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Pediatric Dentistry > Early Childhood Caries + Fluoride > Flashcards

Early Childhood Caries + Fluoride Flashcards

(84 cards)

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1
Q

ECC (according to AAPD)

A

presence of 1 or more decayed (cavitated or non-cavitated), missing (due to caries), filled tooth surfaces in any primary tooth in a child 71 months of age or younger

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2
Q

types of ECC

A
  • Type I: mild to moderate
  • Type II: moderate to severe
  • Type III: severe
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3
Q

severe ECC: 3 years and younger

A

any signs of smooth surface caries

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4
Q

severe ECC: ages 3-5 years old

A
  • 1 or more cavitated, missing, filled smooth surface in primary dentition
  • DMFT score greater than or = to 4 (age 3), >/= 5 (age 4), >/= 6 (age 5)
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5
Q

modes of transmission of cariogenic microorganisms

A
  • vertical transmission
  • horizontal transmission
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6
Q

modes of transmission: vertical

A

mother/primary caregiver to child

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7
Q

modes of transmission: horizontal

A
  • child/other person via things to the patient
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8
Q

2 types of dental caries

A
  • active
  • inactive/arrested
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9
Q

active vs inactive caries: location

A

active - plaque retentive areas (pit and fissure, proximal, gingival)

inactive - not in plaque retentive areas

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10
Q

active vs inactive caries: plaque over the lesion

A

active - thick and/or sticky

inactive - not thick/sticky

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11
Q

active vs inactive caries: surface appearance

A

active - matte/opaque

inactive - shiny

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12
Q

active vs inactive caries: tactile feeling

A

active - rough enamel/soft dentin

inactive - smooth enamel/hard dentin

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13
Q

active vs inactive caries: gingival status

A

active - inflammation/BOP

inactive - no inflammation/no BOP

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14
Q

why do we need to classify active and inactive caries

A
  • to know what should be prioritized when treating
  • to assess if it will progress or not
  • to know what type of treatment to do
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15
Q

associated risk factors for ECC

A
  • bottle feeding
  • breastfeeding
  • free sugars
  • oral hygiene
  • fluoride
  • socioeconomic factors
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16
Q

previous name for ECC

A

nursing bottle caries

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17
Q

why milk causes caries

A

sugar content

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18
Q

breastfeeding age (WHO)

A

until 24 months

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19
Q

breastfeeding age (ADA)

A

soon after child’s 1st birthday

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20
Q

WHO recommendation for free sugars

A

(strong recommendation) reduce intake of sugar to less than 10% of total energy intake

(conditional recommendation) further reduction of free sugar intake to below 5% of total energy intake

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21
Q

2 factors for free sugars

A
  1. age
  2. frequency of consumption
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22
Q

most cariogenic carbohydrate

A

sucrose

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23
Q

why sucrose is the most cariogenic carbohydrate

A
  • combination of glucose + fructose
  • small molecule; easily enters biofilm
  • produces extracellular polysaccharide (dextran)
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24
Q

purpose of dextran

A

helps biofilm stick to the tooth surface, making it more difficult to remove

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25
acid produced by energy production induced by sucrose
lactic acid
26
why children who do not have their teeth cleaned at night have higher risk of ECC
less saliva production at night = less protection from cariogenic microorganisms
27
minimum amount of recommended fluoride concentration
1000 ppm
28
professionally applied fluoride should be done...
every 6 months
29
best age for first dental visit
1 year old
30
children from low income families tend to:
- make first visit to dentist at older age - less frequent dental visits - visit only when there is an established dental problem
31
consequences of non-treatment of ECC
- cellulitis - abscess - dental problems
32
T or F: ECC is a preventable disease.
True
33
ways on preventing ECC
parent education
34
how to clean infant teeth as soon as they erupt
- washcloth - soft bristle brush
35
recommended brushing for children
brush 2x a day with fluoride toothpaste and soft age-appropriate toothbrush
36
toothpaste amount: 2 years below
smear amount
37
toothpaste amount: 2 years and up
pea size amount
38
regular removal and prevention of its accumulation on teeth and adjacent gingival surfaces
plaque control
39
cornerstone of non-operative treatment
plaque control
40
T or F: Plaque can be washed away by action of saliva or by rinsing with fluids.
False; it cannot
41
T or F: Plaque re-attaches within minutes after cleaning of tooth surface
True
42
duration of time for plaque to form and become visible
24-48 hours
43
duration of time it takes for plaque to produce signs of gingival inflammation
48 hours
44
only practical means for improving oral health
daily mechanical removal of plaque
45
oral hygiene index and patient education: what patient should be instructed on
- objectives and goals of plaque control - OH devices: toothbrush, toothpaste, fluoride, floss, etc. - brushing technique
46
when brushing habits should start
as soon as 1st deciduous tooth erupts
47
age when potential brushing is needed
up to 6 years of age
48
age when children should still be supervised by an adult when brushing
up to 12 years of age
49
recommended brushing frequency
2-3x a day for 2-3 minutes
50
recommended toothpaste
fluoridated toothpaste (not less than 1000ppm)
51
age for smear (grain) amount of toothpaste
6 months to 2 years old
52
age for pea size amount of toothpaste
2-6 years old
53
toothbrush recommendation for pedia patients
- soft bristle toothbrush - small head - broad handle
54
toothbrushing methods
1. roll - roll method/modified Stillman technique 2. vibratory - Stillman, bass techniques 3. circular - Fones technique 4. vertical - Leonard technique 5. horizontal - Scrub technique
55
toothbrushing method: roll
roll method, modified Stillman technique
56
toothbrushing method: vibratory
Stillman, Bass techniques
57
toothbrushing method: circular
Fones technique
58
toothbrushing method: vertical
Leonard technique
59
toothbrushing method: horizontal
Scrub technique
60
other toothbrushing methods
- Charters - Bass - Modified Bass - Stillman - Modified Stillman
61
bristles on cervical crown obliquely pointing coronally, horizontal motion with rotations
Charters
62
bristles in sulcus 45 degree pointing apically, horizontal back and forward motion
Bass
63
bristles in sulcus 45 degrees pointing apically, horizontal motion with rotations to occlusal
Modified Bass
64
bristles in gingival margin obliquely towards the apex; vibratory movements without moving the brush
Stillman
65
bristles in gingival margin obliquely towards the apex; vibratory movements with rotations towards occlusal
Modified Stillman
66
2 types of fluoride mouthrinse
- 0.05% NaF - 0.2% NaF
67
frequency of rinse: 0.05% NaF
rinse once daily
68
frequency of rinse: 0.2% NaF
rinse once weekly
69
order of treatment plan
1. Plaque control 2. Chief complaint 3. Preventive/Restorative procedures 4. Pulp therapy 5. Extraction 6. Orthodontic/Prosthodontic care 7. Recall
70
last step before patient can go after charting
fluoride application
71
3 types if professionally applied fluoride
- 2% sodium fluoride (gel) - 1.23% acidulated phosphate fluoride (gel) - 8-10% stannous fluoride
72
most common professionally applied fluoride
2% sodium fluoride (gel)
73
2% sodium fluoride: ppm and pH
8% 9,050 ppm fluoride ion pH 7 (neutral)
74
1.23% acidulated phosphate fluoride: ppm and pH
12,330 ppm fluoride ion pH 3.2
75
8-10% stannous fluoride: ppm and pH
19,500 ppm fluoride ion pH 2.4-2.8
76
why 8-10% stannous fluoride is not used anymore
causes tooth discoloration
77
steps in fluoride gel application
1. Correct sized trays to fit UL arches of the patient 2. Minimal amount of gel that will permit complete coverage of the tooth surfaces (5ml per arch) 3. Px should sit upright 4. Teeth must be cleaned and dried 5. After UL trays are positioned, small saliva ejector should be placed between trays or in the vestibule 6. Instruct the patient not to swallow the gel 7. Fluid gel should be left in the mouth for 4 mins 8. After trays are removed, excess saliva and gel should be evacuated 9. Tell the patient to spit the remaining oral fluid 10. Instruct the patient not to eat, drink or rinse for 30 mins 11. Repeat every 6 months
78
fluoride varnish: %NaF
50 mg/ml NaF
79
fluoride varnish: ppm and pH
2.2% fluoride ion; 22,600 ppm pH 7
80
where fluoride varnish is applied
clean, dry tooth surface
81
when fluoride varnish sets
in presence of moisture
82
duration of time fluoride varnish remains on tooth surface
12 hours
83
steps in applying fluoride varnish
- oral prophylaxis - isolate - dry - apply - patient instruction
84
post-op instructions after fluoride application
- no food/drinks (hard, sticky, abrasive food and hot beverages) - no rinsing with water - brush teeth after 12 hours - repeat every 3 months/6 months

Pediatric Dentistry (10 decks)

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