (if <8, confirm that parent is assisting)
Do teeth hurt? (esp in bed or when eating icecream)

Question 31

Extra-oral exam

Answer 31

Look at general appearance, any visible asymmetries or swelling (swelling may be in eye/cheek/lips/neck areas)

Question 32

Intra-oral screening: teeth

Answer 32

Count teeth
document cavities/dark staining using letter “D” under tooth in question
Record if fillings with “F” or broken with “B”
If in doubt, document decay

Question 33

Intra-oral screening: soft tissues

Answer 33

Look at floor of mouth (under tongue) and gums
If any swellings record with “A” under the tooth number
Swellings require immediate attention

Question 34

Tooth Brushing recommendations

Answer 34

Brush twice daily (nightime = most important)
Soft or extra-soft bristles
Fluoride toothpaste (rice grain until 3yrs, pea size 3-6yrs)
Assist children up to 8 yrs

Question 35

Flossing recommendations

Answer 35

Start when teeth touch
Do before toothbrushing
Target areas toothbrushing can’t access

Question 36

Plaque control - Interdental cleaning

Answer 36

Target space beneat interproximal contact area of teeth

Question 37

Fluoride Varnish

Answer 37

Topical fluoride
Safe in young children
Easy to apply
Application q6months

Question 38

Fluoride Varnish Application

Answer 38

Dry teeth with gauze
Apply to teeth (not gums)
Wait desired time and close mouth
Instruct pt not to brush or floss until evening, eat soft diet for the day.
teeth may feel rough and discolored until brushing

Question 38

Fluoride varnish contraindications

Answer 38

People with allergies to colophony or pine rosin
Those at low risk for dental caries
Those who attend dentist regularily

Question 39

Enemies for your teeth

Answer 39

Starchy, refined carbs (chips, potatoes, crackers, bread, pasta) Sugary candy (hard candies, taffy&caramel, chocolate, cookies/cake/brownies) Acidic foods & fruit (lemons & citrus, diet sodas, vinegars) and Sugary beverages & juice (all soda, fruit juices, alcohol, sugar-added coffee/tea)

Question 40

When to wean baby from bottle

Answer 40

12-15 months

Question 41

When should cup be introduced

Answer 41

6-8months

Question 42

How often can child have juice

Answer 42

NO MORE than 1-2oz/day and NEVER in a bottle