Think like a doc
The mechanisms of fluoride are both topical and systemic, but this one mechanism is the most important, especially over the lifespan.
What is topical?
Children with special health care needs are most at risk of dental caries if they have this disease.
What is congenital heart disease?
This is by far the most common source of lead exposure for US children.
What is house paint?
Medicaid mandates screening for elevated blood lead levels at these ages, and in our clinic we make this universal.
What is 12 months and 24 months?
As pediatricians, our key intervention in prevention of lead poisoning is this.
What is education?
80% of dental disease is in children who can be categorized into these 2 groups.
What is Lower Socioeconomic group (or poverty) and minority groups?
The dose of fluoride varnish is 0.25 ml in a single dose applicator pack and there are 2 steps to application, which are these.
Be Specific!!
What is
1. dry teeth with a 2x2 gauze
2. paint varnish onto all the surfaces of the tooth with the brush. ?
Fluoride is available from these 3 major sources.
What is
1. tap water
2. home administered fluoride (like toothpaste)
3. professionally applied (like varnish)?
Oral chelation therapy is recommended for a venous lead level between these parameters and involves Succimer 10 mg/kg/dose given orally every 8 hours for 5 days then every 12 hours for an additional 14 days.
What is >44 mcg/dL and 70 mcg/dL?
This is when fluoridated toothpaste should be used first.
What is when the first tooth erupts?
These 3 are the biggest risk factors for elevated lead levels in children.
What are
1. poverty
2. old housing
3. non-Hispanic Black race?
This is the level that acute clinical symptoms of lead typically appear, such as gastrointestinal upset, anemia, and encephalopathy.
What is 60 mcg/dL?
Sources of lead, excluding the most common source, include coatings on miniblinds made before 1998, smelters, glazes on imported pottery and ceramics, imported toys, cosmetics, folk remedies, spices and these 2 common substances outside and around a home.
What is water and soil?
After this age there is no further risk of fluorosis except for the third molars because all of the other permanent teeth enamel is fully mineralized.
What is age 8 years?
These 3 items are instructions given to parents after dental varnish application.
What is
1. child can eat and drink immediately after
2. eat soft foods
3. don't brush teeth until morning ?
Studies have shown that above 5 mcg/dL, children display increases in antisocial behavior and hyperactivity along with a significant reduction on a standardized test in these 3 areas.
What is
1. reading
2. writing
3. spelling?
For the highest lead levels, children are admitted to the hospital for chelation therapy using either of these 2 agents.
What is
1. calcium disodium EDTA or
2. BAL British Anti-Lewisite?
These are the 5 risk factors for dental caries.
What is: 1. Mom with active decay past 12 mo. 2. Mom without dental home. 3. continual use of bottle/sippy cup 4. frequent snacking 5. special healthcare needs
Lead levels tend to peak around this age, although the chronic impact of lead on IQ, scholastic performance, and behavior is usually not measurable until this age.
What is age 2 years and age 5 years?
If a child has an elevated lead, moderately, the pediatrician should discuss the child's diet with a focus on these 2 nutrients.
What are iron and calcium?
Fluoride promotes one thing, reduces one thing, inhibits these as well.
What is
1. promotes enamel remineralization
2. reduces enamel demineralization
3. inhibits bacterial metabolism and acid production?
Before beginning fluoride supplementation, this factor needs to be thoroughly assessed.
What is ALL potential sources of fluoride?
The optimal fluoride concentration in drinking water is this, which is an amount proven beneficial in reducing tooth decay.
What is 0.7 ppm
0.7mg/L?
While 89% of infants and 1-year-olds have office-based physicians visits annually, only this % have general dental visits.
What is 3.6%?
There are several protective factors against dental caries. Choosing less cariogenic foods, limiting carbohydrate consumption, limiting snacking, and flossing teeth daily plus these three additional instructions.
What is
1. brush teeth twice daily
2. expose teeth to fluoride
3. receive regular dental assessments ?