Caries Symposium 4

Question 1

Define dental caries

Answer 1

Disease of the dental hard tissues, caused by the action of microorganisms found in plaque

Question 2

Name some impact of caries on pre-school children (4)

Answer 2

1. Aeshtetic problems
2. Loss of function
3. Pain
4. Infection

Question 3

Why is abscess formation higher in small children?

Answer 3

Abscess comes from floor of pulp chamber and easily spreads - as bone is softer in kids

Question 4

List some risk indicators for caries in (8)

Answer 4

1. Oral hygiene
2. Diet
3. Bacterial exposure
4. Socioeconomic status
5. Breast/bottle feeding
6. Fluoride exposure
7. Parental smoking
8. Parental oral health status

Question 5

What teeth does early childhood caries effect?

Answer 5

The upper anterior and molar teeth

Question 6

Typical cause of nursing caries

Answer 6

Inappropriate use of feeding cups + bottles

Question 7

Prevention of caries (3)

Answer 7

1. Diet
2. Fluoride
3. Oral hygiene

Question 8

What is a common oral health misconception for pregnant woman?

Answer 8

That there’s a benefit to taking fluoride supplements during pregnancy

Question 9

How long should women breastfeed till?

Answer 9

2 years max

Feeding over night increases caries risk

Question 10

What are some diet tips for babies? (4)

Answer 10

1. Use of a feeding cup rather than a bottle from 6 months (free flow spout)
2. Drinks containing free sugars should never be put in a feeding bottle
3. Children not to be put to bed with a feeder bottle/cup
4. Soya milk formula is potentially cariogenic and should only be used when medically indicated

Question 11

When should sugary drinks be drank?

Answer 11

1. Mealtimes only
2. Dilute as much as possible
3. Take through a straw which should be held at the back of the mouth

Question 12

Name an example of a non-sugar sweetness

Answer 12

Xylitol

Sugar free gum (with xylitol)

Question 13

How should meds containing sugars be given to minimise the caries risk?

Answer 13

Sugar free meds should be requested

Or available doses should be given at mealtime and never after toothbrushing at night

Question 14

Assumptions on cheese

Answer 14

May protect against caries as it is non-cariogenic

Question 15

List examples of safe snacks (5)

Answer 15

1. Milk/water
2. Fruit
3. Savoury sandwiches
4. Crackers and cheese
5. Breadsticks

Question 16

What are some professionals delivered methods of fluoride? (2)

Answer 16

• APF gels (seldom used)

- Varnishes (applied to children 2x a year)

Question 17

When should toothbrushing start?

Answer 17

As soon as the 1st primary teeth erupt

Question 18

Can children under 8yrs old brush their teeth themselves?

Answer 18

No as they lack the dexterity to brush their own teeth effectively

Question 19

Fluoride dose for child formulas?

Answer 19

1000ppm

Question 20

Standard fluoride dose?

Answer 20

1400-1500ppm

Question 21

Fluoride dose for enhanced formulas? (duraphat)

Answer 21

2800ppm

Question 22

Toothpaste strength recommendation for 3 yr olds? (1st tooth eruption)

Answer 22

1000ppmF

Question 23

Toothpaste strength for 4-16yr olds?

Answer 23

1000-1500ppmF

Question 24

Toothpaste strength for high risk children under 10yr olds ?

Answer 24

1500ppmF

Question 25

Toothpaste strength for high risk children 10yrs+?

Answer 25

2800ppmF | Prescription only

Question 26

Toothpaste strength for high risk 16 and overs?

Answer 26

5000ppmF | Prescription only

Question 27

Safe toothpaste amount for children under 3yrs?

Answer 27

Smear of paste (approx 0.1ml) for children under 3

Question 28

Safe toothpaste amount for children aged 3yrs +?

Answer 28

Pea sized amount (approx 0.25ml)

Question 29

How do we work out if a patient has ingested a toxic dose of toothpaste?

Answer 29

Need to know: 1. Weight of child 2. How much toothpaste was ingested 3. Strength of toothpaste

Question 30

Management protocol for toxic fluoride intake: <5mg/kg

Answer 30

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

Question 31

Management protocol for toxic fluoride intake: 5-15mg/kg

Answer 31

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

Question 32

Management protocol for toxic fluoride intake > 15mg/kg (3)

Answer 32

- Admit to hospital immediately - Cardiac monitoring and life support - Intravenous calcium gluconate

Question 33

How much drops of fluoride supplements are given for 6mths-3yrs?

Answer 33

0.25mg/d

Question 34

How much drops of fluoride supplements are given for 3-6yrs?

Answer 34

0.5mg/d

Question 35

How much drops of fluoride supplements are given for 6yrs+?

Answer 35

1mg/d

Question 36

Are under 6's recommended for fluoride mouthrinses?

Answer 36

NO | Even over 6 need to assess the childs ability to properly expectorate

Question 37

State the name of the most common fluoride varnish applied every 4-6months to the high risk caries teeth

Answer 37

Duraphat | Fruit flavoured for kids

Question 38

When should Duraphat be avoided?

Answer 38

For patients with asthma/allergies as the ingredients make it sticky

Question 39

How often should fluoride varnish be applied to the dentition?

Answer 39

- Twice yearly for pre-school children assessed as high caries risk - Floss between contact areas

Question 40

State the methods of community based prevention (2)

Answer 40

1. Health education 2. Health promotion - Promotion of + behaviours and lifestyles

Question 41

How often should radiographs be conducted for high risk children?

Answer 41

Every 6months

Question 42

How often should radiographs be conducted for low risk children?

Answer 42

Every 12-18 months

Question 43

What caries can be easily missed if we don't use bitewings?

Answer 43

Miss 60% of inter-proximal caries