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PED oral health
| Question | Answer |
|---|---|
| teeth eruption | early as 3 mo, usually around 6 months, can be as late as 12 months |
| When do I take my child to the dentist? | disconnect between dentists and PCPs |
| Fluouride greater than 6ppmillion do not need to | supplement Fluoride |
| Dental development begins | in utero at about 6 weeks. 20 primary (deciduous teeth) |
| Number of permanent teeth | 32. |
| 4 components of teeth | enamel, dentin, pulp, cementum |
| crown | portion of tooth that extends above the gingiva. below is the root |
| lingual frenum | connects tongue to base of the mouth |
| First to erupt teeth | mandibular incisors |
| Teething sx | drooling, irritability. Gingival swelling and eruption cysts. Fever is not associated with teething. |
| Tx for teething sx | oral analgesics prefered(ibuprofen or tylenol to kids 6mo or older). Topical analgesics - may be useful but use with caution (methhemoglobinemia) |
| process of loss of primary teeth with eruption of permanent teeth | exfoliation. Usually beings at age of 6 years |
| Red flags of eruption or exfoliation | primary teeth in at age 4, delayed eruption (genetic, hyothyroidism, hypopituitarism, rickets), complete failure of eruption, variation in teeth number |
| Most common chronic disease of childhood | Dental caries |
| Caries pathogenesis | >100 microbes play a role; Strep. mutans most commonly associated. Ferment sugar to lactic acid which decreases pH causeing demineralization of tooth enamel |
| First sign of demineralization | white spot lesion |
| ____ and responsible for the progression of caries | Lactobacilli acidophilus and Lactobacilli casei |
| Risk factors for Dental Caries | Family hx, low SES, Dietary hx (high in sugar), Bedtime bottles/prolonged use of sippy cups, enamel defects, insufficient cleaning (visible plaque), liquid medications, exposure to passive tobacco smoke |
| Early Childhood Caries (ECC) | presence of 1 or more decayed, missing or filled surfaces in any primary tooth in a child aged 1-6 years |
| Protective factors | good salivary flow, good oral hygiene, balanced diet, adequate flouride |
| Primary prevention | improving maternal dental health |
| Secondary prevention | management of child's oral flora; oral hygiene, dietary counseling, fluoride supplementation, dental care, establishment of dental home |
| Oral health at birth | clean gums with soft cloth. Visual screening at HM visits as soon as first teeth erupt. Teeth should be brushed at least 2x/day. Floss when space between teeth too small to clean |
| Role of Fluoride | increases resistance to demineralizationenhances mineralizationinhibits bacterial colonization of plaque |
| Fluoride supplements | should not be used in children<6 months. Should supervise fluoridated toothpaste in children <6 years of age (pea sized). No fluoride rinses in children <6 |
| PAFTs | Professionally applied Fluoride Therapy |
| Flouride toothpast in children <2 only if | children are at high risk of caries |
| Dental appointments | american academy of pediatrics: recommend first visit at age 1 year (or 6 months after first eruption). |
| When to stop the pacifier? | 1yr (AAP) or 3yrs (AAPD-american academy of dentistry). Study has shown that pacifier up to age 6months protects against SIDs |
| Peridontitis | more severe than gigivitis. Loss of attachment, destruction of bone. |
| Juvenile peridontitis | more virulent form of peridontitis around permanent first molars and incisorsPolymicrobial etiology.Treatment: surgical & non-surgical debridement, antibiotic therapy |
| mixed population | permanent and primary teeth |
| once dental infection has spread to the pulp, classic signs of infxn include | pain, facial swelling, parulis (“gumboil”)severe complications can develop: sinus infection, cavernous sinus thrombosis, brain abscesses |
| Abx for odontogenic infxns | Penicillin or erythromycin if PCN allergy. Abx tx followed by root canal therapy or extraction. |
| Most severe tooth injury | intrusion injuries of primary maxillary front teeth. Intrusions<3mm have good prognosis. Severe luxations usually require extraction |
| Subluxation | no displacement, but tooth is mobile |
| Intrusion | tooth driven back up into the bony socket |
| exulsion | entire tooth comes out |
| Rx for Mild injuries (concussions/subluxations) | usually result in color changes; monitor for about 6 weeks. yellow: no intervention needed. Black/brown: pulp necrotic, will likely need extraction |
| Avulsed premanent teeth notes | seek immediate care, DON'T TOUCH ROOT! Try to put it back in. Don't let it dry out if you can't put it in (solution of Hank's salt solution, milk, saline), take child to dentist of ED. |
| Luxations | intrusive: require surgical or orthodontic repositioning. Lateral and extrusive: repositioning and splinting |
| Fractures | fragments can be rebonded |
| Luxation | displacement in general |
| dental trauma tx | update tetanus and abx prophylaxis |
| Number of primary teeth | 20 |
| Primary Dentitition fully erupted by age | 30 months; variationnl, girls sooner than boys |
| Eruption Red flags | early eruption, delayed (>6months) eruption of primary or permanent teetch (genetic, hypothyroidism, hypopituitarism, rickets), complete failed eruption (associated with rare pediatric syndromes) |
| ___ and ___ are rseponsible for the initiation of cariogenesis | S. mutans and S. sobrinus. S. mutans is transmitted from mother to child resulting in colonization of child's oral cavity. Early colonization assoc. with increased caries and ECC risk |
| Stop Pacifier when? | 1 yr (AAP) or 3 years (AAPD). Digit sucking habits should end by age 6 yr or may lead to malocclusion if it persists |
Created by:
ltm12