1.PREVENTIVE PEDIATRIC DENTISTRY THE CONTINUED CARE MODEL Dr. Charles Lekic DDM, MSc, PhD, FRCD(C) 1426 McPhillips Street,Winnipeg, MB

2. Pediatric Preventive Dentistry

Dental caries presents a major dental health problem in children

Etiology of caries:

• • tooth susceptibility, bacterial plaque, carbohydrates, time, oral sugar clearance,saliva flow & pH

3. Pediatric Preventive Dentistry

Most important factors in caries prevention are:

• Oral Hygiene, Diet, Fluoride therapy and Fissure sealants

4. Oral Health Education

Plaque removal & Dietare the most important factors in oral health education

5. Oral Health Education

Plaque Removal

• Use of Disclosing Agents

• Caries Activity Tests

• Tooth brushing

6. Oral Health Education

Plaque Removal (Contd)

Flossing (once posterior contacts close)

Oral Rinsing- removes only soft debris, recommended in patients with ortho appliances

7. Oral Health Education

• Plaque Removal (Contd)

• Chemotherapeutic agents- e.g. Chlorhexidine- short term benefits

• Chewing gums- Trident, CDA approved

8. Oral Health Education

Toothbrushing

• Roll method

• Horizontal scrub- most successful for children

• Modified Bass

9. Oral Health Education

• Diet

• - Instruct Patient/Parent to write down what he/she eats or drinks for 3 consecutive days.

• -Analyze with the patient/parent and makerecommendations :

• • Reduce sucrose consumption

• • Sweets are not to be eaten between meals or at bedtime

• • Emphasize foods that require chewing, stay away from soft/sticky foods

• • Brush teeth after meals and ALWAYS at Bedtime

• • Discuss the danger of hidden sugars such as starchy foods (bread)

10. Fluoride Therapy

Systemic Fluorides

• Provided by water fluoridation and by supplemental therapy

Water Fluoridation

• Concentration of 1 ppm of fluorides in drinking water is considered optimal in reducing caries prevalence

• Optimal fluoride concentration reduces caries up to 50%

• Commonly use sodium fluoride, hydrofluosilic acid and sodium silicofluoride

11. Fluoride Therapy

Water Fluoridation (Contd)

• Effect of systemic fluorides is greater on smooth enamel surfaces

• Most effective method in caries prevention

Supplemental Fluoride Therapy

• Before prescribing supplemental fluoride, must know:

• • • The fluoride content in childs drinking water

• • • Childs weight

• • • Overall fluoride intake

12. Fluoride Therapy

Topical Fluorides

• Delivered via gels, varnishes, mouthrinses, prophy pastes and dentifrices

• No need for topical fluoride in patients with low risk and/or residing in optimally fluoridated areas- use of a fluoridated toothpaste should be sufficient.

• Fluoridated dentifrices are not recommended in small children (12 yrs, high risk) 31. Continued Care Model
  • Following the first round of preventive letters 25% of parents responded,answering the questions.
  • We expect this percentage to increase following the next rounds of letters and more especially following the next recall visit.

  32. Continued Care Model

  • At the next recall visit if the child will present with healthy teeth he/she will earn the membership to the No Cavity Club.

  No Cavity Club No Cavity Club 33. Continued Care Model

  • The child will be able to use this card in Toys R Us stores and the cash value for the first cavity free recall visit will be $15.00

  No Cavity Club No Cavity Club 34. Continued Care Model

  • At the subsequent recall visits if the child continues to have healthy teeth the cash award will increase by $5.00 and will raise up to the full amount reduced only for the actualcost of the recall visit.

  No Cavity Club No Cavity Club 35. Continued Care Model

  • No Cavity Club membership and the health promotion letters, that are to be sent to the parents, are designed to increase the awareness regarding oral health and to award and motivate children and parents in achieving and maintaining health.

  36. Continued Care Model

  • Continued Care Model is a true investment in health and is a unique model to North America.
  • Further research will provide evidence regarding the effectiveness of the program and the dental profession will be given this information as soon as it becomes available

  37. Continued Care Model

  • At the end of the day what is more rewarding then a healthy smile on a pediatric dental patient?

  38.

  • Thanks for your attention