Flashcards in Caries Risk Assessment and Prevention Deck (20):
What are some risk factors to caries development?
-Previous caries experience
-Diet: Food Substrate, feeding habits (Time/Frequency of substrate intake, bottle feeding over night, sugary drinks)
-Medical conditions (sugar based meds, dry mouth, special needs (lower access to care), defective glands)
-Level of parents' education
-Geographic location (lack of F- and access to care)
What are some protective factors to caries development?
What are some preventative measures to prevent childhood caries spread?
-Treating mother's oral health to prevent vertical transmission
-Treat sibling's oral health to prevent horizontal transmission
What are some available caries assessment tools?
-Caries management system (CMS)-Sydney
-CAMBRA (Caries Management by Risk assessment)
-AAPD: American Academy of Paediatric Dentistry
What are some preventative measures available in ADH?
What are some benefits and limitations of CAMBRA assessment tool?
-Some factors based on scienetific evidence
-No evidence of extent of success in individuals
-May not encompass all preventive/risk factors
-Lack of evidence to support population based preventative programs
-Success may be 'temporary', small overall reduction in population
-Should be modified to suit individual needs
-Only a tool, not a guaranteed solution
What preventative advice should be given to parents?
-Between meals snacking
-Growth and Development
What are the Australian guidelines for use of fluoridated toothpaste?
-Start brushing after first tooth erupts
0-17 months: brush without toothpaste
18months - 6 years: child toothpaste 400-550ppm
6 years +: 1000ppm standard adult toothpaste
However if high risk can bump up their dosage, e.g.
-5 year old high risk goes straight to adult
-3-4 year old high risk can just smear adult toothpaste over teeth-->preventative effect is greater than risk of getting fluorosis
*Note this only applies to motivated patients (if not brushing jsut get them to start)
When should fluoride mouthwashes be used in children? What is the fluoride concentration?
-Only above age of 6
-In high risk children at a time of day different from brushing-->no point straight after brushing as fluoride is already everywhere
-Use daily (Neutral NaF: 220-227ppm; acidulated NaF 200ppm)
-If lack motivation then use weekly neutral NaF 900-910ppm
What is the most effective method of professional fluoride application according to the literature?
How much fluoride is contained in fluoride varnish? How often should it be used?
(22 300 ppm)
Used once every 6 months
What should you warn your patient about when applying fluoride varnish?
-It will feel sticky
What is the concentration of fluoride gel/foam? What are some restrictions of gel/foam usage? How is it applied?
(12 300 ppm)
-Do not apply in kids less than 10 years of age due to risk of swallowing/fluorosis (fluoride varnish does not have this restriction)
-Put in trays and left in for 4 mintues, use suction with trays to reduce swallowing, re-apply every 6months
What are the usual toothpastes use and what are teh fluoride concentrations?
Colgate (1-6): 400ppm
Oral B: 500ppm
Colgate Total: 1450ppm
What post-op instructions should be given after fluoride application?
No eating, rinsing or drink 30 minutes post application (but tell patient 1 hour)
What are the percentage reduction in caries of:
Varnish: 33% (about 1/3)
Gel/foam: 26% (about 1/4)
Fissure sealsnt: (50-87%) (over half)
What should you warn parents about when doing fissure sealants?
They won't last forever
What is the toxic dose of fluoride?
3-5mg/kg in young children and frail adults-->GI problems
(thus in 2 year old weighing 10kg, 45g tube of toothpaste is the equivalent)
Lethal dose: 10mg/kg
(in 2 year old weighing 10kg, 90g tube of toothpaste is lethal)
*Warn parents to be careful of where they keep toothpaste
How should tooth mousse be used? What is the concentration of fluoride in toothmousse?
-As a last line, if patient is already doing the maximum, can add tooth mousse on top (this applies due to availability + pt motivation)
-Put over finger and wipe over teeth and leave overnight
-Good for enamel lesions, not dentine lesions
-Evidence limited vs fluoride applications
-Used with hyposalivation and white spot lesions