Oral Health for Children

1. Oral Healthfor Children Lori Ellington, RDH, BSDH East Tennessee State University Masters of Allied Health Program

2. 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

3. Barriers to Dental Care • Age • Dentist does not treat children • Cultural conflict • Beliefs, values, attitudes, perceptions • Language • No access to translator

4. Barriers to Dental Care • Disabilities • Epilepsy, autism, cerebral palsy, mental retardation • Transportation • Can use public, state, or friend to & from appointment • Financial • Low income, Medicare insurance

5. Risk Factors associated withDental 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

6. 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

7. 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

8. 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

9. Powered Toothbrush • Powered Brush • Can be more effective in children having trouble with manual brush • Encourage good oral habits

10. 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

11. 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

12. 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

13. Microbial Screening Kit • Orion Diagnostica’s Dentocult® SM Strip mutans • Determines caries risk in children • Test is well-tolerated, rapid, easy to conduct

14. 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

15. Diet • Good dietary habits • Small meals • Healthy Snacks • Fruits, popcorn, vegetables • Limit intake of • Sugary drinks and carbohydrates • Fruit juices • Avoid using food for behavior alteration

16. Dental Visits • Child’s first dental visit by 1 year old • Every 6 months thereafter • The dental visit checks for • Good oral care • Good dietary practices • Fun, positive & educational visits • Both for child and parent • Support good oral habits

17. Ramifications of noDental visits • Reluctance to smile • Self-conscious of teeth • Pain and infection • Impaired speech development • Reduced self-esteem • Failure to thrive

18. Brushing technique Brush teeth in small circles Outer & inner surfaces of mandibular & maxillary teeth Chewing surfaces (tops of teeth) Brush tongue Timer Brushing Instructions

19. 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

20. Brushing & FlossingVideo

21. 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. 143-156). 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