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DS4101 > W4 - Prevention in Paeds Pts - Mani > Flashcards

W4 - Prevention in Paeds Pts - Mani Flashcards

1
Q

What to educate soon-to-be mothers about (5)

A
  1. Pregnancy gingivitis
  2. Morning sickness - nausea, erosion
  3. Perio link to pre-term, low weight babies
  4. Caries are transmissible
  5. Oral health + diet (cravings and snacking)
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2
Q

What causes pregnancy gingivitis and epulis?

A

Increased progesterone activates immune response to bacteria / plaque

(hypersensitive/exaggerated immune response)

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3
Q

Female pt

A

Pregnancy gingivitis

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4
Q
A

Epulis

  • Usually goes away on its own but if not, will require surgical intervention
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5
Q

What is this a result of?

A

Morning sickness

Erosion- acid reflux and vomiting

  • Advise pt not to brush following morning sickness
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6
Q

What can periodontal disease in pregnant women cause?

A

Low birth weight of babies

  • Should do debridement/clean
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7
Q

Why are pregnant women at a higher caries risk (3)

A
  • Sucking sweets to reduce nausea
  • Cravinga and extra snacking
  • Morning sickness/erosion
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8
Q

Most common teeth affected by ECC (early childhood caries)

A

Primary mx incisors

All molars

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9
Q

Aetiology of ECC

A

Frequent, prolonged exposure to sucrose containing liquids

(milk, formula, fruit juice)

Especially if placed in sippy cup used as a pacifier

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10
Q
A

Early childhood caries

  • Common in pts who use sippy cup filled with milk, juice, fomula, etc.
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11
Q

Long term effects of ECC

A
  • Pain
  • Premature tooth loss → malocclusion
  • Poor function → chewing difficulty → poor nutrition
  • Potential need of GA
  • $$$
  • Growth and sleep disturbances
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12
Q

How to prevent ECC (4)

A
  1. Early education (esp if mom shows high caries risk)
  2. Fluoride varnish from 1 y.o. or AgFl - 3 mthly
  3. Recall - reinforce - reapply
  4. Wean infants off bottle by 12 mo
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13
Q

Advice to parents to prevent ECC (4)

A
  1. Bottle is not pacifier
  2. Wean infants by 6-12 mo
  3. Avoid “on demand” feeding
  4. Snacks - less frequent, low cariogenic
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14
Q

What should be done for early childhood dental care

A
  1. Establish routine on eruption (washcloth, soft small brush)
  2. First dental visit (6 mo ideally)
  3. Risk assessment - MH, OH, habits, diet
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15
Q

Advice to give parents regarding toothbrushing

A
  • Parents are responsible for child’s tooth cleaning
  • Supervise until 6-8
  • No toothpaste <18mo
  • 18mo - 6 yrs → 500-550 ppm
  • Make it routine
  • Positive reinforcement (praise)
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16
Q

Concentrations of fluoride in toothpaste as per age

Exam question

A

0-18 months - 0 fluroide → no toothpaste

18 months - 6 years → 500-550 ppm

6+ → standard TP (1000-1500 ppm)

17
Q

AAPD (American Academy of Pediatric Dentistry) guidelines for prevention of ECC (5)

A
  1. Avoid frequent exposure to sugar-sweetened beverages (bottle, ad libitum breast feeding)
      1. Implementation of OH at time of eruption
      1. Fluoride varnish for children at risk of ECC
      1. First visit to dentist at 6mo for risk assessment and parental education
      1. Work with medical practitioners to ensure infants and toddlers have access to professional dental care
18
Q

When should flossing start

A

When primary molars come out (D+E) or first molar eruption (6 yo)

  • Should start with imitation of parents

Independent flossing should start around 10 years old

19
Q

How to prevent decay in primary school children

A
  • Master brushing via imitation and repetition
  • Be creative/make it fun “bugs in your mouth”
  • Advise parents of the erupting teeth (incisors and 6’s)
  • Establish recall schedule
20
Q

Habits to watch out for (6)

A

Tongue thrust

Speech development

Lip incompetency

Mouth breathing

Pacifier / thumb sucking

Tongue tie / short frenum

21
Q

Intervention of thumb sucking

A
  1. Early recognition
  2. Positive reinforcement, reminders
  3. Bitter fingernail polish
  4. Intra-oral appliances (ortho)
22
Q

How to communicate with older primary school age kids about oral health (11+)

A
  • can engage them more deeply → take time to explain about snacking, OH
  • Give posters and brochures
  • Plaque disclosing dye
23
Q

How to avoid erosion (4)

A
  1. Tell pt to avoid acidic foods/drinks
  2. Avoid swishing
  3. Straws
  4. Rinse with water after or chew gum
24
Q

Signs of erosion on dentition

A
  1. Cupping
  2. Vertical loss
  3. Palatal erosion (bulimia)
25
Q

Features of early onset (aggressive) periodontitis (5)

A
  • Rare
  • Onset occurs around puberty
  • Targets first molars and incisors (but can be generalised)
  • Rapid progression
  • Pocket depth and bone loss inconsistent with plaque levels

DS4101 (43 decks)

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