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Oral Health
for Children
Lori Ellington, RDH, BSDH
East Tennessee State University
Masters of Allied Health Program
Facts & Figures
Children with Dental Caries

Most common childhood disease

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Over ½ of children by 2nd grade have caries
Number of carious lesions in primary teeth has increased
Number of carious lesions in permanent teeth decreased
Oral health is dictated by sociodemographic aspects
Dental care most prevalent unmet need in poor
children of all ages in the US
Other Ramifications

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Low body weight
Lost school hours & parent work hours
Barriers to Dental Care

Age

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Cultural conflict

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Dentist does not treat children
Beliefs, values, attitudes, perceptions
Language
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No access to translator
Barriers to Dental Care

Disabilities

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Transportation

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Epilepsy, autism, cerebral palsy, mental retardation
Can use public, state, or friend to & from
appointment
Financial

Low income, Medicare insurance
Risk Factors associated with
Dental Caries

Familial Factors
Low socioeconomic status
& minorities
 No knowledge or belief of
dental prevention
 No topical or systemic
fluoride
 Dental fear
 Family members with
active caries
 Lack of dental knowledge
& infrequent visits

Risk Factors

Health Concern

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Premature/low birth weight babies
Severe and chronic illness
Early hospitalization/surgery
Developmental disabilities, dental defects
Using sweetened medications
Using antihistamines causes dry mouth
Early Childhood caries
Risk Factors

Dietary Concern

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Low fluoride levels in water supply
Take bottles to bed with sweetened liquid
Extended breast & bottle use
Prolonged use of bottles & sippy cups
Frequent sugary snacks
High carbohydrate diet
Caries Prevention Methods

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Brushing teeth at least twice daily
Flossing daily
Use of fluoride
Education on proper care of teeth
Regular dental visits
Eating a well balanced diet
Powered Toothbrush

Powered Brush


Can be more effective in
children having trouble
with manual brush
Encourage good oral
habits
Manual Brushing



Helps develop manual
dexterity
Child size brushes with
soft bristles are best
Bright color or fun
shape and pattern help
encourage continued use
Toothpaste




Great taste encourages
use
Use a pea size amount
on toothbrush
Easy to use tube make it
easier for children
Fluoride toothpaste is a
MUST
Fluorides & Their Sources

Most effective method for caries prevention
and control

Topical sources



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Toothpaste
Mouth rinse
Fluoride treatment at dentist
Systemic sources

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Food
Drinking water
Fluoride tablets
Microbial Screening Kit

Orion Diagnostica’s
Dentocult® SM Strip
mutans


Determines caries
risk in children
Test is well-tolerated,
rapid, easy to
conduct
Microbial Screening Kit

Test procedure




Test strip is placed in patient’s saliva
Strip is incubated at 36ºC for 48 hours
Bacterial growth cause a color change on strip
Bacterial load determined by comparing with
standard color chart
Diet

Good dietary habits


Healthy Snacks


Small meals
Fruits, popcorn, vegetables
Limit intake of
Sugary drinks and
carbohydrates
 Fruit juices


Avoid using food for
behavior alteration
Dental Visits

Child’s first dental visit by 1 year old


The dental visit checks for



Every 6 months thereafter
Good oral care
Good dietary practices
Fun, positive & educational visits


Both for child and parent
Support good oral habits
Ramifications of no
Dental visits

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Reluctance to smile
Self-conscious of teeth
Pain and infection
Impaired speech development
Reduced self-esteem
Failure to thrive
Brushing Instructions

Brushing technique

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Brush teeth in small
circles
Outer & inner surfaces
of mandibular &
maxillary teeth
Chewing surfaces (tops
of teeth)
Brush tongue
Timer
Flossing Instructions

Flossing



Once a day
Wrap 18” of floss around
middle fingers, hold 1”
between thumb and
index finger, move floss
up & down against tooth
Child flossers
Brushing & Flossing
Video
Bibliography
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Lepeau, N. S. (2005). Pediatric Oral Health Care: Infancy throught Age 5. In E.M. Wilkins
(Ed.), Clinical Practice of the Dental Hygienist (9th ed., pp. 782-802). Philadelphia, PA:
Lippincott Williams & Wilkins.
Matttana, D. J. (2005). Fluorides. In E.M. Wilkins (Ed.), Clinical Practice of the Dental
Hygienist (9th ed., pp. 542-568). Philadelphia, PA: Lippincott Williams & Wilkins.
Nathe, C. N. (2005). Target Populations. In (Ed.), Dental Public Health (2nd ed., pp. 143156). Upper Saddle River, NJ: Pearson Prentice Hall.
Orion Diagnostica. (2005). Dentocult SM Strip mutans. Retrieved July 1, 2006, from
http://www.oriondiagnostica.fi
Proctor and Gamble. (2002). A Parent's Guide Caring for Children's Teeth [Brochure]. OH
Ray, T. S. (2005). Oral Infection Control: Toothbrushes and Toothbrushing. In E.M. Wilkins
(Ed.), Clinical Practice of the Dental Hygienist (9th ed., pp. 402-425). Philadelphia, PA:
Lippincott Williams & Wilkins.
Rethman, J. (2002). Pediatric Patients: Questions and Controversies. Interview with Dr.
Marvin H. Berman. Practical Hygiene, 11(1), 19-22.
Savage, M. F., Lee, J. Y., Kotch, J. B., & Vann, W. F. (2004). Early Preventive Dental Visits:
Effects on Subsequent Utilization and Cost. Pediatrics, 114(4), e418-e423. Retrieved July 1,
2006, from American Academy of Pediatrics Web Site:
http://wwwpediatrics.org/cgi/doi/10.1542/peds.2003-0469-F
U.S. Food And Drug Administration. (06). Establishment Registration Database. Retrieved
July 2, 2006, from Center for Device and Radiological Health Web Site:
http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfRL/Registration.cfm?ID=6091