DENTAL SYMPOSIUM A PROFESSIONAL APPROACH TO ORAL CARE FOR SPECIAL NEEDS

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DENTAL SYMPOSIUM- A PROFESSIONAL APPROACH TO ORAL
CARE FOR SPECIAL NEEDS

• THE DENTAL HYGIENISTS OF THE EAST BAY PRESENT
• ORAL HEALTH BEGINS AT BIRTH!
• SPEAKER EMILIA M. ION, RDH, MS

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Our missionOur goalsTo serve the community!

• Dental Hygienists of The East Bay Component are
  dedicated PREVENTION SPECIALISTS!

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• Who are children with special needs?
• Children with special needs are those who have or
• are at increased risk for a chronic physical,
  developmental,
• behavioral or emotional condition and who
• also require health and related services of a
  type or
• amount beyond that required by children
  generally.
• Why are they at higher risk?
• Common oral problems, such as tooth decay or gum
• disease, affect all children. But children with
  disabilities
• and other special needs have more oral health
• problems than the general population.

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What causes oral health problems in children
with disabilities?

• Oral Conditions.
• Physical limitations.
• Difficulty brushing and flossing.
• Reduced saliva flow.
• Medications.
• Restricted diets.

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Which children may require specialoral health
care?

• Downs syndrome
• Epileptic or Seizure disorders
• Cleft lip or cleft palate
• Other structural anomalies of the head, face,
  and/or mouth
• Cerebral Palsy
• Learning or Developmental Disabilities
• Vision or Hearing Impairments
• HIV Infection

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When should oral health problemsbe suspected?

• Grinding teeth
• Food refusal
• Preference for softer foods
• Changes in behavior, such as touching in or
  around the mouth, teeth, jaws and cheeks.
• Foul smelling breath
• Discolored teeth

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Oral Conditions in ChildrenWith Special Needs

• Tooth eruption may be delayed,accelerated, or
  inconsistent in children with growth
  disturbances. Children with Down syndrome may
  show delays of up to 2 years.

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Oral Conditions in ChildrenWith Special Needs

• Malocclusion, a poor fit between the upper and
  lower teeth, and crowding of teeth occur
  frequently in people with developmental
  disabilities.

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Oral Conditions in ChildrenWith Special Needs

• Tooth anomalies are variations in the number,
  size, and shape of teeth. People with Down
  syndrome, oral clefts, ectodermal dysplasia, or
  other conditions may experience congenitally
  missing, extra, or malformed teeth.

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Oral Conditions in ChildrenWith Special Needs

• Developmental defects appear as pits, lines, or
  discoloration in the teeth. Very high fever or
  certain medications can disturb tooth formation
  and defects may result.

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Oral Conditions in ChildrenWith Special Needs

• Trauma to the face and mouth occur more
  frequently in people who have mental retardation,
  seizures, abnormal protective reflexes, or muscle
  incoordination.

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Oral Conditions in ChildrenWith Special Needs

• Bruxism, the habitual grinding of teeth, is a
  common occurrence in people with cerebral palsy
  or severe mental retardation.

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Oral Conditions in ChildrenWith Special Needs

• Dental caries, or tooth decay, may be linked to
  frequent vomiting or gastroesophageal reflux,
  less than normal amounts of saliva, medications
  containing sugar, or special diets that require
  prolonged bottle feeding or snacking.When oral
  hygiene is poor, the teeth are at increased risk
  for caries.

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Oral Conditions in ChildrenWith Special Needs

• Viral infections are usually due to the herpes
  simplex virus. Children rarely get herpetic
  gingivostomatitis or herpes labialis before 6
  months of age. Herpetic gingivostomatitis is most
  common in young children, but may occur in
  adolescents and young adults.

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Oral Conditions in ChildrenWith Special Needs

• Early, severe periodontal (gum) disease can occur
  in children with impaired immune systems or
  connective tissue disorders and inadequate oral
  hygiene. Simple gingivitis results from an
  accumulation of bacterial plaque and presents as
  red, swollen gums that bleed easily.

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Oral Conditions in ChildrenWith Special Needs

• Gingival overgrowth may be a side effect from
  medications such as calcium channel blockers,
  phenytoin sodium, and cyclosporine. Poor oral
  hygiene aggravates the condition and can lead to
  superimposed infections.

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NUTRITION AND DENTAL HEALTH

• Tooth decay is a common nutritional health
  problem in the United States today.
• Cavities are caused by the acid destruction of
  tooth enamel. Acid comes from fermentation of
  sugars in the mouth.
• All natural or refined sugar including white
  sugar, honey, molasses, brown sugar, and raw
  sugar can cause decay.
• Carbohydrate foods, such as bread, rice,
  potatoes, and pasta, may also cause cavities.

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NUTRITION AND DENTAL HEALTH

• Sugared foods between meals are more harmful than
  when eaten at mealtime.
• Sticky foods and candies are more likely to
  produce cavities.
• Mannitol, xylitol, and sorbitol have lower tooth
  decay producing potential.
• Children with developmental delays may have a
  high rate of cavities because of poor brushing
  habits or techniques, frequent snacking instead
  of regular meals, and a preference for sweets
  that is often supported by overindulgent parents.

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Promote Good Dental Health

• Drink fluoridated water (1 part per million of
  fluoride) or give a fluoride supplement until all
  teeth have broken through the gums.
• Brush the childs teeth morning and night until
  you are certain she or he can do the job very
  thoroughly. Use a pea-sized amount of toothpaste
  for children under age 8 years.
• Discontinue bedtime and naptime bottles or fill
  only with water. NO SNACKS AT BEDTIME!
• Offer sweets only at mealtime or with other
  foods. Avoid sticky, caramel types of candy.
• Offer snacks and desserts such as fresh fruits
  and vegetables, nuts, cheese, and yogurt.

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Promote Good Dental Health

• General Health and Medication Use
• Children with special needs often have poorer
  oral health as they rely on others for oral care.
• Xerostomia leads to increased caries rates
• Physiologic during sleep
• Pathologic
• Medications that have decreased saliva
  production as side effect
• Antispasmodics, antidepressants,
• antihistamines, anticonvulsants

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Promote Good Dental Health

• Tooth brushing and Oral Hygiene
• Increased tooth brushing frequency and oral
  hygiene by parents decrease caries rates
• Regular brushing may counteract the dietary
  effects by reducing plaque levels
• Association between gingivitis, strep mutans and
  caries rates

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THE BEST APPROACH TO FIGHT TOOTH DECAY

• Strengthen the Host Fluoride
• Diminish the Bugs Target diet and maternal
  transmission
• Diminish the substrate Diet and timing of
  snacks and drinks

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TOOTH REMINERALIZATION
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DENTAL SEALANTS Sealants can reduce cavities by
up to 60 percent. 

• Thin plastic / Glass Ionomer coatings
• For chewing surfaces
• Of Back teeth (Molars)
• Suitable teeth
• 1st. Permanent molar
• 2nd. 3rd Permanent molar
• Milk teeth prone to decay
• Benefits
• Makes life easy for your children and you.
• Saves from pain.
• Saves money.
• Lasts from 5 to 10 years

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ORTHODONTIC TREATMENT

• Crowding, poor occlusion ( bad bite), Rotated
  teeth, missing teeth. All these and many other
  conditions need to be addressed and discussed
  with your Dentist.
• Your childs dentist will make the right
  recommendations on what type of treatment may be
  suited for your child your childs cooperation
  is a strong indicator for or against treatment.
• Evaluate and treat orthodontic problems early to
  minimize risk of more complicated problems later
  in life.

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Oral Hygiene Instructions??????

• Organized by Alice Wang, RDH

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What is Plaque???????

• Plaque is a sticky, colorless film of bacteria
  and sugars that constantly forms on our teeth
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What is Plaque???????

• It is the main cause of cavities and gum disease,
  and can harden into tartar if not removed daily
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What is Tartar/Calculus? ??????

• Plaque that has hardened on your teeth
• Only your dentist or hygienist can remove it
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Tooth Brushing Techniques ?????
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What Type of Toothbrush Should I Use? ????????

• Soft-bristled brush
• Small-headed brush
• Powered toothbrush can do a better job of
  cleaning teeth, particularly for those who have
  difficulty brushing or who have limited manual
  dexterity

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How to Brush? ?????

• Tilt the brush at a 45 angle against the gumline
  and sweep or roll the brush away from the gumline
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How to Brush? ?????

• Gently brush the outside, inside and chewing
  surface of each tooth using short back-and-forth
  strokes
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How to Brush? ?????

• Gently brush your tongue to remove bacteria and
  freshen breath
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How Often Should I Replace My Toothbrush?
????????????

• When it begins to show wear, or every three
  months
• After you've had a cold, since the bristles can
  collect germs that can lead to reinfection
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Flossing Tips ??????
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How to Floss?????????

• Starting with about 18 inches of floss, wind most
  of the floss around each middle finger, leaving
  an inch or two of floss to work with
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How to Floss?????????

• Gently follow the curves of your teeth
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How to Floss?????????

• Holding the floss tautly between your thumbs and
  index fingers, slide it gently up-and-down
  between your teeth
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How to Floss?????????

• Gently curve the floss around the base of each
  tooth, making sure you go beneath the gumline
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How to Floss?????????

• Never snap or force the floss, as this may cut or
  bruise delicate gum tissue
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How to Floss?????????

• Use clean sections of floss as you move from
  tooth to tooth
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Thank You!???!
BRUSH at LEAST 2 TIMES PER DAY FLOSS at LEAST 1
TIME PER DAY IT TAKES 2 TO 5 MINUTES PER DAY!

• Organized by Alice Wang, RDH

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IS IMPORTANT TO VISIT YOUR DENTAL OFFICE
REGULARLY!

• Importance of regular office visits.
• Importance of following with optimal home care

SEVERE CALCULUS
CARIOUS LESION
SEVERE STAINING
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YOUR CHILDS FIRST DENTAL VISIT

• Schedule your child in the morning hours, after
  breakfast, especially if the dental office
  prefers that.
• Submit to the requests of your dental
  professionals for example, if they request of
  you to stay or leave the treatment room. Your
  dental professionals are highly qualified and
  trained well to work with your child, and they
  have your childs best interest at heart.
• Seek advice on behavior management techniques
  early intervention and familiarization with the
  dental team may take several visits.
• SEEK A DENTAL CONSULTATION NO LATER THAN THE
  CHILDS FIRST BIRTHDAY!

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What will a child see in the dental office
DENTAL TOOLS
THE DENTIST AND THE DENTAL ASSISTANT
THE DENTAL HYGIENIST
THE HYGIENIST USING POWER TOOTHBRUSHESTO CLEAN
TEETH..
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What will a child see in the dental office
TRY TO FAMILIARIZE YOUR CHILD WITH THE DENTAL
OFFICE ENVIRONMENT. FOR EXAMPLE 1.TAKE YOUR
CHILD WITH YOU TO YOUR DENTAL VISIT. 2. DO NOT
SHOW YOUR CHILD YOUR FEAR. 3. DO NOT USE THESE
WORDS PAIN, SHY, POKING, SHOTS, 4.
.READ A BOOK, OR WATCH A MOVIE ABOUT THE FIRST
DENTAL VISIT EXPERIENCE. 5. MAKE EVERY EXPERIENCE
POSITIVE AND FUN.
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HOW TO HELP YOUR CHILD

• Adhering to a rigorous oral hygiene at home, has
  many benefits easier dental check ups absence
  of pain quality of life for you and your child.
• Your child needs help!
• Underdeveloped dexterity!
• Children rely on their parents for help!

Tips on how to brush and floss your childs teeth
at home.
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DO NOT FORGET

• USE Pea size amount toothpaste
• If unable to brush rinse with water.
• Teach your child the importance of water intake
  throughout the day. Has systemic and oral
  benefits.
• Help your child!
• Brush
• And Floss!

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HELPFUL ORAL HYGIENE PRODUCTS

• FOR BABIES
• This finger toothbrush is extremely useful for
  infants, children with few teeth, and take along
  on vacations for a quick freshen up step. They
  are called Brush-ups by Oral B.

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• USEFUL HOME CARE DENTAL AIDS

GOOD WEBSITES TO LEARN HOW TO BRUSH AND FLOSS
http//dentalcare.com/soap/patient/english/power_b
rush.html
http//dentalcare.com/soap/patient/english/manua
l_brush.html
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THIS IS A MANUAL TYPE FLOSSER.
DENTAL FLOSSING AIDS
THIS IS AN ELECTRIC FLOSSER USES 2 AA BATT.
NAMED HUMMINGBIRD FLOSSER
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NAMED FLOSS MATE GREAT TO USE ON CHILDREN, OR TO
LET CHILDREN USE ON THEIR OWN.
ECONOMY SIZE FLOSSERS NAMED FLOSS PICKS MAY BE
TOO POINTY FOR CHILDREN TO USE ALONE
RECOMMENDED FOR ADULTS, MOSTLY!
ANOTHER GREAT TOOL TO USE ON CHILDREN, OR TO LET
THE CHILD USE BY SELF.
MORE DENTAL FLOSSING AIDS
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THIS IS BY MANY VOTED AS THE BEST FLOSSING TOOL
SO FAR IT IS CALLED REACH ACCESS FLOSSER KEEP
THE HANDLE AND THROW AWAY THE HEAD, AFTER ITS
FIRST USE REFILLS AVAILABLE EVERYWHERE.
MADE BY A DIFFERENT MANUFACTURER BUT IT MIMICS
REACH ACCESS FLOSSER. HAS SIMILARITIES TO REACH
ACCESS. REFILLS ARE THE ECONOMY PACK FLOSS PICKS
PRESENTED EARLIER.
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ELECTRIC/POWER TOOTHBRUSHES
THE LATEST MODEL ORAL B, NAMED TRIUMF GENERALLY
A GREAT SOPHISTICATED POWER BRUSH.
THE BEST AND CHEAPEST ALTERNATIVE ORAL B
VITALITY POWER BRUSH PRECISION CLEAN AND ORAL
B VITALITY SONIC
PHILLIPS-SONICARE POWER TOOTHBRUSH A GREAT TOOL
TO OWN.
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The dental team will care well for your child
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THANK YOU!

• FROM ALL OF US AT CDHA (CALIFORNIA DENTAL HYGIENE
  ASSOCIATION) THE EBC (EAST BAY COMPONENT)