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Paediatrics > Prevention > Flashcards

Prevention Flashcards

1
Q

What did the oral health survey of 5 year old children in 2009 suggest about areas of deprivation and ethnic group in terms of caries

A
  • experience of decay was higher in areas of more deprivation
  • other ethnic groups and asian/asian British showed significantly higher amounts of decay
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2
Q

What did the oral health survey of 5 year old children in 2009 suggest about average number of teeth with decay and percentage of 5yos with decay

A
  • 23.4% of all children had experience with decay

- average number of teeth with experience was 3.4

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3
Q

importance of caries risk assessment

A
  • eseential to deliver tailored preventative plan for a child who is high risk
  • develop an appropriate personal care plan based on child’s susceptibility to disease
  • identifying high risk children enables additional prevention to be delivered to them
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4
Q

what are the main indicators of a child being increased risk of developing caries within the next 3 years

A

1) Previous caries experience- any decayed missing or filled teeth
2) resident in area of deprivation- using home address
3) healthcare worker’s opinion- referral from health visitor, public health nurse of dental health support worker who has identified the need for additional preventive care

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5
Q

what are other factors that influence Childs risk of caries

A
  • clinical findings
  • diet
  • plaque control
  • use of fluoride
  • social history (siblings)
  • saliva
  • med history
  • levels of s mutant
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6
Q

what should the caries risk assessment affect

A
  • frequency of review radiographs
  • provision of preventative interventions
  • frequency of recall
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7
Q

low caries risk factors

A

look at slides

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8
Q

high caries risk factors

A

look at slides

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9
Q

what are the four pillars of prevention of caries in children

A

1) tooth brushing with fluoride toothpaste
2) dietary advice
3) topical fluoride
4) fissure sealant

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10
Q

who requires preventive intervention

A
  • every child is at risk of developing caries
  • so everyone
  • childs parent/carer has a crucial role in following preventive advice and supervising interventions
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11
Q

what kind of prevention should all children receive

what about high risk kids

A
  • standard prevention appropriate to their age
  • if child is at increased risk of developing caries, in addition to standard prevention, ensure they receive enhanced prevention
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12
Q

advice to prevent caries in 0-3 year olds

A
  • from 6 months, infants should be introduced to drinking from a free-flow cup and from age one year feeding from a bottle should be discouraged
  • parents/carers should brush or supervise brushing
  • as soon as teeth erupt brush twice a day with fluoridated toothpaste
  • brush last at night and once other
  • no less than 1000ppm
  • smear of toothpaste
  • frequency and amount of sugary food should be reduced
  • sugar free medicines recommended
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13
Q

standard preventative advice to children between 3-6 years

A
  • at least brush twice daily
  • professionally apply fluoride varnish to teeth twice a year (2.2% NaF-)
  • brushing supervised by parent
  • more than 1000ppm toothpaste
  • pea sized amount
  • spit don’t rinse
  • frequency and amount of sugary food should be reduced
  • avoid sugared meds
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14
Q

advice for children between 0-6 giving concern (likely to develop caries, special needs)

A
  • all same advice as standard preventative advice along with
  • use fluoridated toothpaste between 1350-1500 ppm
  • apply fluoride varnish two or more times a year (2.2% NaF-)
  • reduce recall interval
  • investigate diet and assist adoption of good dietary practice
  • liase with GP to request sugar free meds
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15
Q

standard preventative advice to children from 7 years and up

A
  • brush twice daily with 1350-1500 ppm fluoride
  • spit don’t rinse
  • reduce amount of sugary food and drinks
  • fluoride varnish twice a year (2.2% NAF)
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16
Q

prevention of caries for patients above 7 giving concern (current active caries, ortho appliances, dry mouth, other predisposing factors)

A
  • use fluoride mouth rinse daily (0.05% NaF) at a different time to brushing
  • fissure seal permanent molars with resin sealant
  • apply fluoride varnish two or more times a year (2.2% NaF-)
  • If aged 8 and above, prescribe daily fluoride rinse
  • If 10+ with active caries, prescribe 2800ppm fluoride toothpaste
  • If 16+ with active caries, prescribe 2800 or 5000ppm fluoride toothpaste
  • assist with diet
17
Q

when should parents stop supervising brushing

A

-earliest at 7yo

18
Q

how much and ppm toothpaste should a 0-3yo child low risk use

A
  • smear
  • at least 1000ppm
  • supervised/done for them
19
Q

how much and ppm toothpaste should a 3-6yo child low risk use

A
  • pea sized
  • more than 1000ppm
  • supervised/brushed
20
Q

how much and ppm toothpaste should a 0-6yo child high risk use

A
  • smear or pea sized
  • 1350-1500ppm
  • supervised/brushed
21
Q

how much and ppm toothpaste should a 7yo+ low risk use

A

toothpaste with 1350-1500 ppm

pea sized

22
Q

how much and ppm toothpaste should a 7yo+ high risk use

A
  • prescribed 2800ppm if above 8

- 5000ppm if above 16

23
Q

when can child use mouthwash naf

A

parents aged 7 years and above who are high risk for caries should also be advised to use daily fluoride mouth rinse at another time from brushing
0.05% naF

24
Q

what should dentist say about sugar consumption to patients

A
  • frequent sugar consumption is major cause of dental caries
  • restrict food and drinks containing sugar to no more than 4 occasions in one day
  • graxing sugar containing foods between meals and sipping soft drinks over prolonged periods should be discourages
25
Q

what advice should dentist give regarding milk

A
  • drink only water or milk between meals
  • cow milk is non-cariogenic
  • drinks containing sugars eg. sweetened milk, soy formula milk and fruited juices increase caries risk
  • from 1yo+ to at least 2, children should drink full fat cows milk
  • after 2 years, semi skimmed is acceptable
  • skimmed only suitable for children over 5
26
Q

what advice should dentist give regarding breast feeding

A

-infants should be exclusively breast fed for the first 6 months of life after which they should receive nutritionally adequate complimentary foods while breastfeeding continues

27
Q

what diet advice should dentist give

A

promote healthy snacking between meals
fresh fruit, carrot, peppers, breadsticks, oatcakes, sometimes cheese
fruit does contain natural sugars, but at normal consumption levels there is no evidence of it being cariogenic
cheese can be antiocariogenic but high in fat

28
Q

how can you monitor diet

A
  • food or drink diary
  • child or parent keeps record of all food or drink consumed over a three-day period, at least one of those days being at the weekend
  • member of dental team reviews diary
29
Q

actions of topical fluoride

A
  • sodium fluoride varnish becomes calcium fluoride when in contact with tooth enamel. this stays on tooth surface and acts as a reservoir for fluoride and provides protection against further acid attack
  • provides relief from dentine hypersensitivity by forming calcium fluoride globules which occlude dentine tubules
30
Q

how can fluoride be delivered

A
  • toothpaste
  • mouthwash
  • topical varnish
31
Q

standard v enhanced prevention of topical fluoride and ages

A
  • standard prevention for children above 3yo: apply fluoride varnish to teeth twice a year (2.2%NaF)
  • enhanced prevention for children 0yo and over: apply fluoride varnish to teeth 2 or more times a year (2.2%NaF)
32
Q

how to apply fluoride varnish

A
  • Remove excess plaque
  • dry teeth one quadrant at a time
  • thin layer of varnish to most susceptible areas of teeth using cotton bud, brush or probe
  • no eating or drinking for 20 minutes post application
  • eat soft food and not brush their teeth that day
33
Q

recommended dosages for single application of fluoride varnish in primary, mixed and permanent dentition

A

primary teeth:
-up to 0.25/ml= 5.65mg fluoride

mixed:
-up to 0.4ml = 9.04mg fluoride

permanent
-up to 0.75ml= 16/95mg fluoride

34
Q

contraindications to fluoride varnish use

A
  • hypersensitivity to colophony and other constituents
  • bronchial asthma
  • ulcerative gingivitis
  • allergic or unable to take alcohol
35
Q

when should fissure sealants be placed

A

-high risk pts above 7yo should have fissure sealants using resin sealant applied to all permanent molar teeth once erupted

36
Q

when should radiographs be taken in children

A
  • for children at increased risk of developing dental caries: 6-12 months
  • for all other children: 12-18 months for primary teeth and 2 years for permanent teeth
37
Q

what are recall intervals for children

A
  • NICE guidelines suggest for under 18s recall is 3-12 months
  • depends on risk

Paediatrics (16 decks)

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