New Initiatives In Preventive Dentistry


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New Initiatives In Preventive Dentistry

  1. 1. New Initiatives In Preventive Dentistry
  2. 2. Learning Objectives 1. Describe the role of the child health professional in assessing children’s oral health. 2. Discuss the pathogenesis of caries. 3. Conduct an oral health risk assessment. 4. Identify prevention strategies. 5. State the need for establishing a dental home. 6. Provide appropriate oral health education to families.
  3. 3. Our Mission To empower and assist parents in raising, happy healthy cavity free children!
  4. 4. The Surprising Truth about Cavities It’s an epidemic! If you think a child is too young to need a dentist, you’re wrong. Children's teeth are at risk long before they’ve tasted their first piece of candy.
  5. 5. Tooth Decay • Is the most prevalent childhood disease (5X more common than asthma) • The prevalence continues to rise, because children are exposed to more sugar in the diet at an early age
  6. 6. The traditional model of stressing good oral hygiene has been challenged not only with recent findings in the scientific literature but national averages of tooth decay are increasing. In fact 30% of children are at risk of developing serious tooth decay regardless how well and often they brush and floss.
  7. 7. Prevalence of Dental Disease 67% of 53% early of tweens 22% 5-8yr of olds 2-4yr olds
  8. 8. Early childhood caries
  9. 9. Early Childhood Caries Can Lead to: Extreme pain Extensive and costly treatment Spread of infection Weight loss Damage to permanent teeth Malocclusion
  10. 10. Consequences of Dental Caries Impaired language development Inability to concentrate in school Reduced self-esteem Possible facial cellulitis requiring hospitalization Possible systemic illness for children with special health care needs
  11. 11. Deamonte Driver, a 12-year-old died Sunday in a District hospital after an infection from a molar spread to his brain.
  12. 12. Factors Necessary for Caries FLOW RATE pH Tooth Flora Age Strep, Mutans Fluorides (Substrate) Nutrition Oral Hygiene SAL Trace Elements SALIV A Fluoride in Plaque Tooth Flora IVA Carbonate Level Caries Substrate BU Substrate FF Oral Clearance N O ER TI SI ING Oral Hygiene PO CA M CO Salivary Stimulants PA CI pH TY SALIVA Frequency of Eating Carbohydrate (type, concentration)
  13. 13. Oral Flora Normal oral flora = billions of bacteria. Intraoral bacterial colonization occurs before the eruption of the first tooth.
  14. 14. Oral Flora: Pathogenesis of Caries An infectious process Initiated by pathogenic bacteria— Streptococcus mutans
  15. 15. Dental caries is – Babies are born without these harmful transmissible. bacteria – Studies have shown that moms are the primary source of these bacteria – It happens when you transfer your saliva through kissing, cuddling, or letting your toddler brush with your toothbrush
  16. 16. Vertical Transmission Window of infectivity is the first two years of life The earlier a child is colonized with S. mutans the higher the risk of caries Children whose mothers have high S.mutans counts present with a 9 times greater chance of having cavities. In another study 88% of 2 year old children infected with S. mutans developed tooth decay by age 4
  17. 17. Stephan Curve pH Safe Less snacks and/or sippy cups Zone Danger Zone Added snacks and/or sippy cups 6 7 8 9 10 11 12 1 bottle breakfast snack sippy sippy lunch cup cup
  18. 18. S. mutans and diet Cavity promoting sugars such as glucose, fructose and sucrose present in many fruit juices and baby formulas . They are easily digested by oral bacteria to form acids that break down the enamel of the teeth.
  19. 19. Not Just What You Eat, But How Often Acids produced by bacteria after sugar intake persist for 20 to 40 minutes Frequency of sugar intake is more critical than quantity
  20. 20. Breastfeeding AAP and Kids Dental strongly endorse breastfeeding Breast milk by itself is not cariogenic, however combined with other carbohydrate sources is thought to be For frequent night time feedings with anything but water after tooth eruption, consider an early dental home referral
  21. 21. Determining High Risk Groups for Caries Children with special health needs Children from low socioeconomic and ethno cultural groups Children with poor dietary and feeding habits Children whose caregivers and or siblings have caries Late order off spring Children with disease indicators: caries, white spots, decalcifications or missing teeth
  22. 22. Children With Special Health Care Needs Be cognizant of oral health conditions or complications associated with medical conditions Monitor impact of oral meds and therapies Prescribe non-sugar containing meds if given repeatedly or for chronic conditions Refer early for dental care- before age 1
  23. 23. Severe decay can lead to extreme pain, spread of infection, difficulty chewing, poor nutrition, poor self esteem, behavioral and social interaction problems, lost school days and difficulty learning.
  24. 24. Very Early Decay
  25. 25. Late Decay
  26. 26. Very Late Decay
  27. 27. Now imagine a different reality that launches a generation of cavity free children!
  28. 28. Kids Dental Revolutionary New Model of Care PREVISTAT® Our approach emphasizes a revolutionary new preventive strategy called Previstat® that identifies a child’s susceptibility to tooth decay and customizes a better treatment and preventive regimen.
  29. 29. The traditional drill-and-fill treatment while reparative,does not address caries as a disease process. A new approach called Previstat utilizes a risk assessment model that identifies high risk groups. Utilizing bacterial testing and Innovative preventive treatments children can be screened for caries and receive custom tailored treatments to prevent tooth decay.
  30. 30. Previstat is life changing. Children change from continuous cavities to being decay free for the first time.
  31. 31. …children should be seen no later than 1 year old.
  32. 32. This allows us to build on a foundation of health.
  33. 33. We accomplish this goal by providing a Dental Home that is warm welcoming and full of parenting resources.
  34. 34. During the first visit we will: 1. Inquire about the child's 6. Perform a risk assessment medical history 7. Implement age appropriate 2. Learn about the child’s oral hygiene techniques dietary and feeding habits 8. Prepare to provide 3. Check the need for preventive, interceptive or fluoride supplements restorative treatment 4. Evaluate the child’s 9. Provide guidance for oral hygiene injury prevention 5. Examine the mouth for 10. Introduce the concept of dental caries or other wellness as a lifestyle problems choice
  35. 35. Saliva testing for S. mutans
  36. 36. At Grinich Village, our health discovery centre, children play to learn about their dental and nutritional health.
  37. 37. PREVENTION Parents should avoid mouth-to-mouth transfer of food or soother to baby. Never let a baby fall asleep feeding (bottle or breast). Teeth should be brushed as soon as they erupt and should be brushed after every meal by a parent using a tiny spot of fluoride toothpaste (about the size of a pea). Bottle or breastfeeding should be discontinued usually at one year of age. The first dental appointment should be when the first teeth arrive – usually about 6 months.
  38. 38. Preventive Therapies 1. Fluoride 2. Chlorhexidine 3. Povidone Iodine 4. Xylitol
  39. 39. Pediatricians can make a difference
  40. 40. Positioning a Child for an Oral Exam Position the child in the parents lap facing the caregiver Sit knee to knee with the caregiver Lower the child’s head onto your lap Lift the lip to inspect the teeth and tissues
  41. 41. What To Look For Lift the lip to examine the teeth and soft tissues Assess for plaque, white spots, decay, tooth defects, dental crowding Provide education on brushing and diet during examination
  42. 42. Help make tooth decay history! • Institute oral health risk assessments into well-child visits • Provide patient education regarding oral health • Document findings and follow up • Identify dentists who accept new pediatric patients