4

Question 1

is caries preventable?

Answer 1

yes

Question 2

what is the impact of caries on pre school children?

Answer 2

• aesthetic problems
• loss of function (larger chunks)
• pain
• infection

Question 3

what is a child abscess like?

Answer 3

Unlike adult which is apex and root tip child is below floor of pulp chamber get intra oral swelling as bone spongey so infiltrates it

Painful, pus - some called gum boil

Question 4

what is the population skew of distribution of caries?

Answer 4

25% of Scottsih children have 75% of dental caries

Strongly related to poverty.

• Hard to reach children
• Lower socio-economic groups
• Hard to access because low school attendance , lack of attendance at medical/dental appointments, poor diet

Question 5

early childhood caries a.k.a.

Answer 5

nursing caries

Question 6

what is the pattern of nursing caries/

Answer 6

typically affects the upper anterior and molar teeth

Question 7

what is a typical cause of nursing caries?

Answer 7

inappropriate use of feeding cups and bottle

Question 8

3 methods of nursing caries prevention

Answer 8

• diet and nutrition
• fluoride
• oral hygiene

Question 9

what is the dental message on breast feeding?

Answer 9

breast feed till 2 (rare nowadays)

wean off at approx. 1

no on demand overnight feeding from around 4 months
- over 6 months overnight feeding can lead to caries

all dependent on weight of child

Question 10

why is breastfeeding best for babies?

Answer 10

best nutrition

antibodies
• Dip in maternal antibodies at around 6 months - own immune system into pain - causes crying, fever

Question 11

what is the specific feature of a feeding cup that should be used for babies?

Answer 11

free flow spout

non spill types in most shops are not good for dental development as munch/bite to get fluid
• Should drip when turn over

Question 12

what kind of drinks should not be put in babies’ cups?

Answer 12

drinks containing free sugar

Question 13

why shouldn’t babies/children be put to bed with a bottle?

Answer 13

higher chance of caries if drink has sugar (even milk) as can form over night

can choke on it

causes irregular sleep

Question 14

what is an issue with soya milk?

Answer 14

cariogenic

only be used when medically indicated

Question 15

what should the dentist recommend when they have a strong suspicion sugary drinks are being consumed?

Answer 15

only have at mealtimes (special occasions maybe)

dilute as much as possible and sugar free versions

take through a straw held a back of mouth on top of tongue

Question 16

what is important to consider if medication is needed?

Answer 16

sugar free formulations where possible

if not possible taken at mealtimes

Question 17

pros and cons of cheese as a snack

Answer 17

high energy (good for toddlers)

non-cariogenic

may actively protect against caries (neutralise acid)

can lead to obesity

Question 18

safe snack

Answer 18

• milk/water
• fruit (wary of dried)
• savoury sandwhiches
• crackers and cheese
• bread or veg sticks
• crisps (if plain classic not manufactured ones)

Question 19

what are the positives of carrying out a 4 day diet diary?

Answer 19

can be specific to them - individual advice

actual likes and dislikes taken into consideration
- advise on when best to eat them

Question 20

sources of fluoride

Answer 20

• water (none in scotland)
• toothpaste
• supplementary self-delivered (seldom used - drops, tablets and mouthrinse)
• professionally delivered (gels, varnishes, slow-release devices)

Question 21

when should tooth brushing commence/

Answer 21

as soon as first primary/deciduous teeth erupt

Question 22

children brushing teeth

Answer 22

in general, under the age of 7/8 need assistance to brush their teeth by an adults as they lack the dexterity to do so properly

Question 23

level of fluoride in child formulation toothpaste

Answer 23

1000ppm

e.g. Aquafresh Milk teeth

Question 24

level of fluoride in standard toothpaste

Answer 24

1400-1500ppm

e.g. colgate total, aquafresh little and big teeth

toothpastes given out in Childsmile

Question 25

level of fluoride in enhanced fluoride toothpastes

Answer 25

2800ppm e.g. duraphat toothpaste prescription only

Question 26

toothpaste strength recommendations for first tooth eruption (3 years) standard risk kids

Answer 26

1000ppmF

Question 27

toothpaste strength recommendations for 4-16 years standard risk kids

Answer 27

1000-1500ppmF

Question 28

toothpaste strength recommendations for high risk kids under 10 years

Answer 28

1500ppmF

Question 29

toothpaste strength recommendations for high risk kinds 10 and over

Answer 29

2800ppmF (prescription only)

Question 30

toothpaste strength recommendations for high risk 16 and over

Answer 30

5000ppmF (prescription only)

Question 31

amount of toothpaste for children under 3

Answer 31

smear of toothpaste | approx. 0.1ml

Question 32

amount of toothpaste for children for children 3 or over

Answer 32

pea sized amount | approx. 0.25ml

Question 33

fluorosis

Answer 33

enamel defect when too much fluoride is exposed to teeth ``` white flecks (mild) brown patches (severe) ```

Question 34

good toothbrushing practices

Answer 34

Spit out excess, do not rinse. - Dry brush Manual or powered toothbrushes are both effective when using a fluoride toothpaste. - Use a small headed manual brush. - Power toothbrush use small round oscillating head A Cochrane Review has indicated that tooth brushing is more effective when using a powered brush with a small round, oscillating head compared to manual brushing. - Take into account patient situation when recommending products

Question 35

what should be done if more than 5mg of F per kg body weight has been consumed?

Answer 35

give calcium orally (milk) and observe for a few hours

Question 36

what should be done if more than 5-15mg of F per kg of body weight has been consumed?

Answer 36

Give calcium orally (milk, calcium gluconate, calcium lactate) and admit to hospital

Question 37

what should be done if more than 15mg of F per kg body weight has been consumed?

Answer 37

Admit to hospital immediately, cardiac monitoring and life support, intravenous calcium gluconate. - Can be poisoned (fluoride toxicity

Question 38

what information is needed to assess risk of fluoride toxicity?

Answer 38

weight of person how much toothpaste ingested strength of toothpaste ingested

Question 39

when should flossing be taught?

Answer 39

from 12 years - adult dentition now so no mobile teeth and have manual dexterity skills

Question 40

use of fluoride mouth rinses

Answer 40

- Not recommended for children under the age of 6. | - Even over 6 need to assess the child’s ability to properly expectorate.

Question 41

types of professionally applied fluorides

Answer 41

- APF gels (not really used often) | - varnishes

Question 42

fluoride varnishes

Answer 42

Duraphat – first and most widely used - Yellow, banana taste Now get different flavours and some are white Concerns over asthmatic or atopic (highly allergenic) children - Has resin from tree in it which commonly causes reactions

Question 43

practice based caries prevention

Answer 43

Topical fluoride varnish should be applied to the dentition at least twice yearly for pre-school children assessed as being at increased risk of caries. Floss between contact areas. Fluoride varnish can be administered for high risk adults Good for dentine sensitivity too

Question 44

community based caries prevention

Answer 44

Health education - Is a process that results in individuals or groups having increased knowledge related to health. Health promotion

Question 45

dental and dietary health eduction

Answer 45

Is a process that results in individuals or groups having increased knowledge related to health. The sugar reduction campaign is currently being helped along by anti-obesity public health campaigns. - Obesity crisis is helping to reduce sugar

Question 46

health promotion

Answer 46

Supports individuals in translating their health knowledge into positive behaviours and lifestyles. The rationale is to increase the community’s day-to-day capacity and ability to follow a healthy lifestyle. - Need to become habit – lifestyle change (diets are phases – don’t work in general) Health promotion activities should be directed at a wide variety of areas likely to impact on health, - e.g. Social, economic and structural environments as well as the policies of public and local institutions.

Question 47

techniques used to diagnose of dental caries

Answer 47

bitewing radiographs - Fibre-optic transillumination. - Temporary tooth separation (gently push teeth apart using blue rubber bands over a couple of days) - Air abrasion - CO2 Laser - Electric caries meter