New Initiatives In Preventive Dentistry

Learning Objectives

1. Describe the role of thechild health professional inassessing children’s oralhealth.

2. Discuss the pathogenesisof caries.

3. Conduct an oral health riskassessment.

4. Identify preventionstrategies.

5. State the need forestablishing a dental home.

6. Provide appropriate oralhealth education to families.

Our MissionTo empower and assist parents in raising,

happy healthy cavity free children!

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.

The Surprising Truth about CavitiesThe Surprising Truth about Cavities

• 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

Tooth DecayTooth Decay

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.

Prevalence of Dental DiseasePrevalence of Dental Disease

53%of

5-8yr

olds

53%of

5-8yr

olds

67%of

early

tweens

67%of

early

tweens22%of

2-4yr

olds

22%of

2-4yr

olds

Early childhood caries

Early Childhood Caries Can Lead to:

Extreme pain

Extensive and costly

treatment

Spread of infection

Weight loss

Damage to permanent teeth

Malocclusion

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

Deamonte Driver, a 12-year-old

died Sunday in a District

hospital after an infection from

a molar spread to his brain.

Factors Necessary for Caries

Tooth Flora

Substrate

Caries

Tooth

Age

Fluorides

Nutrition

Trace Elements

Carbonate Level

Substrate

Oral Clearance

Oral Hygiene

Salivary Stimulants

Frequency of Eating

Carbohydrate (type,concentration)

Flora

Strep, Mutans

(Substrate)

Oral Hygiene

Fluoride in Plaque

SALIVA

SA

LIV

AS

AL

IVA

FLOW RATE pH

BU

FFE

RIN

G

CAPA

CITY

pH C

OM

PO

SIT

ION

Oral Flora

Normal oral flora = billions of bacteria.

Intraoral bacterial colonization occurs

before the eruption of the first tooth.

Oral Flora:

Pathogenesis of Caries

An infectious process

Initiated by pathogenic

bacteria—

Streptococcus mutans

Dental caries is

transmissible.

– Babies are born

without these harmful

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

Vertical TransmissionWindow 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

Stephan CurveStephan Curve

6

bottle

7

breakfast

8snack

9 10

sippy

cup

11

sippy

cup

12 1lunch

pH

SafeZone

DangerZone

Less snacks and/or sippy cups

Added snacks and/or sippy cups

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.

Not Just What You Eat, But How Often

Acids producedby bacteria aftersugar intakepersist for 20 to40 minutesFrequency ofsugar intake ismore criticalthan quantity

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

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

Children With Special

Health Care Needs

Be cognizant of oral healthconditions or complicationsassociated with medicalconditions

Monitor impact of oral medsand therapies

Prescribe non-sugarcontaining meds if givenrepeatedly or for chronicconditions

Refer early for dental care-before age 1

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.

Very Early Decay

Late Decay

Very Late Decay

Now imagine

a different reality that launches

a generation of cavity free children!

Kids Dental Revolutionary New Model of Care

PREVISTATPREVISTAT®®

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.

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.

Previstat

is life

changing.

Children change

from continuous

cavities to being

decay free for

the first time.

…children should be seen

no later than

1 year old.

This allows us to build on a foundation of health.

We

accomplish

this goal by

providing a

Dental

Homethat is warm

welcoming

and full of

parenting

resources.

During the first

visit we will:

1. Inquire about the child's

medical history

2. Learn about the child’s

dietary and feeding habits

3. Check the need for

fluoride supplements

4. Evaluate the child’s

oral hygiene

5. Examine the mouth for

dental caries or other

problems

6. Perform a risk assessment

7. Implement age appropriate

oral hygiene techniques

10. Introduce the concept of

wellness as a lifestyle

choice

9. Provide guidance for

injury prevention

8. Prepare to provide

preventive, interceptive or

restorative treatment

Saliva

testing for

S. mutans

At Grinich

Village, our

health

discovery

centre,

children play

to learn

about their

dental and

nutritional

health.

PREVENTIONParents 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.

Preventive Therapies

1. Fluoride

2. Chlorhexidine

3. Povidone Iodine

4. Xylitol

Pediatricians can make a difference

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

What To Look ForLift 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

Help make tooth

decay history!

• Institute oral health risk assessmentsinto well-child visits

• Provide patient education regardingoral health

• Document findings and follow up

• Identify dentists who accept newpediatric patients

128-2025 CORYDON AVE. TUXEDO PARK SHOPPING CENTRE

WINNIPEG, MB CANADA

128-2025 CORYDON AVE. TUXEDO PARK SHOPPING CENTRE

WINNIPEG, MB CANADA

www.kidsdental.cawww.kidsdental.ca