Prevention Flashcards
What is the difference between standard prevention and enhanced prevention?
All children receive standard prevention but some children will receive enhanced prevention if they are deemed to be at increased risk of caries.
Describe the health map of health behaviour change using motivational interviewing?
- Get the child and parent to show you and describe their current oral hygiene routine
- SOARS- seek permission, open questions, affirmations, reflective listening and summarising. - Educational intervention
- Action planning- set time, date and place to start
- Encourage habit formation
- Repeat at each recall visit
Give an example of an appropriate OH action plan.
Describe a time and place for the action plan to start.
Describe a trigger to remind the parent and child to carry out OH.
Use something to get the child to want to brush their teeth- singing toothbrush, games,
Identify a date to review progress
For standard prevention, what is advised for fluoride toothpaste?
1000-1500ppm Fluoride.
Age under 3 years- smear
Age 3 years and over- pea-sized amount
For enhanced prevention, what is advised for fluoride toothpaste?
Use 1350-1500ppm Fluoride or if age 10 yo can prescribe 2800ppm Fluoride (0.619%).
What is the standard prevention for all children for OHI?
Must be given hands on demonstration and instruction at least once a year.
- Ask the parent where they would like to stand- brush from the front or behind the child.
- brush twice a day- in the morning and before bedtime.
- Dont have anything to eat or drink after you brush your teeth at night time.
- Make sure to alter angulation of brush to get all teeth- particularly those that are partially erupted.
- Spit don’t rinse
- Use appropriate amount of toothpaste and coenentration of fluoride for your age.
- Supervise children until they can brush their teeth effectively.
- Demonstrate brushing on the child at least annually- 3 minutes.
- Use action planning to encourage brushing.
Advise the parent/carer to start brushing as soon as their first tooth erupts.
What is the enhanced prevention for OHI?
Give toothbrushing advice at each recall visit (rather than annually).
Give hands on bushing instruction at each recall visit (rather than annually).
Prescribe higher fluoride toothpaste in those high risk if they are ever 10 years old.
Who might you contact if someone is high risk and on the enhanced prevention program?
Health visitor
Childsmile nurse
Social worker
School nurse
What is the standard prevention for diet advice?
At least once per year.
Limit consumption of sugar- if you do want a sugary treat, eat it at meal times.
Only water or milk in between meals.
Exclusive breast feeding up to 6 months old and then with other food up until 2 years old.
Snacks in between meals- sandwiches, cheese, crackers, crisps.
Do not place sugary drinks in feeding bottles or pacifiers.
Recommend free flow spout from 6 months old.
Never put your child to bed with a feeder cup in their mouth.
Drink through a straw.
Do not eat or drink apart from tap water after brushing teeth at night.
Frequency is worse than volume- look out for this in a diet diary.
What is enhanced prevention for diet advice?
Carried out at each recall visit.
Food and drink diary
What is standard prevention for fissure sealants?
Place fissure sealants in all pits and fissures of permanent molars as soon as possible after eruption.
- Resin based is recommended.
- Ensure buccal pits of lower molars and palatal pits of upper molars are done.
If patient is pre-co-operative, you can use FUJI GI to seal the pits.
Check for integrity of FS at each recall visit.
What is enhanced prevention for fissure sealants?
Provide standard prevention plus-
Fissure seal palatal pits of upper lateral incisors and occlusal and palatal surfaces of Ds, Es, first and second permanent molars.
Describe the process for providing a resin FS?
Clean the tooth to remove any obvious debris- cotton wool pledget, toothbrush with no toothpaste, bristle brush with prophy paste or gentle ball ended probe.
Check air line s free form water by blowing air into the mirror.
Isolate the tooth using cotton wool rolls, mouth mirror and saliva ejector- use dry guard as appropriate.
Dry the tooth, etch (37% ortho-phosphoric acid) for 30 seconds.
Wash the etch off and have high volume aspirater close to the tooth.
Dry tooth again.
Apply sealant- do not allow to overflow into the gingival sulcus as this might contaminate the seal.
Light cure the sealant.
Wipe the air inhibited layer from the surface of the sealant.
Use a sharp probe to remove flash, check integrity of the sealant, check there is no excess around the margins of the tooth.
How would you check integrity of the sealant at each recall visit?
Visually check the sealant- opalescence visible at the sealant.tooth interface usually indicates leakage and demineralisation.
Check the sealant with a probe.
Check there are no air blows.
Check no excess material.
Top up sealants as required.
Describe how you would place a GI fissure sealant?
Small amount of GI on one finger tip and some petroleum jelly on the adjacent finger.
Wipe tooth surface with cotton wool.
Apply GI with finger- keep in mouth for 2 minutes.
Apply petroleum jelly immediately to avoid moisture contamination.
