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Flashcards in Prevention for the child Deck (21)
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1

Social risks of caries

Deprivation
Mother’s education
Siblings with caries
Vulnerable group
e.g. in care, homeless, prisoner, asylum seeker
Attendance pattern
Access to dental surgery/distance to travel
Dental Anxiety

2

Medical risks of caries

Sugary medications
May affect behaviour and compliance
May affect dexterity and ability to perform OH
May rely on carers to provide OH
Diet
Xerostomia

3

Dental factors of caries

Current active caries
dmft >4
DMFT >4
Caries in 6s at age 6yrs

Hypoplastic or hypomineralised teeth
Crowding
Fixed/removable orthodontic appliances
Dentures

4

Flouride exposure effecting caries risk

Use of fluoride toothpaste
Correct concentration?
Rinsing after brushing?
Living in fluoridated area

Part of a fluoride varnish scheme?

5

Diet affecting caries risk

3 + sugary snacks per day
Bottle feeding with juice/fizzy drinks/added sugar
Sugar containing food and drink < 1hr before bed

6

OH affecting caries risk

Low frequency of brushing
Poor technique
Unsupervised brushing (when supervision required)

7

5 pillars of prevention

Diet analysis and advice
Fissure sealants
Fluoride varnish
Oral hygiene instruction
Recall interval

8

Risk factor for fluorosis

Inappropriate use of F supplements (OR = 23.7)
Age of child when toothbrushing started (OR = 11 when <23 mo age)
Soya or milk-based infant formula use (OR = 7.2 and 3.3)
Frequency of brushing/swallowing toothpaste (OR = 2.8)
Residence in an optimally F area (OR = 1)

9

How often should recall intervention be?

no less than 3months
for a child no more than 12months

10

Caries prevention in 0-3 years

Breast feeding provides best nutrition for babies
From 6m introduce drinking from free-flow cup.  From 1y discourage feeding from bottle
Do not add sugar to weaning foods and drinks
As soon as teeth erupt in mouth parents must brush them at least twice a day with SMEAR of fluoridated toothpaste containing >1000ppmF  – especially at night
Spit, don’t rinse, after brushing

Reduce frequency and amount of sugary food and drink consumption (<5 intakes containing NME sugars)
Avoid sugar containing food and drink within an hour of bed time
Sugar free medications recommended

11

Flouride amount in 0-3 years

>1000ppm

12

Management of high risk 0-3 years

As normal with 1350-1500ppm smear of toothpaste
Flouride varnish
3 month recall
Diet advice

13

Prevention advice 3-6 years

Brush at least twice a day with PEA SIZED amount fluoridated toothpaste containing >1000ppmF  – especially at night
Spit, don’t rinse, after brushing

Reduce frequency and amount of sugary food and drink consumption (<5 intakes containing NME sugars)
Avoid sugar containing food and drink within an hour of bed time
Sugar free medications recommended

14

Medical intervention for 3-6 years

Fluoride varnish 2x per years

15

Management of high risk 3-6 years

As general but use 1350-1500 ppm
Fluoride varnish 2 or more times
3 month recall
Diet advice

16

Prevention of caries in 7+

Brush at least twice a day with fluoridated toothpaste (1,350-15,00ppmF) – especially at night
Spit, don’t rinse, after brushing

Reduce frequency and amount of sugary food and drink consumption (<5 intakes containing NME sugars)
Avoid sugar containing food and drink within an hour of bed time

17

Professional intervention of caries prevention 7+

Flouride varnish 2x year

18

Prevention of caries in 7+ with high caries risk

8+ = fluoride mouthwash - different time to brushing
10+ and active caries = 2800ppm toothpaste
16+ and active caries = 5000ppm toothpaste
Diet advice
Fissure seal permanent molars

19

when is duraphat (floured varnish brand) contra-indicated?

history of hypersensitivity to colophony or a history of bronchial asthma - use proflouride

20

Flouride varnish method

Dispense correct dose onto pad
Dry the teeth (3 in 1 +/- cotton wool roll)
Paint entire tooth surface, avoid gingivae, using micro-brush
Varnish sets in a few seconds

21

Dose for fluoride varnish
a) primary
b) mixed
c) permanent

Dosage for single application
Primary: up to 0.25ml (5.65mgF)
Mixed: up to 0.40ml (9.04mgF)
Permanent: up to 0.75ml (16.95mgF)