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MODULE 15: ORAL HEALTH ACROSS THE LIFESPAN
Oral Health Across the Oral Health Across the LifespanLifespan
MODULE 15: ORAL HEALTH ACROSS THE LIFESPAN
Part 3: Oral Health in Part 3: Oral Health in ChildhoodChildhood
Erin Hartnett DNP, APRN-BC, CPNP
Learning ObjectivesLearning Objectives
• After completing this module, learners
Learning ObjectivesLearning Objectives
will be able to: • Identify the prevalence of dental caries in children
d d land adolescents• Identify the risk factors for dental caries in
children and adolescentschildren and adolescents• Identify prevention measures for caries in
children and adolescents • Discuss access problems for children and
adolescents
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Prevalence of Dental CariesPrevalence of Dental Caries• Early Childhood Caries
• is the most common chronic disease of children under 72
Prevalence of Dental CariesPrevalence of Dental Caries
months of age• 5x more common than asthma
• 50 million school hours per year lost b/c of oral health related illness (pain, infection)
• 50% of all children have never visited a dentist (Dye 2007)• One in four children living in poverty had untreated dental caries (Dye ,2012)
Child h t t ith th i i id 13 ti i th fi t 36 • Children have contact with their primary care providers 13 times in the first 36
months (Hagan, 2008)• Application of fluoride varnish can reduce caries by Application of fluoride varnish can reduce caries by
25-45% (C Marya, V Dahiya.2006)• Less than half of children between 2 and 17 were offered advice from a health
care provider about the need for routine dental care (Soni 2011)
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care provider about the need for routine dental care. (Soni, 2011)
Prevalence of Dental CariesPrevalence of Dental CariesPrevalence of Dental CariesPrevalence of Dental Caries
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Impact of Untreated Dental CariesImpact of Untreated Dental Caries• Spread of infection
Impact of Untreated Dental CariesImpact of Untreated Dental Caries
• Tooth- lip/gum-• Sinusitis/facial
cellulitis• Periorbital cellulitis/• Brain abscess-• Airway compromise
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Prevalence of Dental SealantsPrevalence of Dental SealantsPrevalence of Dental SealantsPrevalence of Dental Sealants
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Oral health: Percentage of children ages 5Oral health: Percentage of children ages 5––17 with untreated dental 17 with untreated dental caries (cavities) by age, poverty status, and race and Hispanic caries (cavities) by age, poverty status, and race and Hispanic
origin 1988origin 1988––1994 19991994 1999––2004 20052004 2005––2008 and 2008 and 20092009––20102010origin, 1988origin, 1988 1994, 19991994, 1999 2004, 20052004, 2005 2008, and 2008, and 20092009 20102010
Ages Ages 55--1717
Black, non-Hispanic
Mexican American
White, non-Hispanic
2009–2010
100–199% poverty
200% poverty and above 2005–2008
1999–2004
1988–1994
Total
Below 100% poverty
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0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0 45.0
Oral health: Percentage of children ages 5Oral health: Percentage of children ages 5––17 with untreated dental 17 with untreated dental caries (cavities) by age, poverty status, and race and Hispanic caries (cavities) by age, poverty status, and race and Hispanic
origin, 1988origin, 1988––1994, 19991994, 1999––2004, 20052004, 2005––2008, and 2008, and 20092009––20102010g ,g , ,, ,, ,,
Ages 5Ages 5--1111
Black, non-Hispanic
Mexican American
200% d b
White, non-Hispanic
2009–2010
2005 2008
100–199% poverty
200% poverty and above 2005–2008
1999–2004
1988–1994
Total
Below 100% poverty
9
0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0 45.0 50.0
Oral health: Percentage of children ages 5Oral health: Percentage of children ages 5––17 with untreated dental 17 with untreated dental caries (cavities) by age, poverty status, and race and Hispanic caries (cavities) by age, poverty status, and race and Hispanic
origin, 1988origin, 1988––1994, 19991994, 1999––2004, 20052004, 2005––2008, and 20092008, and 2009––20102010g ,g , ,, ,, ,,
Ages 12Ages 12--1717
Black, non-Hispanic
Mexican American
200% poverty and above
White, non-Hispanic
2009–2010
2005–2008
100–199% poverty
200% poverty and above
1999–2004
1988–1994
Total
Below 100% poverty
10
0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0
Risk Factors for CariesRisk Factors for Caries• Mothers with caries history
Risk Factors for CariesRisk Factors for Caries
• Vertical transmission
• Obvious caries, staining, plaque accumulation, d i li tidemineralization• Early signs
Sl i g ith b ttl• Sleeping with bottle• Diet, nutrition, snacking
Special Health care needs• Special Health care needs• medications
• Low socio economic status11
• Low socio-economic status
Prevention Measures for ChildrenPrevention Measures for Children• Start Early
Transmitted mainly from mother or primary
Prevention Measures for ChildrenPrevention Measures for Children
• Transmitted mainly from mother or primary caregiver to infant
• Educate new mothers• Nutrition
• BreastfeedingBreastfeeding• Bottlefeeding• No food sharing
• Oral hygiene• Tooth eruption• Teething
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• Teething
Not Just What You Eat, But How OftenNot Just What You Eat, But How Often
• Acids produced by bacteria after sugar intake persist for
Not Just What You Eat, But How OftenNot Just What You Eat, But How Often
persist for 20 to 40 minutes.
• Frequency of sugar ingestion is more important q y g g pthan quantity.
www aap orgwww.aap.org
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You Are What You EatYou Are What You Eat• Caries is promoted by
carbohydrates, hi h b k d t id
You Are What You EatYou Are What You Eat
which break down to acid.• Acid causes demineralization
of enamel.F ki • Frequent snacking promotes acid attack.
• Foods with complex carbohydrates carbohydrates (breads, cereals, pastas) are major sources of “hidden” sugars.
• High sugar content in sodas is a source of these substrates.
www.aap.org
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Stages of Early Childhood CariesStages of Early Childhood CariesStages of Early Childhood CariesStages of Early Childhood Caries
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Prevention Measures for Prevention Measures for HCildrenHCildren• Healthy Nutrition
Frequency
Prevention Measures for Prevention Measures for HCildrenHCildren
• Frequency• Snacks and drinks
• Fluoride exposurep• Water• Supplements
h• Varnish• Toothbrushing
• Fluoridated 2x/dFluoridated 2x/d• Parental assistance
until age 7D l h b 1
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• Dental home by 1 year
Prevention Measures for AdolescentsPrevention Measures for Adolescents• Oral health is more than
healthy teeth.
Prevention Measures for AdolescentsPrevention Measures for Adolescents
• The mouth is a “mirror” of general health and disease.
• Oral diseases are associated with other health problems.health problems.
• Prevention of common oral diseases.Lif t l b h i ff t • Lifestyle behaviors affect general health and oral health.
U S Department of Health and Human Services (2000) Oral Health in America: A Report of the Surgeon General Rockville
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U.S. Department of Health and Human Services. (2000). Oral Health in America: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutesof Health.
High Risk Behaviors = Oral Health High Risk Behaviors = Oral Health P blP bl
• STDs• HPV
ProblemsProblems
HPV• Oral Cancer• GC
• Tobacco users • Tobacco users • Lung and oral cancer • Periodontal disease
• Alcohol users • Alcohol users • Liver disease • Oral cancer
Drug abusers• Drug abusers• Blood borne infections • Poor hygiene • Gross caries (e g meth mouth)
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• Gross caries (e.g., meth mouth)
Access Problems for Children and Access Problems for Children and Ad lAd lAdolescentsAdolescents
100.0
70.0
80.0
90.0
50.0
60.0
Ages 2–4
Ages 5–17
30.0
40.0Ages 12–17
0 0
10.0
20.0
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0.01997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011