Caries Prevention Highlights

Question 1

Definition of early chidhood caries

Answer 1

presence of 1 or more decayed (noncavitaed or cavitated lesions), missing(due to caries), or filled tooth surface in any primary tooth in a child 71 months of age or younger.

Question 2

Def. Severe childhood caries

Answer 2

Any sign of smooth surface caries in a child younger than 3 years; from age 3 through 5, 1 or more cavitated, missing, or filled smooth surface in primary maxillary anterior teeth; - A decayed, missing, or filled score of ≥4(age 3),≥5 (age4), or ≥6(age5)

Question 3

4 etiological factors for caries

Answer 3

Tooth, Bacteria, Fermentable Carb, Time

Question 4

What kind of caries is ____ good to detect? Visual RG FOTI Tactile EMR?

Answer 4

Visual - All RG, FOTI - Occlusal, Approximal EMR, Tactile - Only occlusal

Question 5

White spot lesions histology, levels of mineralization

Answer 5

Surface zone - 5-10%

Body of lesion - 60%

Dark zone - appearance

Translucent zone - advancing front 5-10%

Question 6

Pregnant anticipatory guidance 6 rules

Answer 6

1. education opportunity 2. Oral hygiene - daily brushing/flossing to reduce bacterial load; nausea may cause avoidance of brushing - rinse with a cup of water with teaspoon baking soda and wait 1h before brushing to minimize dental erosion 3. diet - avoid cariogenic foods 4. 0.05% sodium fluoride helps to remineralize 5. professional care 6. delay colonization by avoiding transmission and chewing xylitol gum

Question 7

Infant anticipatory guidance

Answer 7

1. risk assessment by 6mo
2. dental home est by 12mo
3. teething symptoms - coldlike, chewing, painful gingiva, relieve with cold teething rings or wash cloths
4. oral hygiene - soft brush after feeding/2x daily with smear( less than 3yo) or pea (more than 3yo) floss when contact
5. no sleeping with bottle, no at-will breast-feeding, avoid sugary drinks, drink from cup by 1yo
6. Fluoride - systemic and toothpaste
7. Injury prevention - child proof, discuss electric and car seats, do not replant avulsed baby tooth
8. non-nutritive sucking stop by age 2, dont do anything til then

Question 8

Juice guidelines for infants

Answer 8

no juice until 6mo Juice only 4-6oz/day, only in cups and during meal

Question 9

Daily fluoride supplementation if

Answer 9

See chaht

Question 10

Know the CAT table for 0-5

Answer 10

Question 11

Changes to CAT for 6+ yo?

Answer 11

No criteria for bottle, mother with caries

Clinical findings:

at least 1 interproximal lesion

white spots

low salivary flow

defective restorations

oral appliance

Question 12

Treatment chart for 1-2yo

Answer 12

Question 13

Changes to treatment chart for 3-5yo

Answer 13

Add radiographs:

12-24 for low

6 -12 moderate

6 for high

Add sealants always

Add 0.5% fluoride for high risk

Restore cavitated for moderate

Question 14

Changes to treatment chart for 6+ yo

Answer 14

take away MS monitoring

Add xylitol for high risk

Question 15

Most efficient and cost effective way of reducing caries? How many people have this? Optimal level?

Answer 15

water fluoridation

74%

0.7-1.2ppm

Question 16

Fluoride mechanism of absorbtion, distribution in body?

Answer 16

Absorbed through stomach and small intestine.

Distributed to kidney, skeleton, and teeth

First contact is enamel, second is circulation to developing/not erupted teeth.

Question 17

Fluoride ion effect on enamel during mineralization?

After but before eruption?

After eruption?

Answer 17

Fluoroapatite, improve crystallinity

F acquisition to outer layer of enamel

Topical effect on outer layer, antibacterial and remineralization effect

Question 18

Fluoride supplementation shuold be used until when?

Used in what conditions?

Answer 18

not before 6 months and then until all permanent teeth erupted

Water under 0.6ppm

Question 19

F conc in therapeutic dentifrices?

For children?

Answer 19

1000-1500ppm

4-500ppm

Question 20

F conc in self-applied topical fluoride:

mouth rinse?

gel?

Answer 20

0.05%/225ppm once a day, 0.2%/900ppm once a week

gel 5000ppm

Question 21

F conc in fluoride varnish?

Post varnish instructions?

Answer 21

5% or 22,000ppm

•Post Fluoride Instructions

–Patient can drink and eat

–No sticky or hard foods

No Hot beverages

Question 22

Dental fluorosis scores 0-7

Answer 22

Question 23

Management of fluoride ingestion (5)

Answer 23

Est. amount ingested

Minimize further absorption

Remove fluoride from fluids

Vital signs

If not vomit yet, give TONS of milk

Question 24

Toxic dose? Lethal dose? for fluoride

Answer 24

5mg/kg, 32mg/kg (as low as 16mg/kg)

Question 25

Indications for sealant (3)

Answer 25

Deep pits/fissures

REcently erupted teeth (less than 3 years ago)

High risk pts