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Dr Mani > Week 4- Prevention in Child Pt > Flashcards

Week 4- Prevention in Child Pt Flashcards

1
Q

When should you educate patient on oral health associated with pregnancy?

A

Before 6 months of pregnancy

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2
Q

What are things you should teach patient regarding oral health and pregnancy?

A
  • Pregnancy gingivitis and epulis
  • Morning sickness – nausea, erosion
  • Periodontal disease link to pre-term low, weight babies
  • Caries, a transmissible disease
  • Oral health and diet – cravings and snacking
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3
Q

Why do pregnant patients get pregnancy gingivitis and epulis?

A

Hormones (progesterone) activates immune response to bacteria/plaque.

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4
Q

What is the management for pregnancy epulis?

A

Usually goes away on its own, but needs surgical intervention if not

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5
Q

How can you prevent pregnancy gingivitis and epulis?

A

Good OH and pt education

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6
Q

What are the effects of morning sickness on teeth?

A

Chronic and prolonged morning sickness will lead to acid erosion on teeth

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7
Q

What should you advise patient if they have morning sickness?

A

Don’t brush teeth after morning sickness. Wait at least 30 minutes.

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8
Q

What is the link with perio and pre-term birth?

A

Women who have bad OH and perio during pregnancy are more prone to pre-term, low weight babies.

Endotoxins can enter circulatory system and then enter fetal placental unit.

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9
Q

Describe caries transmission between parents and baby?

A

Strep mutans pass from parent to child. Usually happens in first years of life. Sucrose facilitates adhesion of SM to tooth surface.

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10
Q

What are preventative strategies for pregnant patients?

A
  • Dietary advice
  • Rinse with water after exposure
  • Xylitol products
  • CHX varnish
  • Topical F- for high risk pts
  • Regular brushing and flossing
  • Recalls
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11
Q

Why is caries risk increased during pregnancy?

A
  • Sucking sweets to reduce nausea
  • Cravings and extra snacking
  • Morning sickness and erosion
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12
Q

What is early childhood caries?

A

Caries present 0-3 years of age

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13
Q

What is ECC caused by?

A

Frequent, prolonged exposure to sucrose containing liquids (milk, juice, soft drink)

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14
Q

What is the caries pattern of ECC?

A

Usually primary mx incisors and all molars

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15
Q

What is the aetiology of ECC?

A
  • Pooling of sugary fluid around mx anteriors causing demin. Md anteriors more protected than mx anteriors due to fresh saliva pooling under tongue.
  • Decreased saliva flow during sleep
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16
Q

What are the EEC manifestations?

A
  • White areas of demineralization
  • Cavitation
  • Loss of crown due to caries
  • Need for extraction
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17
Q

What are long term effects of ECC?

A
  • Pain
  • Premature tooth loss (malocclusion, poor self esteem)
  • Chewing difficulty (nutrition)
  • Speech problems
  • Growth and sleep disturbances
  • Risk or need for tx under GA
  • Financial burden
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18
Q

How can ECC be prevented?

A
  • Early intervention/education (esp if mother high caries risk)
  • Train dental team to identify pt at risk
  • Lifestyle change (OH, diet, F-)
  • Apply Fl varnish from 1 yr old
  • Recall
  • Wean infants off bottle by 12 months.
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19
Q

When can you start applying Fl varnish?

A

From 1 year old

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20
Q

When should infants be weaned off bottle?

A

12 months

21
Q

What is some advice for parents to prevent ECC?

A
  • Limit bottle feeding to water, milk formula
  • Bottle is not pacifier
  • Wean infants by 12 months
  • Avoid on demand feeding
  • Less frequent and low cariogenic snacks.
22
Q

When should child have their first dental visit?

A

6 months ideal

23
Q

How should parent clean babies teeth once erupted?

A

Once first tooth erupts, use washcloth, gauze or soft small brush.

24
Q

When should F- toothpaste be introduced?

A

18 months

25
Q

How much and ppm F- toothpaste should be used in patients 18months-6years?

A

Smear to pea sized, 500-550ppm

26
Q

What are some strategies for reinforcing toothbrushing for children?

A
  • Have routine
  • Make song
  • Praise or gold star
27
Q

What ppm F- toothpaste should be used in patients over 6 years?

A

1000-1500ppm

28
Q

What children can use adult F- toothpaste?

A

High risk children in non-fluoridated areas

29
Q

What are the ppm F- for Jack n Jill, Colgate childrens, Macleans little teeth and Macleans milk teeth tooth paste?

A
  • Jack n Jill TP = No Fl
  • Colgate’s children’s = 500ppm Fl
  • MacClean’s Little Teeth – 1000ppm Fl
  • MacClean’s Milk Teeth = 500ppm Fl
30
Q

How should we teach children to floss?

A
  • Watch parents brush & floss (imitation)
  • Floss sticks (easier)
  • Start with primary molars (broad contact)
31
Q

When should children start flossing themselves?

A

10 years

32
Q

What is the protocol for high risk primary school aged children (5+)?

A
  • 3-6 month recalls
  • F- TP
  • Diet assessment, new meds, new hobbies
  • F- varnish
  • Tooth mousse
  • Fissure seal molars and premolars on eruption
33
Q

When can F- tooth mousse start being used?

A

8 years old.

34
Q

How can you describe bacteria in children’s mouth to them?

A

Bugs in your mouth

35
Q

What habits should be watched for in children?

A
  • Tongue position
  • Lingual frenum for tongue tie
  • Speech & language development
  • Lip competency
  • Mouth breathing
  • Pacifier use, thumb or digit sucking
36
Q

What can happen if patient continues thumb sucking habit?

A

Altered occlusion and facial development

37
Q

What age is thumb sucking and tongue thrusting normal until?

A

Thumb sucking, tongue thrusting until 2-3 years is acceptable and won’t have effect. Habit beyond this stage is a concern. Need to identify these habits early on.

38
Q

What are early interventions to prevent thumb sucking?

A
  • Positive reinforcement, identify trigger, reminders
  • Bitter fingernail polish
  • I/O appliances if habit continues
39
Q

What patients are more prone to trauma to central incisors?

A

Patients with Class 2 Div 1

40
Q

How can older primary school aged children be managed (11+)?

A
  • Plaque disclosing gel
  • Explain diet, snacking, brushing and flossing
  • Posters and brochures
41
Q

What do the 3 colours for GC tri-plaque ID gel indicate?

A
  • Pink: recently cleaned surfaces with immature biofilm
  • Blue-Purple: Undisturbed biofilm for 48hours+
  • Blue: Acid production from plaque bacteria
42
Q

How should adolescent patients be managed?

A
  • Respect them & avoid judgement
  • Discuss impact of social media and unrealistic expectations
  • Introduce tongue brushing
  • Advice on OH, diet, smoking, alcohol and drug use.
  • Explain impact of poor oral health (aesthetics of caries, halitosis)
43
Q

How should you manage patients with braces?

A
  • Demonstrate OH technique
  • F- varnish
  • Tooth mousse
  • If necessary, high F- TP or mouthwash
44
Q

What are common sources of acid erosion in patients?

A
  • Acid drinks
  • Citrus
  • Vinegar
45
Q

What are some tips to prevent erosion?

A
  • Avoid swishing
  • Straws
  • Rinse with water after
  • Chew gum to increase saliva flow
46
Q

What are signs of acid erosion?

A
  • Cupping
  • Vertical loss
  • Palatal erosion
47
Q

What are characteristics of early onset periodontitis?

A
  • Rare, can occur in young with family susceptibility
  • Onset – puberty targeting first molars and incisor, but can be generalised
  • Rapid progression
  • Episodic – intermittent attachment destruction
  • Signs – pocket depth and bone loss inconsistent with plaque levels
48
Q

How long should parents supervise thier child brushing thier teeth?

A
  • Brush children’s teeth until 6 years.
  • Supervision until 6-8 years

Dr Mani (2 decks)

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