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Early Childhood Oral Health for MCH Professionals Julia Richman, DDS, MSD, MPH.

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Presentation on theme: "Early Childhood Oral Health for MCH Professionals Julia Richman, DDS, MSD, MPH."— Presentation transcript:

1 Early Childhood Oral Health for MCH Professionals Julia Richman, DDS, MSD, MPH

2 Who are we? A. Medical care providers (ie MD, RN) B. Dental care providers C. Social services providers D. Other public health professionals

3 Healthy People 2010 Oral Health Goal: Prevent and control oral and craniofacial diseases, conditions, and injuries and improve access to related services Dental caries experience 21-2 Untreated dental decay 21-3 No permanent tooth loss 21-4 Complete tooth loss 21-5 Periodontal diseases 21-6 Early detection of oral and pharyngeal cancers 21-7 Annual examinations for oral and pharyngeal cancers 21-8 Dental sealants

4 Healthy People Community water fluoridation Use of oral health care system Use of oral health care system by residents in long-term care facilities Dental services for low-income children School-based health centers with oral health component Health centers with oral health service components Referral for cleft lip or palate Oral and craniofacial State-based surveillance system Tribal, State, and local dental programs

5 Dental Caries Dental caries is the most common chronic childhood disease –5x more prevalent than asthma Entirely preventable and treatable 80% of caries in permanent teeth affect 25% of the children –NHANES III –Poor children disproportionately affected Early childhood caries: caries affecting teeth in a child under 72 months of age

6 Dental Caries

7 Early Childhood Caries Sequellae of dental caries Pain Poor sleep due to pain Problems with school readiness and learning Poor nutrition due to pain eating Need for sedation or general anesthesia –Problems with access to this care Negative dental experiences Emergency room care Hospitalization for severe dental infections

8 Early Childhood Caries

9 Courtesy of Dr. Bryan Williams

10 Some Photos from My Practice Sugar, dextrose, corn syrup, malic acid, citric acid, buffered lactic acid, artificial flavor and color

11 For Want of a Dentist By Mary Otto, Washington Post Staff Writer Wednesday, February 28, 2007 Twelve-year-old Deamonte Driver died of a toothache Sunday. A routine, $80 tooth extraction might have saved him. If his mother had been insured. If his family had not lost its Medicaid. If Medicaid dentists weren't so hard to find. If his mother hadn't been focused on getting a dentist for his brother, who had six rotted teeth. By the time Deamonte's own aching tooth got any attention, the bacteria from the abscess had spread to his brain, doctors said. After two operations and more than six weeks of hospital care, the Prince George's County boy died.

12 Disparities in Untreated Caries CDC. NHANES I and NHANES III 2002 Annual Report

13 Disparities in Untreated Caries CDC. NHANES I and NHANES III 2002 Annual Report

14 Caries in Washington State According to the WA Smile Survey 2005, Significant increases since 2000 in: –Caries experience (55.6% 59.0%) –Rampant caries (15.2% 22.6%) –Caries in permanent teeth (15.3% 22.1%) Caries disproportionately affects Native American children –3-5 year olds in Head Start –25% of HS children had untreated caries –48% of Tribal HS children had untreated caries

15 Please use the text chat to share your experience. Questions Have you had a recent frustrating experience with trying to help a family obtain dental care for a young child? What barrier(s) to access did you encounter?

16 Barriers to Care Knowing when to seek dental care Finding a dentist who will take Medicaid Finding a dentist who will see a young child Transportation Geographical isolation Workforce shortage Need to take time off from work Language Finances Other barriers (dental fear, culture, health beliefs)

17 Medicaid An estimated 47 million children eligible but not enrolled (1996) Only 1 in 3 children enrolled in Medicaid visited the dentist in the past year Coverage does not guarantee access to oral health care. GAO 2000

18 What Dentists Can Do Practice in rural or underserved areas Accept Medicaid See young children, or refer to pediatric dentists Provide anticipatory guidance to pregnant moms Be active in dental organizations Be an active member in the community

19 What MCH Non-Dental Professionals Can Do Be aware of oral health issues affecting clients and refer to dentists Do not dismiss dental concerns as trivial Be aware of the recommendation for the age one dental visit Work with dentists to improve access and reduce barriers to care Be an active member of the MCH community and lobby for oral health

20 Oral Health: How to Keep Your Childs Teeth Healthy February 11 th, 2009 Julia Anne Richman, DDS Jessica De Bord DDS Penelope Leggott DDS MS Department of Pediatric Dentistry University of Washington

21 Goals of this Presentation Parents and families will learn About tooth eruption and dental development How to help keep childrens baby and permanent teeth healthy, and prevent cavities Why oral health is important for pregnant moms What things you need to go and see a dentist for

22 Primary (Baby) Tooth Development and Eruption Tooth development begins at 4-6 weeks after conception The first primary tooth comes in at approx 6 months The permanent teeth develop in close proximity to the primary teeth Six year molar Eye tooth/cuspid

23 Differences between baby and permanent teeth Baby teeth are whiter and smaller than permanent teeth Baby teeth have thinner enamel (outer covering) and cavities can grow faster when the enamel is damaged The first permanent teeth to come in are the lower front incisors (age 6) Baby teeth Permanent teeth

24 How do I prevent my child from getting cavities? What are cavities?

25 What are Cavities? Cavities are caused by germs, or bacteria, on the teeth Most of us carry these cavity-causing bacteria in our mouths The bacteria can be spread from a mother or caregiver to a baby When we dont brush our teeth, bacteria build up on the teeth to become plaque, sticky white stuff that can cause cavities easily

26 Cavities The bacteria feed on the sugars in foods and make acids When children get lots of sugar exposures in a day (snacks and juice), the bacteria can make acids all day. The acids dissolve tooth surfaces, causing defects which become cavities over time Dissolving tooth surface Enamel defect Cavity

27 Early Tooth Decay White Spots (pre-cavities) You can stop pre-cavities from getting worse!

28 Cavities Why are cavities bad for children? –Pain –Difficulty sleeping –Difficulty concentrating at school –Difficulty eating and speaking –The need for fillings or crowns at a young age –Teeth may need to be pulled (extracted) This can lead to future crowding of the teeth –Teeth roots can get infected, called an abscess –Sickness or death as a result of the infection

29 Why Fix Cavities in Baby Teeth? Cavities in baby teeth will not go away or get smaller - Cavities can spread to other teeth in the mouth - They need to be fixed to get rid of the disease damaged enamel on developing permanent tooth abscess

30 How do I prevent my child from getting cavities? What are cavities?

31 Prevention Cavities are an infection that can be prevented with: –Good brushing –A diet low in sugary and starchy foods Healthy teeth dont have cavities Healthy mouth Healthy body

32 Prevention Tips for Parents Serve water, not pop or juice Give fruits and vegetables, not fruit snacks, chips, crackers, or sweets as snacks Brush twice a day and floss every day Take your child to the dentist every 6 months starting by age 1 3 meals and 2 tooth friendly snacks each day Wean from the bottle by age months

33 Snacking Snacks which are not healthy for childrens teeth: Fruit juice Soda pop Gatorade Crackers Chips Sweet snacks Gummy bears and fruit snacks

34 Starchy Snacks Snacks like chips, pretzels, and crackers have starch or carbohydrates Carbohydrates are a form of sugar Carbohydrates turn into sugar in the mouth Starchy snacks cause cavities just like sweet snacks Children should not eat starchy snacks frequently Teeth should be rinsed or brushed after children eat starchy snacks

35 Snacking Healthy snacks for teeth and bodies are: Vegetables like carrots, celery, cucumbers Fresh fruit Lean meat Cheese Nuts Wa ter

36 Tooth Brushing Tips Start brushing your childs teeth when they come in Brush twice a day using a small soft toothbrush A smear of fluoride toothpaste should be used Babies and young children may not like tooth brushing, but it is very important for health

37 When should I take my child to the dentist? What kinds of things do I need to go to the dentist for?

38 A Visit to the Dentist Babies should visit the dentist no later than their 1 st birthday At that visit, the dentist will check the teeth, brush them, and put fluoride on them The dentist will talk to you about how to take care of baby teeth

39 A Visit to the Dentist Some people think that young children are too young to go to the dentist Babies and toddlers will usually cry when their teeth are checked Even if a baby or toddler cries, the visit to the dentist is very important for their health A pediatric dentist, or child dentist, has special training to take care of young children

40 How does the dentist fix cavities in a young child? Small cavities can be fixed easily and quickly in the office If a child has a lot of cavities or has big cavities, they may need medicine to make them sleep when the cavities are fixed This medicine is called general anesthesia

41 When should I take my child to the dentist? What kinds of things do I need to go to the dentist for?

42 See a dentist as soon as possible for: Pain, swelling, fever Chipped or loose tooth (injury) Gums are very red and bleed easily See a dentist in the next few days: Gums bleed when teeth are brushed Something looks like a cavity (no pain) Teeth arent coming in straight Loose tooth abscess

43 Did You Know? Taking care of your mouth while you are pregnant is very important for you AND your baby. Children born early (< 33 weeks), are 12 times more likely to have cavities at ages 3-5 years Cavity-causing bacteria can be spread from a mother to her baby 28% of children age 2-5 years have cavities

44 Take Home Messages! Childrens oral health is part of their overall health Cavities are preventable Limit sugar exposures Take your child to get his/her teeth checked by age one

45 Thank You!


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