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Pediatrics > Oral Health > Flashcards

Oral Health Flashcards

1
Q

What is the most common health condition globally?

A

untreated tooth decay

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2
Q

How many people do oral diseases and tooth decay effect globally

A

3.5 billion and 2.3 billion

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3
Q

What percent of the population does periodontal disease affect?

A

50%, 10% suffer severe which may result in tooth loss

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4
Q

What is most common chronic disease of childhood?

A

Tooth decay

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5
Q

Tooth decay is ____x more common than asthma and ____x more common than allergies

A

5, 7

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6
Q

2/3rds of all Canadians aged ___ to ____ have tooth decay

A

6 - 11

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7
Q

__ out of ___ kids entering grade 1have tooth decay

A

1 3

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8
Q

What is the leading cause of day surgery for children in Canada?

A

Early childhood caries

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9
Q

What disease is oral health directly linked to and what is is more likely to cause

A

Diabetes, thrush infection r/t increased rates of infections in diabetics

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10
Q

A mouth infection can result in a _______ event. What is the implication of this?

A

Cardiac; those with CVD have to take antibiotics when going to the dentist

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11
Q

What can a mouth infection cause in a pregnant client?

A

Preterm labour, low birth weight

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12
Q

What considerations might you have regarding the oral care capacity of a child with impaired cognitive function?

A

poor hand dexterity have inability to perform self-care (teeth brushing)

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13
Q

Implications of poor oral care in ICU patients

A

Result in aspiration pneumonia

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14
Q

Bacteria causing dental caries

A

streptococcus mutans
- gram positive coccus
- commonly found in oral cavity

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15
Q

Process of tooth decay

A

bacteria + sugar = acid
acid + tooth = cavity

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16
Q

5 roles of nurse in relation to dental caries

A
  1. understand importance of oral health/what dental caries are
  2. assess risk
  3. anticipatory guidance
  4. oral health screening
  5. referrals
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17
Q

4 components that lead to dental caries

A
  1. host
  2. time
  3. cariogenic biofilm
  4. fermentable carbohydrates
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18
Q

Dental Caries Primary Modifying Factors

A
  • tooth anatomy
  • saliva
  • biofilm
  • use of fluoride
  • diet specifics
  • oral hygiene
  • immune system
  • genetics
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19
Q

Dental caries secondary modifying factors

A
  • socioeconomic status
  • education
  • life style
  • environment
  • age
  • ethnic group
  • occupation
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20
Q

In the non-disease state, there is a normal equilibrium between ___________ & _________ – dental caries occurs in an oral environment that favors ____________

A

demineralization and remineralization

demineralization

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21
Q

Pathological factors of dental caries

A
  1. cariogenic bacteria
  2. subnormal salivary function
  3. diet (fermentable carbs)
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22
Q

How does saliva protect our teeth from caries?

A
  • buffers/neutralizes acidic environment
  • contains calcium and phosphate for mineralization
  • antibacterial proteins
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23
Q

Protective factors against dental caries

A

salivary flow and components

fluoride, calcium, phosphate

antibacterials and chemotherapeutics

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24
Q

6 common sites for decay

A
  1. near gum line
  2. contact point (just at or below where 2 teeth touch)
  3. pits/fissures
  4. exposed root surfaces
  5. underneath existing fillings
  6. teeth which hold dentures or other dental work in place
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25
Q

Description of early dental lesion

A
  • white and chalky
  • at gum line of where ortho brackets were previously
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26
Q

Description of progressing/advanced lesion

A
  • light brown and wet
  • cavitated
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27
Q

description of inactive/arrested lesion

A
  • dark brown or black leathery appearance
  • feels hard with probing
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28
Q

What is periodontal disease?

A

Inflammation of the supporting tissues of the teeth leading to progressive destructive change leading to loss of bone and periodontal ligament, extending of inflammation from gingiva into the adjacent bone and ligament

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29
Q

Periodontal disease effects ____% of Canadians, ____% of low income

A

24, 47

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30
Q

Periodontitis increases risk for (4)

A
  1. CVD
  2. Diabetes
  3. Respiratory Diseases
  4. Adverse pregnancy outcomes
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31
Q

How does diabetes effect oral health/periodontitis?

A

 Inability to regulate blood sugar; circulation of sugar effects teeth in mouth
 Only issue with those who manage poorly

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32
Q

What adverse pregnancy outcomes can occur in those with periodontitis?

A

Sepsis leading to preterm/LBW

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33
Q

What considerations about fluoride must you consider for those at risk for ECC?

A

Many rural communities are not fluoridated, or drink bottled water which does not contain fluoride

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34
Q

How does fluoride prevent dental caries?

A
  1. promotes remineralization
  2. inhibits bacterial acid production
  3. strengthens enamel to resist bacteria
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35
Q

What considerations of a childs diet must you consider r/t risk for ECC?

A
  • walking around with bottle all day vs cup
  • sugary, sticky liquids/food without teeth brushing
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36
Q

Sleeping with a ______ increases risk for ECC

A

bottle

37
Q

Describe how oral hygiene should be performed on an infant

A

lift the lip, use clean cloth, and wipe gums so they become accustomed to brushing - start early

38
Q

when should you start brushing an infant’s teeth

A

as soon as they come in

39
Q

When should a child be supervised/assisted in brushing their teeth until?

A

8

40
Q

When should children go into the dentist by?

A

1 or within 12 months of eruption of first tooth

41
Q

True or False: Indigenous people all have dental coverage

A

If they have a treaty card or if they are low income

42
Q

6 Biological High Risk Factors for Caries 0-3 year olds

A
  1. mother has active cavities
  2. low economic status
  3. more than 3 sugar containing snacks/beverages per day
  4. put to bed with bottle containing sugar
  5. special health care needs
  6. recent immigrant
43
Q

4 Protective Factors for Caries 0-3 year olds

A
  1. optimally fluoridated drinking water/supplements
  2. teeth brushed daily with fluoridated tooth paste
  3. receives topical fluoride from health professional
  4. regular dental care/has dental home
44
Q

3 Clinical Findings that put 0-3 children at high risk for caries

A
  1. has white spot lesions/enamel defects
  2. visible cavitities
  3. plaque on teeth
45
Q

6 Components of Oral Health Screening

A
  1. Confirm medical hx/allergies
  2. Simple questions to determine dental IQ
  3. Follow same protocol each time
  4. start big, end small
  5. extra-oral then intra-oral
  6. done with tongue depressor and light
46
Q

What simple questions should be asked in oral health screening to determine level of dental IQ/dental health history?

A
  1. when was your last dental visit?
  2. who and where is your dentist?
  3. do you have dental coverage?
  4. do you brush? how often?
  5. do you floss? how often?
  6. do your teeth hurt?
  7. do your teeth hurt when you drink something cold/hot?
47
Q

Describe extra-oral exam

A
  1. Look at person’s general appearance
  2. Are there any visible asymmetries or swellings
  3. Swellings may be in the eye/cheek/lips/neck areas

Assess face for symmetry, swelling, bruising?

48
Q

What are the 8 steps to intra-oral screening?

A
  1. count teeth and record if missing
  2. record teeth with decay
  3. assess for holes, dark staining on biting surfaces, cheek and tongue side of teeth
  4. assess gums for bleeding, redness, gum recession
  5. assess in mouth for bumps/lumps, sores
  6. assess tongue and lips - record piercings
  7. pull cheeks away from teeth and assess inner cheeks and teeth
  8. note any fillings or previous dental work
49
Q

Steps in observing teeth in intra-oral screening

A
  1. count and record if any are missing
  2. document “d” for any cavities/dark staining
  3. document “f” for any filling
  4. document “b” for any broken
50
Q

True or false: if you are unsure of if a teeth has a cavity, you should not record it as “d”

A

False: in doubt, record as decay

51
Q

Describe intra-oral screening of soft tissues

A
  1. look at floor of mouth/under tongue and gums
  2. Any inappropriate swelling record the letter A
52
Q

If seen on intra-oral screening, what do swelling require?

A

IMMEDIATE ATTENTION BY A DENTAL PROVIDER

53
Q

What does D indicate on documentation?

A

Decay/Cavity

54
Q

What does F indicate on documentation?

A

Filling

55
Q

What does B indicate on documentation?

A

Broken

56
Q

What does A indicate on documentation?

A

Swelling

57
Q

When and what first primary/deciduous teeth begin to erupt?

A

Central incisors 6-8 months

58
Q

By what age are primary/deciduous teeth shed?

A

12

59
Q

Toothbrushing recommendations

A
  1. twice a day - at night most important
  2. soft bristles
  3. fluoridated toothpaste
  4. importance of manual dexterity
  5. bleeding normal and will go away as oral care increases
60
Q

Size of toothpaste for children up to 3

A

rice grain

61
Q

Size of toothpaste for children 3-6 and up?

A

green pea

62
Q

When should flossing begin?

A

As soon as any teeth touch

63
Q

When should flossing occur?

A

When baby or adult teeth touch
Before teeth brushing

64
Q

What areas does flossing target

A

Areas where toothbrush cannot access

65
Q

5 Step Process of Flossing

A
  1. Take ~18 inches of floss and hold between thumb and index finger
  2. Place floss between teeth at a 45 degree angle
  3. Move up and down either side of gums (back drying method)
  4. Stay in same location until nothing else is removed
  5. Bleeding may occur with first attempt
66
Q

What is interdental cleaning?

A

Plague control between visits

  • Targets space beneath the interproximal contact area of teeth (toothbrushing cannot reach here)
  • Best if done in conjunction with toothbrushing
  • Can use floss, brushes, wooden sticks
67
Q

What is fluoride varnish?

A

Topical fluoride - around 22600ppm or 5% sodium fluoride

68
Q

Who is fluoride varnish contraindicated in? (3)

A
  1. allergies to colophony/pine rosin
  2. low risk for dental caries
  3. those who attend dentist regularly
69
Q

Ideal # of dental visits per year

A

2

70
Q

True or false: fluoride varnish is safe for use in young children

A

True - safe for all ages

71
Q

Evidence supports applications of fluoride varnish every ______

A

6 months

72
Q

3 steps to fluoride varnish application

A
  1. dry teeth with gauze
  2. apply varnish to teeth, not gums
  3. wait desired time then allow patient to close mouth
73
Q

What instructions should you give to patient following fluoride varnish application?

A
  • To not brush or floss until that evening
  • Eat a soft diet for the remainder of the day
  • Teeth may appear discoloured or feel rough (this will change once they brush their teeth)
74
Q

When should child be weaned from bottle to prevent ECC?

A

12-15 months

75
Q

What should be limited to prevent ECC?

A

“grazing” and sticky foods (raisins, gummies, sugary beverages (pop/soda, juice)

76
Q

When should you recommend first and reoccuring dental visits for children?

A
  • See dentist at least 1x/year, 2x for high risk
  • Recommend first dental visit by 12 months old
77
Q

Cup should be introduced at

A

6-8 months

78
Q

When are no spill sippy cups recommended?

A

not recommended for home general use. Reserved for use in the car or other instances when spills should be avoided.

79
Q

Recommendations regarding juice for ECC?

A

No more than 1-2 onces per day. NEVER in a bottle.

80
Q

What is an avulsed tooth?

A

Knocked out

81
Q

True or false: baby teeth can be replanted

A

False

82
Q

When should adult avulsed teeth be replanted?

A

As soon as possible

83
Q

Where should an avulsed adult tooth be kept until it can be replanted?

A

moist environment (Put it in Hank’s Balanced Salt Solution, Milk, Saliva, Water, Other)

84
Q

When does a dentist need to be seen after a tooth is knocked out?

A

within 30 minutes (max 1 hour)

85
Q

Cost of in hospital dental referrals

A

Incurred if referred within working hours

More if after hours

86
Q

True or false: there is a defined referral pathway for community dental professionals

A
  • No defined referral pathway
  • Letter with same details as provided on the hospital form
  • Low cost services:
    o College of Dentistry
    o Saskatoon West Clinic
87
Q

By age ____ most toddlers will have a full set of _____ primary teeth

A

3

20

88
Q

In toddlerhood, cleaning of teeth should progress from __________ to use of _________ toothpaste at age ________

A

water brushing

rice kernel size fluoridated tooth paste

2-3

Pediatrics (12 decks)

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