Prevention for the child Flashcards
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
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
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
Flouride exposure effecting caries risk
Use of fluoride toothpaste
Correct concentration?
Rinsing after brushing?
Living in fluoridated area
Part of a fluoride varnish scheme?
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
OH affecting caries risk
Low frequency of brushing
Poor technique
Unsupervised brushing (when supervision required)
5 pillars of prevention
Diet analysis and advice Fissure sealants Fluoride varnish Oral hygiene instruction Recall interval
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)
How often should recall intervention be?
no less than 3months
for a child no more than 12months
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
Flouride amount in 0-3 years
> 1000ppm
Management of high risk 0-3 years
As normal with 1350-1500ppm smear of toothpaste
Flouride varnish
3 month recall
Diet advice
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
Medical intervention for 3-6 years
Fluoride varnish 2x per years
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
