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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 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 Low body weight Lost school hours & parent work hours Barriers to Dental Care Age Cultural conflict Dentist does not treat children Beliefs, values, attitudes, perceptions Language No access to translator Barriers to Dental Care Disabilities Transportation 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 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 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 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 Toothpaste Mouth rinse Fluoride treatment at dentist Systemic sources 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 Reluctance to smile Self-conscious of teeth Pain and infection Impaired speech development Reduced self-esteem Failure to thrive Brushing Instructions Brushing technique 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 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