Oral Health in Children Quiz

Oral Health in Children

• Oral health in children has improved significantly in the past four decades.
• Many children still present with oral disease at their first dental visit.
• Oral disease often begins developing during infancy.
• Early professional intervention is recommended, consisting of an oral examination, risk assessment, and anticipatory guidance for parents.

Initial Dental Visit

• Initial oral evaluation should occur within six months of the first tooth eruption, or no later than 12 months of age.
• Dentist should obtain complete medical and dental history.
• Dentist should assess the risk of oral and dental disease.
• Dentist should provide guidance on oral and dental development, fluoride status, non-nutritive habits, injury prevention, oral hygiene, and diet.

Mutans Streptococci

• Mutans streptococci (S. mutans and S. sobrinus) are the primary bacteria responsible for dental caries.
• Infants acquire these bacteria from their mothers.
• The window of infectivity for mutans streptococci is estimated to be 19-31 months of age.
• Early acquisition of mutans streptococci is associated with factors like sibling caries, maternal caries, feeding habits, dietary habits, fluoride exposure, and oral hygiene.

Early Childhood Caries (ECC)

• ECC is characterized by rapid and extensive dental caries.
• It often occurs in very young children.
• ECC affects an estimated 1-11% of infants in urban populations.
• ECC is associated with prolonged bottle or breast feeding.

Feeding Practices

• Prolonged bottle or breast feeding provides the substrate for bacterial proliferation and acidogenic plaque formation.
• This leads to an acidic oral environment, promoting enamel demineralization and caries.
• Parents should avoid putting infants to sleep with a bottle and avoid ad libitum nocturnal breastfeeding after the first tooth erupts.
• Infants should transition to a cup by their first birthday.
• Weaning from the bottle should occur between 12-14 months of age.
• Juice should be avoided from a bottle.

Oral Hygiene and Dietary Habits

• Poor oral hygiene and dietary habits contribute to the development of caries in children.
• Mothers are often the primary source of dental knowledge for children.
• Early education for mothers is critical to prevent dental problems in children.
• Dietary counseling should address alcohol and tobacco use, breast feeding, and medication warnings.

AAPD Age-Specific Home Oral Hygiene Instructions

• Clean infants' gums daily before the first tooth erupts using a moistened gauze square or washcloth.
• Consider introducing a soft-bristled toothbrush, but avoid fluoride toothpaste due to ingestion risk.
• Introduce a toothbrush for toddlers alongside plaque removal, using a pea-sized amount of fluoride toothpaste.
• Encourage toddlers to start brushing, but parents remain the primary caregivers.
• Preschool children should continue to receive primary oral hygiene supervision from parents.
• Parents should use a pea-sized amount of fluoride toothpaste and floss interproximal areas with tooth-to-tooth contact.

Anticipatory Guidance

• Anticipatory guidance provides developmentally appropriate information about children's health to prepare parents.
• Topics include oral hygiene, dietary habits, injury prevention, non-nutritive habits, substance abuse, and speech/language development.
• Oral hygiene counseling involves both the parent and the child.
• The child should take on more responsibility for oral hygiene as they develop.
• Home care effectiveness should be monitored at every visit.
• Parents should understand the connection between dietary choices and oral health.
• Parents should be educated on the importance of a healthy diet for overall health and development.

Injury Prevention

• Counseling for oro-facial trauma should be age-appropriate.
• Young children should be protected from play objects, pacifiers, and electrical cords.
• Motor coordination development necessitates additional safety measures, such as athletic mouthguards.
• Most primary dentition trauma occurs between ages 2-3 years.
• Common injuries to permanent teeth include falls, traffic accidents, violence, and sports-related incidents.

Non-NutritiveOral Habits

• Non-nutritive habits like digit sucking, pacifier use, bruxism, and abnormal tongue thrusts can affect occlusion and facial development.
• Early intervention is crucial to discontinue these habits before malocclusion or skeletal dysplasias occur.
• Counseling for school-aged children and adolescents regarding habits like nail biting, clenching, and bruxism is important.

Speech and Language Considerations

• Speech and language are essential parts of early development.
• Delays or deficiencies in speech or language production can be recognized early and addressed.
• Communication and coordination with speech and language professionals can assist in addressing speech disorders.
• Early dental intervention supplements parent education on oral health, including proper hygiene, injury prevention, and ECC prevention.
• Intervention can help familiarize children with the dental environment.
• Early and regular dental care for children remains uncommon.