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
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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.
DENTAL DECAY
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)
Eruption of baby teeth.
Tooth type
Lower arch
Upper arch
Central incisors
6 1/2 months
7 1/2 months
Lateral incisors
7 months
8 months
First molars
12 to 16 months
12 to 16 months
Cuspids
16 to 20 months
16 to 20 months
Second molars
20 to 30 months
20 to 20 months
PREVENTION
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
NUTRITION
Oral Health Nutrition
• To tell the tooth; begin with a grin
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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
PREGNANCY
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
GENERAL HEALTH LINK
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
Oral Health & Diabetes
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/