Preventive Child Dental care

Preventive child dental care involve the maintenance of healthy oral tissues should be incorporated in the daily routine of the child. The parents and also the children should be involved in this.

Preventive Child Dental Care

Many oral health diseases start in childhood, including malocclusion, dental caries, fluorosis, and much more. It can be prevented through regular preventive dental care and counseling. Despite the drop in the prevalence of dental caries among school-aged children from approximately 75 percent in the 1970s to 37 percent in 2011 to 2012, caries continues to be one of the most common recurring oral diseases. 

An entry from the Centers for Disease Control and Prevention imply that tooth decay in primary teeth of children aged two to five years has fluctuated since the 1980s but has not decreased overall, increasing from 24 percent in 1988 to 1994 to 28 percent in 1999 to 2004 and then decreasing to 23 percent in 2011 to 2012.

The practice of family dentistry is more then just working with children, it is working with people of all ages providing a range of dental services.


This essentially involves;

   1.  Counseling and advice

   2.  Maintenance of good oral hygiene

   3.  Dietary counseling

   4.  Fluoridation

What is counseling and advice in child dental care?

   This entails advice on care and maintenance of a healthy state of the mouth it must be emphasized that the health of the mouth is as important as that of the other parts of the body. The maintenance of healthy oral tissues should be incorporated in the daily routine of the child. The parents and also the children should be involved in this.

What are the maintenance and method of good oral hygiene for child care?

This is very essential as bad oral hygiene encourages the accumulation of plaque which causes most diseases of the teeth and the periodontal tissues.

The child must commence cleaning of the mouth as soon as the eruption of teeth starts which may then be by using cotton wool, pledgets and a tiny streak of prophylaxis paste with more teeth in the mouth.

The use of toothbrush must commence initially with the help of the parents, but as soon as the child in capable should be left to do it him/herself.

Method

The most accepted method is the sweep and roll method the bristle of the brush is held on the surface of the teeth. It is pressed hard on the surface and on the upper teeth it is swept downwards and on the lower teeth, it is swept upward. It should be emphasized that the mouth should be open during toothbrushing. The tongue, cheek, and palate should be cleaned too. A small pea-side amount of prophylaxis is enough. Tooth brushing is ideally done the last thing in the night and after breakfast the next morning. It can also be done before breakfast as is done in this part of the world.

Dietary control in child care

The major dietary cause of dental diseases is refined sugar essentially sucrose. This has been found to build up of plaque structure and hence contributing to disease affecting the dental tissues.

Dental plaque is highly implicated in dental caries and periodontal diseases. 

  This is why a reduction in consumption of refined sugar should be emphasized. Parents should make intakes of sweets, such as ice cream and other confectioneries a special occasion and when taken the child should be made to rinse the mouth immediately the use of pacifiers dummies and sugar in formulas should be discouraged or reduced as all these have been incriminated in rampant caries. In taking of sugar in the child should be seriously controlled as the outcome in later years may be very bad.

How to make use of fluoride application?

1. Fluoridation:

Flouride application to the teeth has been found to produce tremendous success in the reduction of occurrence of dental diseases by :

   1. Making enamel more resistant to the solution by acid - by the formation of fluoroapatite structure.

   2.  Promoting remineralization of enamel after the carious attack.

   3.  Interfering with bacterial metabolism in plaque.

What is the process?

   1. Community water supply:

Addition of fluoride to public water has been found to decrease the incidence and prevalence of caries tremendously. This has been used successfully in Europe. Optimal dose is 1 ppm.

   

   2. Addition of salt and milk:

This has also been used successfully in Europe.

   3. Flouride tablets:

This is like a tablet taken but the intelligent cooperation of the parents is needed to ensure regular intake and to prevent an overdose. It is better chewed or sucked to allow a local effect. 

The tropical use: This is by allowing a 1mg tablet to dissolve slowly in the mouth at bedtime so that it can provide a local concentration of up to 1000 ppm. The long period also adds to the activity.
   4. Topical application of fluorides
Forms of this preparation are :
   a. Sodium fluoride 

   b. Stannous fluoride   C.  Acidulated phosphate fluoride (APF)

THE TECHNIQUES

   a. Clean crowns with a rubber cup and fluoridated prophylaxis paste.
   b. Add fluoride solution to isolated and dried teeth quadrant by quadrant.
   c.  Allow teeth to remain moist for 3 to 4 minutes.
   d.  Use fluoridated dental floss to run through the interproximal space.
   e.   Acidulated phosphate fluoride can also come in gels. This is applied by the use of special trays for one or both arches in a single procedure.

THE TECHNIQUES

    a.  Polish teeth throughly with prophylaxis paste.
    b.  Wash and dry enamel surfaces.
    c.   Fluoride gel is applied to the tray.
    d.   Each arch is dried separately before the tray is inserted the trays are then left in place for 4 minutes. A saliva ejector is used to suck saliva.
    e.   After 4 minutes tray are removed and the excess gel is wiped off with gauze patient should not rinse the mouth for at least 30 minutes.

Other method include:

Flouride mouth rinses: This has been used extensively and successfully in school in Europe. It is in form of solution used to rinse the mouth at a particular period of the day.

Dentrifices: Tooth pastes this is the commonest mode of fluoride application in third world countries.

If there is other method please feel free to let us know by commenting.

Read 

• The most diseases of the teeth- Periodontal diseases.
•  4 guides to dentistry including dental caries.

REFERENCES

1. Section On Oral Health. Maintaining and improving the oral health of young children. Pediatrics 2014; 134:1224.
2. Dye BA, Thornton-Evans G, Li X, Iafolla TJ. Dental caries and sealant prevalence in children and adolescents in the United States, 2011-2012. NCHS Data Brief 2015; :1.
3. Kelly JE, Harvey CR. Basic data on dental examination findings of persons 1-74 years. United States, 1971-1974. Vital Health Stat 11 1979; :1.
4. Kaste LM, Selwitz RH, Oldakowski RJ, et al. Coronal caries in the primary and permanent dentition of children and adolescents 1-17 years of age: United States, 1988-1991. J Dent Res 1996; 75 Spec No:631.

Edelstein BL, Douglass CW. Dispelling the myth that 50 percent of U.S. schoolchildren have never had a cavity. Public Health Rep 1995; 110:522.