What did the oral health survey of 5 year old children in 2009 suggest about areas of deprivation and ethnic group in terms of caries
- experience of decay was higher in areas of more deprivation
- other ethnic groups and asian/asian British showed significantly higher amounts of decay
What did the oral health survey of 5 year old children in 2009 suggest about average number of teeth with decay and percentage of 5yos with decay
- 23.4% of all children had experience with decay
- average number of teeth with experience was 3.4
importance of caries risk assessment
- eseential to deliver tailored preventative plan for a child who is high risk
- develop an appropriate personal care plan based on child’s susceptibility to disease
- identifying high risk children enables additional prevention to be delivered to them
what are the main indicators of a child being increased risk of developing caries within the next 3 years
1) Previous caries experience- any decayed missing or filled teeth
2) resident in area of deprivation- using home address
3) healthcare worker’s opinion- referral from health visitor, public health nurse of dental health support worker who has identified the need for additional preventive care
what are other factors that influence Childs risk of caries
- clinical findings
- diet
- plaque control
- use of fluoride
- social history (siblings)
- saliva
- med history
- levels of s mutant
what should the caries risk assessment affect
- frequency of review radiographs
- provision of preventative interventions
- frequency of recall
low caries risk factors
look at slides
high caries risk factors
look at slides
what are the four pillars of prevention of caries in children
1) tooth brushing with fluoride toothpaste
2) dietary advice
3) topical fluoride
4) fissure sealant
who requires preventive intervention
- every child is at risk of developing caries
- so everyone
- childs parent/carer has a crucial role in following preventive advice and supervising interventions
what kind of prevention should all children receive
what about high risk kids
- standard prevention appropriate to their age
- if child is at increased risk of developing caries, in addition to standard prevention, ensure they receive enhanced prevention
advice to prevent caries in 0-3 year olds
- from 6 months, infants should be introduced to drinking from a free-flow cup and from age one year feeding from a bottle should be discouraged
- parents/carers should brush or supervise brushing
- as soon as teeth erupt brush twice a day with fluoridated toothpaste
- brush last at night and once other
- no less than 1000ppm
- smear of toothpaste
- frequency and amount of sugary food should be reduced
- sugar free medicines recommended
standard preventative advice to children between 3-6 years
- at least brush twice daily
- professionally apply fluoride varnish to teeth twice a year (2.2% NaF-)
- brushing supervised by parent
- more than 1000ppm toothpaste
- pea sized amount
- spit don’t rinse
- frequency and amount of sugary food should be reduced
- avoid sugared meds
advice for children between 0-6 giving concern (likely to develop caries, special needs)
- all same advice as standard preventative advice along with
- use fluoridated toothpaste between 1350-1500 ppm
- apply fluoride varnish two or more times a year (2.2% NaF-)
- reduce recall interval
- investigate diet and assist adoption of good dietary practice
- liase with GP to request sugar free meds
standard preventative advice to children from 7 years and up
- brush twice daily with 1350-1500 ppm fluoride
- spit don’t rinse
- reduce amount of sugary food and drinks
- fluoride varnish twice a year (2.2% NAF)
prevention of caries for patients above 7 giving concern (current active caries, ortho appliances, dry mouth, other predisposing factors)
- use fluoride mouth rinse daily (0.05% NaF) at a different time to brushing
- fissure seal permanent molars with resin sealant
- apply fluoride varnish two or more times a year (2.2% NaF-)
- If aged 8 and above, prescribe daily fluoride rinse
- If 10+ with active caries, prescribe 2800ppm fluoride toothpaste
- If 16+ with active caries, prescribe 2800 or 5000ppm fluoride toothpaste
- assist with diet
when should parents stop supervising brushing
-earliest at 7yo
how much and ppm toothpaste should a 0-3yo child low risk use
- smear
- at least 1000ppm
- supervised/done for them
how much and ppm toothpaste should a 3-6yo child low risk use
- pea sized
- more than 1000ppm
- supervised/brushed
how much and ppm toothpaste should a 0-6yo child high risk use
- smear or pea sized
- 1350-1500ppm
- supervised/brushed
how much and ppm toothpaste should a 7yo+ low risk use
toothpaste with 1350-1500 ppm
pea sized
how much and ppm toothpaste should a 7yo+ high risk use
- prescribed 2800ppm if above 8
- 5000ppm if above 16
when can child use mouthwash naf
parents aged 7 years and above who are high risk for caries should also be advised to use daily fluoride mouth rinse at another time from brushing
0.05% naF
what should dentist say about sugar consumption to patients
- frequent sugar consumption is major cause of dental caries
- restrict food and drinks containing sugar to no more than 4 occasions in one day
- graxing sugar containing foods between meals and sipping soft drinks over prolonged periods should be discourages
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Behaviour Management40
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Dental Development21
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Prevention37
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History and Examination27
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Pharmacological Pain Control and LA26
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Primary Tooth Trauma45
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Review on Restoring Primary Carious Teeth17
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Hall Technique17
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Caries48
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Pulp Therapy39
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Molar Incisor Hypomineralisation30
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General Anaesthesia28
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Inhalation Sedation30
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Child Protection 132
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Child Protection 212
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Operative Techniques for Dental Trauma18
