6/29/17

Preventive Child Dental Care

This essentially involves;
   1.  Counseling and advice
   2.  Maintenance of good oral hygiene
   3.  Dietary counseling
   4.  Flouridation

What is counseling and advice in child dental care?

   This entails advice on care and maintenance of 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.
Pediatric dentistry

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

This is very essential as bad oral hygiene encourages 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 eruption of teeth starts which may then be by using cotton wool, pledgets and 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 last thing in the night and after breakfast 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 intake 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 may be discouraged or reduced as all these has been incriminated in rampant caries. In take 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 ?

Flouridation:
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 carious attack.
   3.  Interfering with bacterial metabolism in plaque.

What are 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. Tropical application of fluorides
Forms of this preparation are as :
   a. Sodium fluoride
   b.  Stannous fluoride
   C.  Acidulated phosphate fluoride (APF)

THE TECHNIQUES

   a. Clean crowns with 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 tray.
    d.   Each arch is dried separately before 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 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.
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