Professional Documents
Culture Documents
strategies in children.
By
Dr. Nida Liaquat
MSPH 2009-10
Dental caries:
• Definition:
• It is a disease of microbial origin in which the dietary carbohydrates are
fermented by the bacteria forming an acid which causes the
demineralization of the inorganic part and disintegration of the organic part
of the tooth
Dental caries
• Dental caries is one of the most common of all disorders.
• It usually occurs in children and young adults but can affect any
person.
• In 1942, Authorities like Robert Robertson and his co workers carried out major break
through was the relationship of dental caries and fluorides.
• Fluorides was an accidental discovery, which opened the doors of preventive dentistry.
• The evidence for trends in dental caries is especially interesting amongst North
American Indians.
• When sugars have been introduced into the diet, fissure and proximal surface cavities,
particularly in children, became dominant.
Etiology
• An interplay of three
principal factors is
responsible for this
multifactorial disease.
• More than half of all children in the U.S. have dental caries by the
second grade of school. By the age of 17, approximately 80% of
young people have had a dental cavity.
10
8
DMFT
6 1999
4 2003
0
12 15 34-44
AGE IN YEARS
Fluoride analysis of drinking water
(1999-2000) (WHO)
District Fluoride levels (ppm)
Karachi 0.1-0.14
Lahore 0.08-1.42
Multan 0.07-0.35
Peshawar 0.11-0.15
Quetta 0.86-1.11
Global policy for improvement of oral health
in the 21st century – implications to oral
health research WHO 2007.
• For the first time in 25 years oral health was subject to discussion.
• Advances in oral health science have not yet benefited the poor
and disadvantaged populations worldwide.
• At a present time there are very few programs aiming at increasing the
awareness regarding child’s oral health
Objectives
5. Multisectoral approach.
1. ESTABLISHMENT OF
CHILDREN’S DENTAL CLUB
Children’s club has been specifically designed a
program, including a reward\motivation
system that benefits the child and a somewhat
of a counseling\guidance system that will
frequently remind and help the caregiver
maintain the child’s oral health.
Children Dental Club Model
• Forms will be distributed to the children’s parents who are coming to clinics.
• Dental club recall patients every after 6 weeks, health promotion material are provided to them related risk factors
involved.
• Parents are at the same time asked to answer two to three questions and mail them in the envelope provided.
• At the next recall visit if the child will present with healthy teeth he/she will earn the membership to “Dental Club”.
• The member child will be able to use this card to get Toys
from the dental clinic.
• Tooth brushing
• Flossing
• Chemotherapeutic agents-
e.g. Chlorhexidine- short
term benefit
• Chewing gums- ADA
approved
Diet
Recommendations:
• Reduce sucrose consumption
• Sweets are not to be eaten between meals or at
bedtime
• Emphasize foods that require chewing, stay away
from soft/sticky foods
• Brush teeth after meals and ALWAYS at Bedtime
• Discuss the danger of “hidden” sugars such as
starchy foods (bread)
Fluoride Therapy
• Systemic Fluorides
– Provided by water fluoridation.
• Water Fluoridation
– Concentration of 1 ppm of fluorides in drinking
water is considered optimal in reducing caries
prevalence
– Optimal fluoride concentration reduces caries up
to 50%
Fluoride Therapy
• Topical Fluorides
– Delivered via gels, varnishes, mouth rinses and dentifrices.
– Commonly use topical fluorides sodium fluoride,
hydrofluosilic acid and sodium silicofluoride
– No need for topical fluoride in patients with low risk and/or
residing in optimally fluoridated areas- use of a fluoridated
toothpaste should be sufficient.
– Fluoridated dentifrices are not recommended in small
children (<3 years)
Toxicity by fluorides:
– Pea-sized amount.
– Dental fluorosis.
• Health Department
• Education Deptt.
• Private schools
• NGOs
• Dental clinics
• Pharmaceuticals (Colgate, MacLean's etc.)
Evaluation
• No. of children include in dental club.
• No. of their parents/caregivers involved.
• No. of seminars conducted.
• No. of sessions conducted.
• No. of dental offices included.
• No. of schools included.
• No. of dental nurses hire/trained.
• DMFT Index
• No. of Dental Caries diagnosed
Dental diseases are largely preventable
and increased emphasis on prevention
should be the goal of every dental
practice.
“Knowing is not enough, we must apply.
Willing is not enough, we must do.”
- Johann Wolfgang von Goethe