Oral health/smiles for life Flashcards

1
Q

_____ is the most common chronic disease of
childhood from ages 6 to 19

A

Dental caries

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2
Q

Early Childhood Caries (ECC)

A

Aggressive form of caries in
children < 6 years of age

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3
Q

Etiology of ECC

A

o Feeding habits
o SES influence
o Access to dental care
o Fluoride exposure
o Family caries experience

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4
Q

Severe Consequences of Caries

A
  • Pain
  • Infection
  • Impaired chewing and
    nutrition
  • Increased caries in
    permanent dentition
  • Sleep difficulty
  • Poor self-esteem
  • School/Work absences
  • Poor school performance
  • Extensive and expensive
    dental work under
    anesthesia
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5
Q

What causes dental caries?

A

Oral bacteria (Polymicrobial including Mutans
Streptococci and Lactobacilli) metabolize
dietary sugars into acid
* Acids demineralize the tooth enamel

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6
Q

Cariogenic bacteria are transferred by:

A
  • Vertical transmission from the primary caregiver, often the
    mother, via saliva contact
  • Horizontal transmission from family members and care providers-
    in school and daycare settings
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7
Q

Caregivers with high bacteria levels usually have:

A
  • High frequency of sugar intake
  • Poor oral hygiene
  • High levels of dental caries
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8
Q

Etiology: Sugars and teeth

A
  • Acids produced by oral bacteria persist 20–40 minutes after sugar ingestion and cause enamel demineralization
  • Remineralization occurs when acid is buffered by saliva
  • Frequent sugar consumption = insufficient time for remineralization to occur; teeth are subjected to continued demineralization and the caries process progresses
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9
Q

T/F Any tooth surface can develop a cavity

A

T

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10
Q

Surfaces with high cavity risk:

A
  • Newly erupted teeth
  • Enamel defects
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11
Q

Early ECC : White Spots

A
  • White spots and lines are the
    first clinical signs of demineralized enamel
  • Usually affects upper front teeth first and typically appear at the gingival margin
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12
Q

Severe ECC signs

A
  • Enamel destruction has exposed underlying dentin which may appear dark
  • Multiple dark cavities appear in anterior and posterior teeth
  • Possible abscesses and draining fistulae
  • Patients may experience pain, but young children often unable to verbalize it
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13
Q

Pediatric Oral Exam

A
  • Examine the soft tissues – tongue, lips, gums, cheeks
  • Examine the hard tissues – front, back, sides of all teeth for plaque, white spots, cavities, & abscesses
  • Palpate for submucosal clefts
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14
Q

Small Children: Knee-to-Knee Exam

A
  1. Child is held facing the caregiver in a
    straddle position
  2. Child leans back onto examiner
    while caregiver holds child’s hands
  3. Provider performs exam while caregiver
    holds child’s hands and legs
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15
Q

Prevention of caries

A
  • Toothbrushing/flossing
  • Fluoride
  • Diet
  • Dental home establishment
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16
Q

Oral Hygiene: Brushing and Flossing guidelines

A
  • Brush twice daily starting with first tooth
    emergence
  • Caregiver should brush child’s teeth
    until age 8 or 9
  • Floss once daily between teeth that
    touch
17
Q

How Much Toothpaste for children < 3 vs > 3?

A

Small smear or “grain of rice”: Less than 3 years of age
Pea sized: All children age 3 and older

18
Q

Effects of Fluoride: Topical vs. Systemic mechanism

A

Topical Mechanisms (main effect)
* Inhibiting tooth demineralization
* Enhancing remineralization
* Inhibiting bacterial metabolism
Systemic Mechanism (lesser effect)
* Reducing enamel solubility by incorporating into the
structure during tooth development

19
Q

Fluoride Sources

A

Topical:
* Fluoride toothpastes
* Gels, foams, mouthwashes
* Fluoride varnish
Dietary:
* Water fluoridation
* Systemic fluoride supplements

20
Q

All fluoride prescriptions should specify a ____

A

sugar-free prescription

21
Q

Diet & Feeding Advice - Infancy

A

Encourage the following:
* Breastfeeding
* Introduce sippy cup by 6 months; stop
bottle use by 12 months of age
* No bottles or sippy cups in bed
* No juice in the first year of life
* Healthy snack choices to promote a
lifetime of healthy snack habits

22
Q

All children should establish a
dental home by age ____

A

1

23
Q

Dental home provides:

A

– Evaluation and diagnosis of oral disease
– Dental trauma management
– Evaluation of growth and development
– Enhanced preventive services including:

24
Q

Caries Management

A

Caries Management
* Comprehensive dietary and oral hygiene
counseling
* Urgent dental referral for comprehensive
treatment
Fluoride varnish may arrest small cavitated lesions and prevent development of new lesions

25
Q

What is SDF?

A
  • Silver Diamine Fluoride
  • Colorless liquid with silver particles
    How does it work?
  • Antibacterial properties
  • Acts as a physical barrier
  • Fluoride strengthens enamel
26
Q

Silver Diamine Fluoride effectiveness

A

*Effectiveness: Caries arrest ~70%
-Biannual application better than annual
*Disadvantage: Treated area of the tooth is
permanently stained black

27
Q

Two main effects of sealants:

A
  1. Prevent and arrest cavities in pits and
    fissures (grooves) of primary and
    permanent molars
  2. Minimize progression of early carious
    lesions in occlusal teeth
28
Q

Infancy: Teething Concerns

A
  • Drooling is common
  • Does not cause fever, colds, ear
    infection, or diarrhea
  • May cause fussiness
29
Q

Infancy: Teething guidance

A
  • Apply cold teething ring or cloth to gums
  • Avoid teething gels (benzocaine is dangerous)
  • Tooth emergence may be preceded by a collection of
    blood in the tissues - no treatment necessary
30
Q

Pacifier and Thumb Sucking guidance

A
  • Stop habit by 3 years, especially if bite or tooth
    position affected
  • Pacifiers preferable to digit sucking
  • Break the habit: Limit opportunity (bed only)
    − Cover hands at night; provide alternate comfort object
  • Never dip pacifier in honey or other sweet food
31
Q

Injured primary teeth may:

A

✓ Discolor (turn brown or black)
✓ Cause pain
✓ Become infected
✓ Need to be removed
✓ Affect underlying permanent tooth development
o NEVER reinsert a primary tooth

32
Q

Substance Use effects to the mouth

A
  • Alcohol, tobacco and marijuana can cause
    inflammation and xerostomia
  • Methamphetamine use and can lead to severe tooth decay and gum disease