Oral Health Prevention strategies for better living and a better life. Jennifer Smits, RDH AAAS September 10, 2010 University of Michigan E-Learning Program
Economic Downturn • Alternate economic consequences such as costly medical fees due to emergency room treatment and hospital fees occur when dental disease goes untreated. • provide treatment/prevention strategies for oral infections and disease to those with special needs= overall health care costs dramatically reduced, quality of life of these individuals will improve, needless pain and suffering can be minimized.(Glassman, mod 1 readings)
Educational Goal To increase staff and parents awareness of the importance and need for efficient oral hygiene care, good oral hygiene habits, and tooth friendly nutritional choices to decrease unnecessary pain and suffering and increase prevention strategies.
While most Americans seek care from a dentist regularly, some individuals and families face challenges accessing dental care. These Americans, including racial and ethnic minorities, people with disabilities, and those whose families are economically disadvantaged, may also suffer a disproportionate share of dental disease. Access challenges include difficulty getting to a dental office, prioritizing dental care among other health crises, overcoming financial barriers, and navigating government assistance programs. These dental patients may need special financial arrangements, help accessing a dental office, or special oral hygiene instruction. Also, basic awareness of oral health issues for many Americans may be quite limited because of cultural or language barriers or problems with literacy. (ada.org)
Goal • Education = PREVENTION! • Education to change parental attitudes and behaviors regarding oral health • Sealants • Fluoride • Effective brushing/flossing technique • Tooth friendly snack/food choices • Oral vs. systemic health link
Fatal Dental Abscess • A 7 year old Liberian boy presented with a high fever, inability to walk, bulging eyes, facial swelling, reduced level of consciousness, and the loss of vision for three days at the United Nations Mission in Liberia. • The parents informed the child was diagnosed with a dental abscess one week prior to their hospital visit. Extremely decayed permanent teeth on the upper and lower right side were present. • Extraction (removal) of the molars was performed followed by heavy doses of antibiotics and a transfer to the intensive care unit (ICU) at a local civilian hospital. • Unfortunately, cavernous sinus thrombosis had formed during this bad dental infection, causing quick deterioration of his health and ultimately death four days after hospital admission. • Cavernous sinus thrombosis is caused by severe infection of the sinus cavity, which in this case was from severe dental infection. • Although rare, dental abscess’ can potentially cause life-threatening complications.
Caries (Cavity) Development 1. Pit and fissure-can spread to dentin causing severe damage 2. Smooth surface (interproximal caries) 3. Root surface-when gingiva recedes(widespread problem in adults
ECC (Early Childhood Caries) • The most common childhood disease in children • National reports and studies clearly indicate ECC is highly prevalent in children of lower socioeconomic status • -Consequences can be substantial • -Treatment of ECC often requires extensive restorative treatment or extraction of the tooth • -Previously known as “milk bottle mouth” or “baby bottle tooth decay” • -ECC is rampant caries assumed to be caused by inappropriate use of baby bottles • -We now know that ECC is multifactoral (factors include: previous caries, diet i.e. sugar consumption, plaque, lack of fluoride, low SES)
Sealants -plastic coating that covers the deep pits/grooves on chewing surfaces of teeth -this coating acts as a physical barrier that deflects food debris/bacteria out of these hard to clean areas, decreasing risk of forming decay -approximately 80% of all dental caries in children occur on the chewing surfaces of teeth -cost effective for those at high risk
Fluoride WHAT IS FLUORIDE? • A protective coating that helps prevent decay from forming and reverses incipient (early) dental cavities WHY APPLY FLUORIDE? • Simple, inexpensive, easy prevention method • Low cost of fluoride prevention can avoid the high cost and pain related to cavity restoration. • Most children do not lose all their deciduous (baby) teeth until 11 or 12 years of age IS IT SAFE? • Fluoride varnish is safe to use as soon as teeth begin to erupt • The American Dental Association and FDA approved WHEN TO APPLY? • 2-4 times a year
Oral Health Nutrition • To tell the tooth; begin with a grin • High frequency sugar intake is common in those with lower SES • Frequency of meals/snacking increases risk for decay • Bottles with milk/sweetened fluids • Sugary foods with sticky consistency develop environment for decay • Snacking before bedtime (saliva flow lowered during sleep, can not buffer acidic environment)
Oral Health Nutrition Cont… • Decay causing bacteria can be transmitted from parent/caregiver to child via saliva • Sweets are often used as rewards, but should be limited to mealtimes • Eating patterns have changed over time to calorically dense, nutrient poor food choices (convenience) • Poor eating can lead to poor tooth development/formation, eruption, and increase risk to decay
Infant Oral Health • Parents need to be made aware of importance of primary (baby) teeth • Regular dental examinations, cleanings, fluoride are essential to optimal health • Initial dental exams for infants should be done 6 mo-1yr after eruption of first tooth according to ADA • Parents should be assisting tooth brushing from time when first tooth erupts to age 8 • Fluoride toothpaste should only be used if child is expectorating (spitting) it out and not ingesting
Infant Oral Health Continued… -A young child’s daily oral care should be provided by the parent -children lack the manual dexterity to perform simple tasks of personal hygiene
Maternal Oral Health • Studies indicate that maternal oral health can affect the infants future oral health and/or systemic health • Pregnant women need to be encouraged to seek routine dental care • Periodontal disease linked with premature birth/low birth weight babies • Breast feeding provides the best sources of nutrients for infants and lowers risk of decay found in bottle usage that contain sweetened beverages and feeding at will
Oral health & General health • ADA states there is a link between periodontal disease and diabetes, heart disease, adverse pregnancy outcomes
What is periodontal disease? • A disease that affects the tissues that support your teeth (gingiva, bone) • There is a v shaped sulcus between the tooth and gum called a pocket, this is where disease begins • As disease progresses, pocket deepens and tooth attachment is weakened with destruction of supporting tissues • The more severe the disease, the greater the pocket • 2 stages: gingivitis (this is milder, reversible stage but without treatment can progress into the later stage), periodontal disease • It is common to have periodontal disease with no warning signs • Signs if present: oral malodor/persistent bad taste in mouth, tender/red/bleeding gums, loose teeth, shifting teeth
Diabetes • WHAT IS IT? • Pancreas is unable to control blood glucose levels properly • High blood glucose levels can allow bacteria in mouth to thrive • Oral Concerns: • Increased risk for periodontal disease • Poor healing (surgical sites, periodontal disease, gingivitis, oral infections) • Lower resistance to infection • Xerostomia (dry mouth) • Dental decay
Closing Statement Today we have discussed various efforts on how to protect our teeth, which in turn will better our overall dental health and well-being. With knowledge on prevention, dental decay and cost can be greatly reduced and quality of life at its best!
Great Resources • American Dental Association: ada.org • American Dental Hygienists Association: adha.org • Action for Healthy Kids: www.actionforhealthykids.org/ • Children’s nutrition center: www.kidsnutrition.org/