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2 - Caries Symposium > How Do We Advise Patients > Flashcards

How Do We Advise Patients Flashcards

1
Q

What are dental caries?

A

disease of the dental hard tissues caused by the action of microorganisms, found in plaque, on fermentable carbohydrates.

At an individual level, caries is a preventable disease.

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2
Q

What is the impact of caries on pre-school children?

A
  • Aesthetic problems
  • Loss of function (eating/speaking)
  • Pain
  • Infection
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3
Q

What factor is caries strongly related to in Scotland?

A

poverty

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4
Q

What are the risk indicators in children?

A

– Oral hygiene
– Diet
– Bacterial exposure
– Socioeconomic status
– Breast/bottle feeding
– Fluoride exposure
– Parental smoking
– Parental oral health status

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5
Q

What teeth do early childhood/nursing caries typically affect?

A

the upper anterior and molar teeth.

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6
Q

What is the typical cause of nursing caries?

A

Inappropriate use of feeding cups and bottles used overnight

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7
Q

What is the advice given to pregnant women regarding fluroide supplements?

A
  • Pregnant women should be advised that there is no benefit to the child of taking fluoride supplements during pregnancy as it does not cross the placenta in high amounts enough to affect tooth structure
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8
Q

What is the advice given to pregnant women regarding breastfeeding and milk?

A

support and promote for general health
* Use of a feeding cup rather than a bottle should be recommended from 6 months (free-flow spout).
* Drinks containing free sugars should never be put in a feeder bottle.
* Children should not be put to bed with a feeder bottle or cup.
* Soya milk formula is potentially cariogenic and should only be used when medically indicated.

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9
Q

When is soya milk formula encouraged?

A

when child is lactose intolerant

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10
Q

Regarding diet and nutrition, what should dentists advice?

A
  • The use of sweetened drinks should not be advocated but where there is a strong suspicion that they are being used;
  • -mealtimes only.
  • -dilute as much as possible.
  • -take through a straw which should be held at the back of the mouth.
  • Food and confectionary containing free sugar should be minimised and restricted to mealtimes only.
  • Sugar free chewing gum is encouraged especially xylitol
  • Sugar free medicines should be requested where available, where not available doses should be given at mealtimes and never after tooth- brushing at night.
  • Plain water or milk are the only safe drinks to have between meals
  • Cheese is a good high energy food for toddlers, it is non- cariogenic and may actively protect against caries.
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11
Q

What are snacks that are alternative to cariogenic foods?

A
  • Milk/water.
  • Fruit.
  • Savoury sandwiches.
  • Crackers and cheese.
  • Bread sticks.
  • Crisps (not maize)
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12
Q

What should a diet diary have?

A

weekend day
time, quantity and type of food

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13
Q

Where is flouride found/present?

A
  • Water
  • Toothpaste
  • Supplementary self-delivered
  • Drops (seldom now used)
  • Tablets (seldom now used)
  • Mouthrinse
  • Professionally delivered
  • APF gels (seldom used)
  • Varnishes (should be applied to all children at least twice yearly)
  • Slow-release devices
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14
Q

Is there fluoridated water in Scotland?

A

no

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15
Q

What is ppm for flouride in water?

A

1ppm is optimum level

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16
Q

What is the advice for tooth-brushing for children?

A
  • Should be started as soon as the first primary teeth erupt.
  • Children under the age of 8 lack the dexterity to brush their own teeth effectively.
  • Young children should have their teeth brushed by an adult before bed and at one other time in the day.
  • Older children who are unable to brush their own teeth effectively should be assisted.
17
Q

What is the recommended flouride amount for child toothpaste?

A

1000ppm

18
Q

What is the recommened flouride amount for standard/adult toothpaste?

A

1400-1500ppm

19
Q

What is the amount of toothpaste for children recommened?

A
  • Smear of paste (approx. 0.1ml)
    for children under 3
  • Pea-sized amount (approx. 0.25ml) for children age 3 and over
20
Q

What can excess flouride cause?

A

fluorosis

21
Q

What is tooth brushing practice that is advised?

A
  • Spit out excess, do not rinse.
  • Manual or powered toothbrushes are both effective
    when using a fluoride toothpaste.
  • Use a small headed manual brush.
22
Q

What do you need to know conerning child fluoride toxcitiy?

A

Assess how much they have ingested (need to know weight of child and amount of toothpaste swallowed).

23
Q

How is flouride toxcitiy treated?

A

Management by dosage
* <5mg/kg Give calcium orally (milk) and observe for a few hours.
* 5-15mg/kg Give calcium orally (milk, calcium gluconate, calcium lactate) and admit to hospital.
* >15mg/kg Admit to hospital immediately, cardiac monitoring and life support, intravenous calcium gluconate.

24
Q

Why do modern protocols advice against induction of vomiting in poisoning?

A

due to the risk of aspiration of vomitus

25
Q

When is floss advised?

A
  • A combination of brushing with fluoride toothpaste and flossing is more efficient.
  • For those with ortho/fixed pros, gingival recession interdental cleaning may be better carried out alternative aids
26
Q

What fluoride methods are not used now?

A

drops
tablets
caused flourosis

27
Q

What is the advice for fluroide mouthrinse for children?

A
  • Not recommended for children under the age of 6.
  • Even over 6 need to assess the child’s ability to properly spit
28
Q

What is practise based prevention?

A
  • Topical fluoride varnish should be applied to the dentition at least twice yearly for pre-school children assessed as being at increased risk of caries.
  • Floss between contact areas.
  • Fluoride varnish can be administered for high risk adults
29
Q

What is community based prevention?

A
  • health education
  • health promotion
30
Q

What is health education?

A

a process that results in individuals or groups having increased knowledge related to health.

31
Q

How should dental health education be taken?

A
  • Dental or dietary health education in isolation should not be undertaken as a community based prevention approach as studies have shown it does not work.
  • It should, however, form part of an overall prevention plan for individual patients.
32
Q

What is health promotion?

A
  • Supports individuals in translating their health knowledge into positive behaviours and lifestyles. Health promotion activities should be directed at a wide variety of areas likely to impact on health, eg. Social, economic and structural environments as well as the policies of public and local institutions. The rationale is to increase the community’s day-to-day capacity and ability to follow a healthy lifestyle.
33
Q

What are oral health promotion programmes?

A
  • aiming to reduce the risk of early childhood caries should be available for parents during pregnancy and postnatal.
  • for young children should be initiated before the age of three years.
  • should address environmental, public and social policy changes in order to support behaviour change.
  • help of lay persons and non-dental health professionals
34
Q

How is diagnosis given?

A

– Clinical exam
– Bitewing radiographs
– Fibre-optic transillumination.
– Temporary tooth separation
– Air abrasion
– CO2 Laser
– Electric caries meter

35
Q

When are radiographs recommened for children and why?

A
  • Bitewings every 6 months for high risk children.
  • Every 12-18 months for low risk.
  • Miss 60% of interproximal caries if do not take bitewings.

2 - Caries Symposium (6 decks)

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