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3rd Year > Paeds- prevention > Flashcards

Paeds- prevention Flashcards

Including fluoride use and fissure sealants

1
Q

What are the arrows pointing to?

A

The Dentine layer showing through non-carious enamel

The bluish- grey colour due to dentine thinning towards the incisal edge. This colour is due to the shadow at the back of the mouth.

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2
Q

Where does the colour of the tooth come from?

A

dentine

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3
Q

Compare the appearance of the enamel lesion on the surface and in transmitted light.

A

Enamel lesion on the surface will appear matte/ opaque and chawky white.

In transmitted light- the lesion will appear darker than healthy enamel.

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4
Q

Why does a caries cause the tooth to appear more matte?

A

Caries dissolves the prisms sheaths, creating pores- these pores refract light back instead of letting it through.

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5
Q

What clinical feature indicates dentinal involvement?

A

Opalescent enamel beside stained fissures.

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6
Q

What are we looking for in a radiograph ?

A

If the carious lesion extends into the dentine and if so, what part of the dentine (outer/ middle/ inner)

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7
Q

How do we prevent via recall appointments?

A

Provide oral hygiene advice

Provide diet advice

Closely monitor any lesions you are treating with prevention.

Check fissure sealants are still intact

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8
Q

Your patient is deemed normal caries risk, How often should you book a checkup?

A

Every 6 months

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9
Q

Your patient is deemed high caries risk, How often should you book a checkup?

A

Every 3 months

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10
Q

Your patient is deemed normal caries risk, How often should take radiographs?

A

Every 2 years

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11
Q

Your patient is deemed high caries risk, How often should take radiographs?

A

Every 6-12 months

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12
Q

Your patient is deemed normal caries risk, How often should you provide toothbrushing instruction.

A

Every year

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13
Q

Your patient is deemed high caries risk, How often should you provide toothbrushing instruction.

A

At every recall appointment

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14
Q

Your patient is deemed normal caries risk, what strength of toothpaste should you advise?

A

1350-1500ppm

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15
Q

Your patient is deemed high caries risk and aged >10 what strength of toothpaste should you advise?

A

2800ppm

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16
Q

Your patient is deemed normal caries risk, how often should you apply fluoride varnish?

A

Twice a year

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17
Q

Your patient is deemed high caries risk, how often should you apply fluoride varnish?

A

4 times a year

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18
Q

What fluoride supplements would you give high risk patients?

A

Alcohol free fluoride mouthwash.

(for patients over the age of 7)

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19
Q

Your patient is deemed normal caries risk, how often should you provide diet advice?

A

Once a year

20
Q

Your patient is deemed high caries risk, how often should you provide diet advice?

A

At every recall visit.

Use food and drink diaries

21
Q

Your patient is deemed normal caries risk, which teeth should you fissure sealant

A

1st permanent molars after eruption.

Buccal pits of lower 1st permanent molars

Palatal fissures of upper 1st permanent molars

22
Q

Your patient is deemed high caries risk, which teeth should you fissure seal.

A

All permanent molars and premolars sealed on eruption.

palatal pits on upper lateral incisiors

Occlusal and palatal surfaces of the D/E.

23
Q

What does the fluoride varnish consist of?

A

5% sodium fluoride.

24
Q

What children are at risk of an allergy to duraphat and why?

A

Those who :

  • have recently been hospitalised due to asthma or an allergy
  • are allergic to sticking plaster.

Because duraphat contains colophony.

25
Q

Discuss the cocentration of duraphat varnish and the volume used.

A

22,600 ppm.

We use 0.25ml on children aged 2-5 (nursery & P1)

We use 0.4ml on primary 2 and above

26
Q

How much fluoride needs to be ingested to cause toxicity and what factors impact this?

A

5mg/kg for toxicity.

The concentration of the toothpaste and the weight of the child affect this

27
Q

How do you manage a child who has swallowed <5mg/kg of toothpaste?

A

Give them milk and monitor them for a few hours.

28
Q

How do you manage a child who has swallowed 5-15mg/ kg of toothpaste?

A

Give them calcium orally and take them to hospital.

29
Q

How do you manage a child who has swallowed >15mg/ kg.

A

Admit them to hopsital immediately

For: cardiac monitoring

Life support

Intravenous Calcium glucon

30
Q

What is a fissure sealant?

A

It is a protective plastic coating that is used to seal fissures and pits of a tooth to prevent food or bacteria getting stuck.

31
Q

Why are fissures more vulnerable to caries?

A
  • They are less protected by fluoride than other tooth surfaces.
  • A toothbrush cannot reach the whole way into a fissure.
32
Q

What material is a fissure sealant made of?

A

Normally BIS gma resin

sometimes RMGIC

33
Q

What teeth do we fissure seal for children with disabilities,

A

All teeth.

34
Q

What teeth do we fissure seal for high risk children with learning difficulties

A

all teeth

35
Q

What teeth do we fissure seal for high risk children who are medically compromised.

A

All teeth

36
Q

What preventative action should you take if a child presents with caries in 1 permanent molar?

A

Fissure seal the other 3 1st permanent molars.

If the caries is occlusal- seal the 2nd permanent molars on erruption.

37
Q

What are the SDCEP guidelines for all children no matter their risk.

A

All permanent molars should be sealed as soon as possible after eruption.

38
Q

What surfaces should you ensure to seal on upper molars?

A

Occlusal surface and palatal pits.

39
Q

What surfaces should you ensure to seal on lower molars?

A

Occlusal surface and buccal pits.

40
Q

What surfaces should you ensure to fissure seal on the upper incisors.

A

Cingulum pits.

41
Q

Why do we not want to overfill the fissure sealant?

A

overfilling decreases long term retention.

42
Q

How should you check a fissure sealant after application?

A

Check for:

  • adhesion
  • air bubbles
  • Material interproximally
  • Excess material distal to the tooth.
  • for opaqueness.
43
Q

How often do we review fissure sealants?

A

Every 4-6 months.

44
Q

What should we look for when checking the fissure sealant at recall meetings?

A

Visual check- Is there opalescence visible- this indicates leaking and demineralisation.

Physical check- use a probe to try and lift away the fissure sealant.

45
Q

When do we chose a glass ionomer fissure sealant?

A

When good moisture control cannot be achieved.

If the patient has very sensitive teeth (so drying would be painful)

As a temporary sealant on primary and secondary molars until they fully erupt.

Covid- this doesn’t require an AGP.

46
Q

Discuss glass ionomer cement as a fissure sealant.

A

adv- they release fluoride

Disadv- they are poorly retained

they require regular re-application.

3rd Year (63 decks)

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