Fluoride Tx Flashcards
(26 cards)
What does ECC stand for? (dental)
Early Childhood Caries
What are ECC?
One or more decayed, missing, or repaired tooth surfaces in primary tooth of child <6 yo
What are the causes of ECC?
ECC is a chronic, infectious disease that is orally transmitted from family members to infants and young children
Caused by: bacteria (strep mutans), plaque (biofilm), fermentable CHO, poor oral hygiene
Results in demineralization of tooth
Why should NPs provide fluoride varnish?
Within scope of practice
Prevention: avoid primary tooth decay, avoid caries, avoid negative oral-systemic effects of dental caries
What is fluoride varnish?
Contains 5% fluoride concentrated at 22,600 ppm sodium fluoride
Cost per unit dose application: $0.55
What are fluoride’s mechanisms of action/effects?
- Reduces demineralization of enamel
- Inhibits bacterial metabolism
- Inhibits acid production
- Promotes enamel remineralization
What are the stages of the progression of dental caries?
Adhesion, colonization, de&remineralization, white spots, enamel lesion, dentin lesion, pulpal lesion
At what stages in dental caries progression can prevention occur?
Colonization and de/remineralization
At what stage in dental caries progression does a diagnosis occur?
The presence of white spots
At what stages in dental caries progression does restoration occur?
Enamel, dentin, and pulpal lesions
Prevention and early treatment of white spots
- Remineralization with fluoride varnish (FV)
- Proper home care
- Decrease CHO consumption
- Caregiver education
What do children with white spot lesions have and need?
- Dental caries
- ECC
- Immediate referral to dentist
Healthy People 2020 goal for oral health
- Reduce the proportion of children and adolescents who have dental caries in primary or permanent teeth
- Reduce the proportion of children 3-5yo with dental caries in primary teeth
Healthy People 2030 oral health goal
Increase the use of the oral health care system
USPSTF Oral Health Recommendations Children <5yo
Category B
Children <5yo: PCPs Rx oral fluoride starting at 6mos for children with deficient fluoride in water supply
Children <5yo: PCPs apply FV to primary teeth of all infants/children with first tooth eruptions
USPSTF Oral Health Recommendations Children <5yo
Category I
Uncertain harm/benefit for routine screening/dental exams for dental caries performed by PCP for children <5yo
What are the only proven strategies to reduce dental caries?
Fluorides and sealants
Dental caries risk factors
- 60-90% of people are affected by dental caries
- Lower socio-economic status increases r/f caries
What are the risks associated with fluoride treatment?
Cosmetic: Dental fluorosis
No cosmetic risk demonstrated in FV research
Otherwise no known risks
Supplies for FV application
Gloves, 2x2 gauze, FV, light source
Steps for applying FV for pediatrics
- Position child (knee to knee position for young children)
- Inspect oral cavity, noting white spot lesions or advanced decay
- Dry teeth with gauze
- Paint on FV
- Continue until all surfaces of teeth have been treated
FV Education
After care: avoid sticky food, hot beverages on the day of tx
Oral hygiene recommendations for children
Brush BID with soft brush
Toothpaste Smear < 3yo
Toothpaste Pea size > 3yo
Diet modifications for optimal oral health peds
Avoid highly fermentable CHO, avoid grazing, avoid bottles in bed
