Prevention

Question 1

describe caries?

Answer 1

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

Question 2

what are risk indicators in children for caries?

Answer 2

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

Question 3

what is early childhood caries also known as and what does it typically affect?

Answer 3

• Also known as nursing caries.
• Typically affects the upper anterior and molar teeth

Question 4

what is typical cause of nursing caries?

Answer 4

• Inappropriate use of feeding cups and bottles

Question 5

what is important in prevention?

Answer 5

• diet
• fluoride
• oral hygiene

Question 6

what is diet and nutrition advice to a new mother with her baby?

Answer 6

• 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.

Question 7

what is advice to give to people taking sweetened drinks?

Answer 7

• mealtimes only.
• dilute as much as possible.
• take through a straw which should be held at the back of the mouth.
• plain water or milk only safe drink between meals

Question 8

what advice is given in regards to sugars?

Answer 8

• Food and confectionary containing free sugar should be minimised and restricted to mealtimes only.
• encourage use of non-sugar sweeteners
• use sugar free chewing gu,
• clinicians should prescribe sugar free medicines

Question 9

what age should children be able to brush their own teeth and why?

Answer 9

• 8 years
• Children under the age of 8 lack the dexterity to brush their own teeth effectively

Question 10

what is toothpaste strength recommendations?

Answer 10

• First tooth eruption- 3 years
  1000ppmF for standard risk kids
• 4-16 years
  1000-1500ppmF for standard risk kids
• High risk children under 10 years
  1500ppmF
• High risk 10 and over
  2800ppmF (prescription only)
• High risk 16 and over
  5000ppmF (prescription only)

Question 11

what is amount of tooth paste for children?

Answer 11

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

Question 12

what is tooth brushing practice instructions?

Answer 12

• Spit out excess, do not rinse.
• Use a small headed manual brush.
• don’t put under water

Question 13

what is amount of toothpase that is toxic?

Answer 13

5mg/kg body weight

Question 14

how to manage fluoride toxicity?

Answer 14

• <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.

Question 15

what age should children use mouthrinse?

Answer 15

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

Question 16

when should fluoride varnish be applied?

Answer 16

• every 4 to 6 months in high risk children

Question 17

what is conditions impair good oral hygiene?

Answer 17

• autism
• learning difficulties

Question 18

high caries risk patients what is interventions for the ages 8+, 10+ and 16+?

Answer 18

• 8+ - prescribe 0.05% NaF daily fluoride rinse
• 10+ - prescribe 2800ppmF toothpaste
• 16+ - prescribe 2800/5000ppmF toothpaste

Question 19

what age do you start applying fluoride varnish?

Answer 19

3 years

Question 20

how often do you give fluoride varnish for low and high risk patietns

Answer 20

• 2x a year
• 4x a year

Question 21

what is dosages of fluoride varnishes for ages 2-5 years and 6+ years

Answer 21

2-5 years - 0.25ml
6+ - 0.4ml

Question 22

what are instructions for fluoride varnish?

Answer 22

• avoid eating, drinking or rinsing for 30 mins

Question 23

what are contraindications for fluoride varnish?

Answer 23

• allergy to colophony
• have been hospitalised to severe asthma in last 12 months
• ulcerative gingivitis

Question 24

what is instructions for fissure sealants for high risk?

Answer 24

• fissure seal all newly erupted permanent first molars. use resin based sealants

Question 25

when and what do you use for fissure sealants if can't use resin based sealants

Answer 25

- if patient is uncooperative and can't get good moisture control or partially erupted tooth - you would use GIC sealant

Question 26

when do you take radiographs?

Answer 26

- biteweings every 6 months for high risk children - every 12-18 months for low risk