dental caries paeds

Question 1

What are some basic facts?

Answer 1

10th most prevalent disease- untreated caries

1/3 5 year olds have/had caries

1/2 8 year olds have/had caries

Question 2

What are implications of caries?

Answer 2

Pain
Infection
General health
Psychosocial

Question 3

What is pain?

Answer 3

An unpleasant sensory and emotional response to actual/potential tissue damage

Question 4

How can people describe pain?

Answer 4

Adults- McGill pain scale

Kids- “weird”, “hurts”, “lots of bees stinging”, “uncomfortable”, “sore”, “hitting”, “dizzy”

Question 5

When is pain more likely in caries?

Answer 5

At young age
2+ surfaces
In lower molars

Question 6

How might kids describe pain?

Answer 6

Crying
Stopping from playing
Missing school
Related to eating/sleeping/school
Annoyed, sad, grumpy and worse than most people

Question 7

What are signs of caries in v young children?

Answer 7

Pain on tooth brushing
During eating
Not crying at night

Question 8

What infection could be present?

Answer 8

CHRONIC
Buccal sinus
Hypoplasia of permanent successor (Turners tooth)

ACUTE
Facial swelling
Pyrexia
Hospitalisation?

Question 9

What are some associated factors with caries in kids?

Answer 9

Poor diet
Lower weight than peers
Mean height between 10th-25th percentile
Higher no of x=lower Haemoglobin, 80% iron deficiency

Question 10

What are psychosocial measures?

Answer 10

Oral symptoms
Functional limitations
Social well being
Emotional well being

Question 11

What did the 2014 children’s dental health survey (about caries) say?

Answer 11

Pain most common impact
22% 12 year olds and 19% 15 years have difficulty eating
12 year olds have lower self confidence

Question 12

How does caries impact smiling?

Answer 12

34% sad about teeth
35% 12 year old and 28% 15 year olds embarrassed to smile/laugh
31% ashamed to smile
Kids w decay show less teeth when smiling
Parents and kids were less positive

Question 13

What are implications of the tx?

Answer 13

Not little adults
Short attention span
Fear of unknown

Question 14

What do we know about child dental anxiety?

Answer 14

1/5 of kids have it
More female

IMPACTS
Child- OH status, QofL, waiting lists, travel
Dentist- occupational stress, time consuming
Service- financial, more missed/cancelled appts, more specialist referrals

BETTER COMMUNICATION NEEDED

Question 15

How can you manage a child w dental anxiety?

Answer 15

Tell them what’s going to happen in the visit
Explain in an age appropriate and non patronising manner
They are intolerant to changes once a plan has been agreed
Self help CBT resources

1. Challenge unhelpful thoughts (normalise anxiety, provide info)
2. Enhance control (Message to the dentist, Stop signal contract)
3. Reflect and plan reward

Question 16

What are some childrenese terms?

Answer 16

Buzzy bee- slow hand piece
Mr whistle- fast hand prices
Magic wind- IS
Sleepy juice- LA
Rubber raincoat- rubber dam
Tooth paint- FS
Hoover- suction

Question 17

What is conscious sedation?

Answer 17

Nitrous oxide/oxygen

Oral, transmucosal, IV

Question 18

What are minor/major risks of GA?

Answer 18

N&V
Headache

Mortality 1:250000 (more likely to die from lightening strike, road traffic is 1:84)
Highest in infants and >70years

Question 19

What is the impact of GA on kids?

Answer 19

Pre-op- hunger, being scared/worried

Post-op- IV discomfort, nausea, bleeding, tiredness, disturbed eating

Question 20

What are the benefits of GA?

Answer 20

One visit
Multiple procedures
Cost effective

Less pain
Eat and sleep better
Improved OH related QofL

Question 21

How can you minimise the impact of caries in kids?

Answer 21

Prevention (DBOH)
Community OH promotion
Reduce dental anxiety

Question 22

What are some community OH promotions?

Answer 22

Targeted fluoride varnish programmes (schools/care homes)
Targeted provision of tooth brush/paste (post/school/visitors)
Supervised brushing in school
Healthy food/drink policies
Public water fluoridation
Local and National government policies