MODULE 15: ORAL HEALTH ACROSS THE LIFESPAN Oral Health Across the Lifespan
MODULE 15: ORAL HEALTH ACROSS THE LIFESPAN Part 3: Oral Health in Childhood Erin Hartnett DNP, APRN-BC, CPNP
Learning Objectives After completing this module, learners will be able to: Identify the prevalence of dental caries in children and adolescents Identify the risk factors for dental caries in children and adolescents Identify prevention measures for caries in children and adolescents Discuss access problems for children and adolescents 3
Prevalence of Dental Caries Early Childhood Caries is the most common chronic disease of children under 72 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) Children have contact t with their primary care providers 13 times in the first 36 months (Hagan, 2008) 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) 4
Prevalence of Dental Caries 5
Impact of Untreated Dental Caries Spread of infection Tooth- lip/gum- Sinusitis/facial cellulitis Periorbital cellulitis/ Brain abscess- Airway compromise 6
Prevalence of Dental Sealants 7
Oral health: Percentage of children ages 5 17 with untreated dental caries (cavities) by age, poverty status, and race and Hispanic origin, 1988 1994, 1999 2004 2004, 2005 2008 2008, and 2009 2010 2010 Ages 5-17 Mexican American Black, non-hispanic White, non-hispanic 2009 2010 200% poverty and above 2005 2008 1999 2004 1988 1994 100 199% poverty Below 100% poverty Total 0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0 45.0 8
Oral health: Percentage of children ages 5 17 with untreated dental caries (cavities) by age, poverty status, and race and Hispanic origin, 1988 1994, 1994, 1999 2004, 2005 2008, 2008, and 2009 20102010 Ages 5-11 Mexican American Black, non-hispanic White, non-hispanic 2009 2010 200% poverty and above 2005 20082008 1999 2004 1988 1994 100 199% poverty Below 100% poverty Total 0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0 45.0 50.0 9
Oral health: Percentage of children ages 5 17 with untreated dental caries (cavities) by age, poverty status, and race and Hispanic origin, 1988 1994, 1994, 1999 2004, 2005 2008, 2008, and 2009 20102010 Ages 12-1717 Mexican American Black, non-hispanic White, non-hispanic 200% poverty and above 100 199% poverty 2009 2010 2005 2008 1999 2004 1988 1994 Below 100% poverty Total 0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 10
Risk Factors for Caries Mothers with caries history Vertical transmission Obvious caries, staining, plaque accumulation, demineralization Early signs Sleeping with bottle Diet, nutrition, snacking Special Health care needs medications Low socio-economic status 11
12 Dental Caries are Preventable!!!
Prevention Measures for Children Start Early Transmitted mainly from mother or primary caregiver to infant Educate new mothers Nutrition Breastfeeding Bottlefeeding No food sharing Oral hygiene Tooth eruption Teething 13
Not Just What You Eat, But How Often Acids produced by bacteria after sugar intake persist for 20 to 40 minutes. Frequency of sugar ingestion is more important than quantity. www.aap.org 14
You Are What You Eat Caries is promoted by carbohydrates, which h break down to acid. Acid causes demineralization of enamel. Frequent snacking promotes acid attack. Foods with complex carbohydrates (breads, cereals, pastas) are major sources of hidden sugars. High sugar content in sodas is a source of these substrates. www.aap.org 15
Stages of Early Childhood Caries 16
Prevention Measures for HCildren Healthy Nutrition Frequency Snacks and drinks Fluoride exposure Water Supplements Varnish Toothbrushing Fluoridated 2x/d Parental assistance until age 7 Dental home by 1 year 17
Prevention Measures for Adolescents Oral health is more than healthy teeth. The mouth is a mirror of general health and disease. Oral diseases are associated with other health problems. Prevention of common oral diseases. Lifestyle behaviors affect general health and oral health. 18 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 Institutes of Health.
STDs High Risk Behaviors = Oral Health HPV Oral Cancer GC Tobacco users Lung and oral cancer Periodontal disease Alcohol users Liver disease Oral cancer Drug abusers Problems Blood borne infections Poor hygiene Gross caries (e.g., meth mouth) 19
Access Problems for Children and Adolescents 100.0 90.0 80.0 70.0 60.0 50.0 40.0 Ages 2 4 Ages 5 17 Ages 12 17 30.0 20.0 10.0 00 0.0 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 20
Role of Primary Care Clinician Oral Health Promotion Monitoring and Management Collaboration & Advocacy 21