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BDS2 Caries Symposium > Caries Symposium 4 > Flashcards

Caries Symposium 4 Flashcards

1
Q

What are dental caries?

A
  • A disease of the dental hard tissues caused by the action of microorganisms, found in plaque, on fermentable carbohydrates
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2
Q

What are possible impacts of caries on pre-school children? (4 points)

A
  • Aesthetic problems
  • Loss of function
  • Pain
  • Infection
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3
Q

What is the population skew of caries in Scottish children an d what is this strongly related to?

A
  • Population skew - 25% of Scottish children have 75% of the disease
  • Strongly related to poverty
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4
Q

What are various risk indicators for predicting the caries risk of children? (8 points)

A
  • Oral hygiene
  • Diet
  • Bacterial exposure
  • Socioeconomic status
  • Breast/bottle feeding
  • Fluoride exposure
  • Parental smoking
  • Parental oral hygiene status
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5
Q

Which teeth does early childhood caries/nursing caries usually affect?

A
  • Upper anterior and molar teeth
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6
Q

What is a typical cause of the presence of nursing caries?

A
  • Inappropriate use of feeding cups and bottles
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7
Q

What are the three main factors that will prevent the production of caries?

A
  • Diet
  • Fluoride
  • Oral hygiene
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8
Q

In pregnancy, is there a benefit to the child of taking fluoride supplements?

A
  • No

- Fluoride will not cross the placenta enough to be effective

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9
Q

Should the dental team support and promote breastfeeding and what advice should they give?

A
  • Yes
  • Dental advice: try to wean the child off of breastfeeding after a year and stop on-demand feeding at night after 4-6 months once the baby does not need it anymore
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10
Q

What should be recommended to use for a child after the age of 6 months, a feeding cup or a bottle?

A
  • A feeding cup with a free-flow spout
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11
Q

What types of drink should never be put in a feeder bottle?

A
  • Drinks containing free sugars
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12
Q

Should children be put to bed with a feeder bottle or cup?

A
  • No
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13
Q

Which type of milk formula is potentially cariogenic and should only be used when medically indicated?

A
  • Soya milk formula

- Needed for children who are lactose intolerant

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14
Q

The use of sweetened drinks should not be advocated but where there us a strong suspicion they are being used, what advice could you give the patient to reduce the harm to the teeth? (3 points)

A
  • Mealtimes only
  • Dilute them as much as possible
  • Take them through a straw which should be held at the back of the mouth (the straw should be on top of the tongue to keep it away from anterior teeth)
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15
Q

In respect to food and confectionary containing free sugar, what advice should be given to prevent their harm to the teeth? (3 points)

A
  • The consumption should be minimised and restricted to mealtimes only
  • Dietary advice should encourage the use of non-sugar sweeteners, in particular Xylitol
  • Patients should be encouraged to use sugar-free chewing gum, particularly containing Xylitol
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16
Q

When prescribing medicine to patients, what should the dentist ensure to include on the prescription in respects to sugar?

A
  • They should prescribe sugar-free medicines whenever possible and should recommend the use of sugar-free forms of non-prescription medicines
  • Have to write S/F on prescriptions to ensure it is sugar free
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17
Q

What drinks are safe to drink between mealtimes and what should you specify to the patient about these? ( 4 points)

A
  • Plain Water
  • Plain milk
  • Tea and coffee
  • Make sure that you say plain because if you don’t they may go and buy flavoured milk etc which is full of sugar
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18
Q

Sugar free medicines should be requested where available, where not available, when is it suggested the patient takes them? (2 points)

A
  • Doses should be given at mealtimes

- Never give after toothbrushing at night

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19
Q

What is a good high energy food for toddlers, which is no n-cariogenic and may actively protect against caries? However, what are the health issues from eating too much of this food?

A
  • Cheese

- Can’t eat too much of it as there are issues with a high salt and fat content

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20
Q

Are sugar free snacks likely to be cariogenic?

A
  • No
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21
Q

What is preferable to eat? confectionary and beverages containing sugar substitutes or those containing sugar?

A
  • Sugar substitutes
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22
Q

Give a list of safe snacks, that you can suggest to patients as an alternative to high sugar snacks? (6 points)

A
  • Milk/water
  • Fruit (fresh)
  • Savoury sandwitches
  • Crackers and cheese
  • Bread sticks
  • Crisps ( tricky one, if trying to give child something that is going to harm their teeth like sweets, crisps are probably a better alternative, however crisps with a shape or with a lot of flavouring will also have more sugar in it)
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23
Q

How many days should a diet diary be?

A
  • 4 days, at least one day should be a weekend
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24
Q

What 4 ways can fluoride be given?

A
  • In water
  • Toothpaste
  • Supplementary self-delivered
  • Professionally delivered
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25
Q

What are the different forms of supplementary self-delivered fluoride? (3 points)

A
  • Drops (seldom now used)
  • Tablets (seldom now used)
  • Mouthrinse
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26
Q

What are the different ways fluoride can be professionally delivered? (3 points)

A
  • APF gels (seldom used)
  • Varnishes (should be applied to all children at least twice yearly)
  • Slow-release devices
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27
Q

How many people worldwide receive fluoride in the water?

A

300 million

28
Q

How many people in the UK receive fluoride in the water?

A

5.5 million

29
Q

What is the optimum level of fluoride when in water sources?

A

1.0ppm

30
Q

Is water fluoridated in Scotland?

A
  • No
31
Q

When should toothbrushing be started?

A
  • As soon as the first primary teeth erupt
32
Q

At what age could it be thought that a child can brush their own teeth?

A
  • Around 7/8
33
Q

At what times of day should a young child have their teeth brushed?

A
  • Before bed

- At one other time in the day

34
Q

What is the concentration of fluoride in ‘child’ formula toothpastes? (2 points)

A
  • 450-600ppm (not recommended in Scotland)

- 1000ppm (aquafresh milk teeth)

35
Q

What is the concentration of fluoride in standard fluoride toothpaste?

A
  • 1400-1500ppm (colgate total, aquafresh little teeth and big teeth)
36
Q

What is the concentration of fluoride in enhanced fluoride toothpastes?

A
  • 2800ppm (duraphat toothpaste)

- Have to have a prescription for this

37
Q

What is the suggested fluoride concentration in toothpaste from first tooth eruption - 3 years for standard risk kids?

A

1000ppmF

38
Q

What is the suggested fluoride concentration in toothpaste for standard risk kids 4 - 16 years?

A

1000-1500ppmF

39
Q

What is the suggested fluoride concentration in toothpaste for high risk children under the age of 10?

A

1500ppmF

40
Q

What is the suggested fluoride concentration in toothpaste for high risk people aged 10 and over?

A

2800ppmF (prescription only)

41
Q

What is the suggested fluoride concentration in toothpaste for high risk people ages 16 and over?

A
  • 5000ppmF (prescription only)
42
Q

How much toothpaste would you use when brushing the teeth of children under the age of 3?

A
  • A smear of toothpaste

- Following this recommendation will decrease the risk of mild fluorosis

43
Q

How much toothpaste would someone aged 3 and over put on their toothbrush when brushing?

A
  • A pea sized amount

- Following this recommendation will decrease the risk of mild fluorosis

44
Q

What should you do with excess toothpaste when brushing?

A
  • Spit out excess, do not rinse
45
Q

What is more effective when brushing teeth with a fluoride toothpaste: manual or electric toothbrush?

A
  • Both effective when using a fluoride toothpaste but Cochrane review indicated that tooth brushing is more effective when using a powered brush with a small round, oscillating head compared to a manual brush
46
Q

What is the tolerable daily volume of toothpaste (mls) ingestion for children aged 1-3 (13kg) at 1000, 1500 and 2800ppmF?

A

1000 - 1.3mls

1500 - 0.86mls

2800 - Not recommended

47
Q

What is the tolerable daily volume of toothpaste (mls) ingestion for children aged 4-8 (22kg) at 1000, 1500 and 2800ppmF?

A

1000 - 2.2mls

1500 - 1.46mls

2800 - not recommended

48
Q

What is the tolerable daily volume of toothpaste (mls) ingestion for children aged 9-13 (40kg) at 1000, 1500 and 2800ppmF?

A

1000 - 10mls

1500 - 6.7mls

2800 - 3.6mls

49
Q

When working out fluoride toxicity in a child what do you need to know about them? (3 points)

A
  • Weight of child
  • How much they have swallowed
  • Strength of the toothpaste
50
Q

If someone has had a toxic dose of <5mg/kg of fluoride what should you do?

A
  • Give calcium orally (milk) and observe for a few hours
51
Q

When using a manual brush to brush teeth, what should the head of the brush be like?

A
  • Small headed brush
52
Q

What percentage of interproximal caries are missed if bitewing radiographs are not taken?

A
  • 60%
53
Q

How often should you take bitewing radiographs for low risk children?

A
  • Every 12-18 months
54
Q

How often should bitewing radiographs be taken for high risk children?

A
  • Every 6 months
55
Q

What are different techniques that can be used to diagnose caries? (7 points)

A
  • Clinical exam
  • Bitewing radiographs
  • Fibre-optic trans illumination
  • Temporary tooth separation
  • Air abrasion
  • CO2 laser
  • Electric caries meter
56
Q

What do oral health promotion programmes aim to do? (4 points)

A
  • reduce risk of childhood caries
  • For young children should be initiated before they’re 3
  • Should address environmental, public and social policy changes in order to support behaviour change
  • Help of lay persons and non-dental health professionals
57
Q

What is health education?

A
  • It is a process that results in individuals or groups having increased knowledge related to health
58
Q

What are the community based prevention methods for caries prevention?

A
  • Health education

- Health promotion

59
Q

How often should fluoride varnish be applied for pre-school children assessed as being at increased risk of caries?

A
  • At least twice yearly
60
Q

For high risk caries children how often may fluoride varnish be applied?

A
  • Every 4-6 months
61
Q

Which children would you have concerns about applying fluoride varnish on to?

A
  • Children that are asthmatic or have quite a lot of allergic reactions
62
Q

What ages are not recommended to take fluoride mouth rinse’s?

A
  • Under the age of 6

- Even over 6 need to be assess the child’s ability to properly expectorate

63
Q

Previously, it was considered standard practice to administer and emetic and induce vomiting after someone has ingested a toxic dose of fluoride, why does modern protocol advise against this?

A
  • Due to the risk of aspiration of vomitus
64
Q

If someone has had a toxic dose of >15mg/kg of fluoride what should you do?

A

Admit to hospital immediately, cardiac monitoring and life support, intravenous calcium gluconate

65
Q

If someone has had a toxic dose of 5-15mg/kg of fluoride what should you do?

A

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

66
Q

What is another name for early childhood caries?

A

-Blank-

BDS2 Caries Symposium (5 decks)

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