Prevention and Management of dental caries in children Flashcards
What does GIRFEC stand for?
Getting it right for every child.
When should an assessment for a child first be carried out?
Before the child is 6 months old in order that parent/carers can be encouraged to adopt optimum caries preventative practices early.
What is the definition of dental neglect for a child?
“The persistent failure to meet a childs basic oral health needs, likely to result in the serious impairment of a child’s oral or general health or development.”
What would you see clinically if only the enamel is affected by caries?
The lesion will be matt, opaque, chalky white.
What is a bitewing radiograph radiation dose equivalent to?
A few days worth of background radiation.
How often should you take bitewings for children at increased risk of developing caries?
6-12 months.
How often should you take bitewings for children at moderate/low risk of developing caries?
2 years.
What is MIH?
Hypomineralisation of system origin of 1-4 permanent first molars, frequently associated with affected incisors. Second primary molars can similarly be affected.
What factors are to be taken into consideration when determining whether teeth affected are of poor prognosis?
- Enamel colour in order of severity and increasing likelihood of breakdown: white/cream, then yellow, then brown.
- Location of the defects in order of severity: smooth surface, then occlusal surface/incisal edge, then cuspal involvement.
- sensitivity to brushing or temperature
- atypically shaped restorations.
- any patient reported symptoms
What are 7 risk factors known to be associated with development of caries?
- clinical evidence of previous disease
- dietary habits, especially frequency of sugary food and drink consumption.
- social history, especially socio-economic status
- use of fluoride
- plaque control
- saliva
- medical history
What does MCDAS stand for?
Modified Child Dental Anxiety Scale
Name 8 behavioural management strategies that you can use with anxious children/ patients.
- Communication (non-verbal and verbal)
- Enhancing control
- Tell, show, do
- Behaviour shaping and positive reinforcement
- Structured time
- Distraction
- Relaxation
- Systemic desensitisation
It is imperative that ALL children receive caries prevention and appropriate behaviour management. True or false?
True
What is the first priority when planning care/treatment for a child?
To keep the permanent molars free from caries, as these teeth are more likely to experience decay than other permanent teeth in a childs dentition.
What is the second priority when planning care/treatment for a child?
Reduce the risk of any caries in the primary dentition resulting in pain or infection before the tooth exfoliates.
What are the symptoms of reversible pulpitis?
Pain is provoked by a stimulus e.g cold/sweet and relieved when it is removed. The pain is intermittent, difficult for the child to localise and does not tend to affect the childs sleep. The pulp is still vital and the tooth is not tender to percussion. Management of the carious lesion alone may be enough to resolve inflammation, and allow pulpal healing.
What are the symptoms of irreversible pulpitis?
Pain can occur spontaneously but if provoked by a stimulus is typically not relieved when stimulus is removed. The pain may last for several hours, may be difficult for the child to localise and may keep the child awake at night. The pain may be dull, throbbing, worse by heat and relieved by cold. No obvious sign and symptoms of infection such as TTP or PAP.
What are the symptoms of a dental abscess?
Acute pain, likely to be spontaneous, will keep the child awake at night and can easily be located by the child. The tooth may show increased mobility and may be TTP. There may be clinical evidence of a sinus, abscess or swelling of radiographic evidence of PAP. When chronic the child may not report pain but other symptoms may be present.
When should antibiotics only be prescribed?
If there is evidence of spreading infection (swelling, cellulitis, lymph node involvement) or systemic involvement (fever, malaise).
Based on a review of the literature, SIGN guideline, recommended that oral health promotion strategies should:
A) Facilitate daily toothbrushing with fluoride toothpaste
B) Be based on recognised oral health behaviour theory and models such as motivational interviewing
C) Be specific to individuals, and be tailored to their particular needs.
D) All of the above.
D - all of the above.
Current guidelines suggest a 5 stage approach to health behaviour change using motivational interviewing. What are the 5 steps?
- Explore current practice and attitudes using a motivational interview approach (e.g SOARS).
- Educational intervention (improve knowledge and skills).
- Action Planning (set time, date and place to start).
- Encourage habit formation (achieve sufficient repetition).
- Repeat at each recall visit.
What does SOARS stand for?
S - Seek permission
O - Open questions
A - Affirmations
R - Reflective listening
S - Summarising
What is the amount and strength of fluoride toothpaste recommended for children under 3 years with standard risk of caries?
A smear and 1000-1500ppm.
What is the amount and strength of fluoride toothpaste recommended for children under 3 years with increased risk of caries?
A smear and 1350- 1500ppm or for ages 10 and over consider 2800ppm.
