Prevention

Question 1

What are the four evidence based interventions?

Answer 1

• OHI with fluoride toothpaste
• Dietary advice
• Topical fluoride
• Fissure sealants

Question 2

Define standard care/standard prevention ?

Answer 2

Preventative intervention that should be given to all children

Question 3

What is enhanced care/enhanced prevention?

Answer 3

Preventative intervention required for those at an increased risk of caries

Question 4

List enhanced prevention for children 0-6 yo

Answer 4

• Standard care PLUS
• 1350-1500ppm Fluoride
• F- varnish 2x annually
• Diet and OH advice
• Sugar free medications
• Shorter recall interval

Question 5

List enhanced prevention for children 7+

Answer 5

• Fissure sealants
• Diet and OH advice
• Fluoride -
• -> daily mouth wash
• -> high conc toothpaste (2800 if 10+ or 5000 if 16+)
• -> F varnish 2x year

Question 6

List general toothbrushing advice

Answer 6

• Brush teeth as soon as they erupt 2x day with fluoride TP
• Spit dont rinse
• Supervise brushing

Question 7

How much ppm fluoride should be in toothpaste for the following - 
0-3 low risk 
3-6 low risk 
0-6 high risk 
7+ low risk 
10+ active caries 
16+ active caries

Answer 7

0-3 = 1000ppm 
3-6 - >1000ppm 
0-6 HIGH RISK = 1350-1500 
7+ - 1350-1500
10+ active caries - 2800 
16+ active caries - 5000

Question 8

When should fluoride mouthwash be prescribed

Answer 8

7+ high risk patients can be prescribed a daily mouthwash

Question 9

What conc fluoride is the daily mouthwash? How much fluoride is this?

Answer 9

0.05%

225ppm

Question 10

When to apply fluoride varnish according to standard and enhanced care?

Answer 10

• Standard - 2x year aged 3+

- Enhanced - 2 or more times a year aged 0+

Question 11

What conc fluoride is in fluoride varnish? How much fluoride is this?

Answer 11

2.2%

22,600ppm

Question 12

Dose of fluoride varnish for:

• Primary dentition
• Mixed dentition
• Permanent dentition

Answer 12

• Primary - 0.25ml
• Mixed - 0.4ml
• Permanent - 0.75ml

Question 13

Contraindications for fluoride varnish

Answer 13

• Hypersensitivity to constituents
• Bronchial asthma
• Ulcerative gingivitis
• Allergic to or unable to take alcohol for cultural reasons

Question 14

List general diet advice

Answer 14

• Avoid frequent snacks between meals
• Avoid drinking juices, fizzy drinks between meals
• Be aware of sugar content and hidden sugars
• Parents should not put sugary drinks in bottles at night (e.g. sweetened milk)

Question 15

What are good alternatives to high sugar snacks?

Answer 15

• Fresh fruit and veg
• Breadsticks
• Small amount of cheese

Question 16

What is a diet diary

Answer 16

Child or parent/carer records all food and drink consumed over a 3 day period (with one day being a weekend)

Question 17

Drinks between meals

Answer 17

• Water

- Cows milk

Question 18

What are fissure sealants?

Answer 18

Material placed in susceptible areas on teeth to prevent the development of caries

Question 19

What sites in the mouth are susceptible to caries

Answer 19

Fissures 
Grooves
Cingulum pits 
Dens in dente pits 
Anywhere food collects

Question 20

Types of material used for fissure sealants

Answer 20

Flowable resin composite

GIC as a temporary sealant (high wear)

Question 21

Indications for fissure sealant

Answer 21

• High risk children >7yo

Question 22

When may a gic sealant be placed?

Answer 22

Partially erupted teeth

Uncooperative patient

Question 23

How to monitor already placed fissure sealants

Answer 23

Assess wear, leakage or loss of integrity

Question 24

What is the radiographic recall period for low and high risk children?

Answer 24

Low risk - 12-18 months for primary teeth and 2 years for permanent

High risk - 6-12 months