Paedodontics: Treating Children in Primary Care Flashcards
(33 cards)
What is the first point of contact for NHS dental care?
General Dental Service (GDS)
Who can get free dental care in Scotland?
< age of 26
How much does plastic restoration of a primary tooth cost?
£10.15
How much does a preformed metal crown cost?
£26.60
What are the roles of the GDP for children? [contractually]
- Capitation = check ups, scaling, prevention
- Childsmile = food & drink advice, fluoride varnish
- Emergency dental care
- Management of dental caries
- Molar incisor hypomineralisation management
- Simple ortho treatment
What symptoms associated with molar incisor hypomineralisation may require management?
- hypersensitivity
- crumbling back teeth
- aesthetic concerns regarding incisors
What management options are available for symptomatic molar incisor hypomineralisation?
- seal
- restore with plastic restoration
- PMC
- extraction and timing of this
- aesthetic management of incisors
What simple orthodontic treatment may GDPs be required to carry out in children?
- removable appliances
- fixed appliances
What factors are involved in caries development?
- personal factors = eg poverty, toothbrush habits
- oral environment factors = eg saliva
- time, tooth, bacteria, dietary carbohydrate
What should be looked at when deciding a child’s caries risk assessment?
- clinical evidence of previous disease
- dietary habits
- oral hygiene habits
- exposure to fluoride
- social history / socioeconomic status
- saliva
- medical history
What can affect the makeup of saliva, leading to increased caries risk?
- diabetes [high blood sugar levels]
- asthma inhaler users [beta 2 agonists & corticosteroids]
- anticonvulsants
- antihistamines
What are the 3 key elements of prevention in paediatric primary dental care?
- caries risk assessment
- behaviour modification
- tooth protection
Behaviour modification is the 2nd element of prevention, what does it consist of?
- attendance patterns
- tooth brushing habits
- use of home fluoride
- drinking and dietary habits
- acclimitisation
Give an example of a behaviour modifcation technique:
Motivation interviewing
Tooth protection plays a role in paediatric prevention, what may be involved?
- application of 5% sodium fluoride varnish
- placement of fissure sealants
- prescription of 2800ppmF toothpaste
- SDF
What is the fluoride content of SDF?
44800ppmF
How does SDF work?
Synergistic effects
- occludes dentinal tubules
- silver is antibacterial
- fluoride encourages remineralisation
Discuss the advantages of using SDF:
- safe
- simple easy quick
- non AGP
- non invasive
- evidence based
Discuss the disadvantages of using SDF:
- stains caries black
- can cause temp tattoo
- relatively expensive
- metallic taste
Why is caries progression faster in primary molars?
- wider contact points [more food trapping]
- larger pulps close to occlusal surface therefor faster spread
From what age should dental bitewings be taken?
consider BWs from age 4
What are examples of non invasive caries interventions?
- biofilm control
- remineralisation
- dietary control
What are examples of micro-invasive caries interventions?
- sealing
- resin infiltrations
What are examples of minimally invasive caries interventions?
ART [atraumatic restorative treatment]
- cleaning out decay using hand instruments
