presenter · the mouth contains bacteria that form part of a sticky white substance called plaque....
TRANSCRIPT
Northern Devon Healthcare NHS Trust
Improving oral health
Presenter
Northern Devon Healthcare NHS Trust
• Recognise how good oral health contributes to overall health and wellbeing
• Explain the consequences of poor oral health
• Identify the causes, symptoms and ways to prevent tooth decay, gum disease and oral cancer
• Demonstrate the techniques needed to help people maintain good oral hygiene
• Locate the local pathways for accessing dental care
Learning outcomes
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Why is good oral health important?
• Take a few minutes
• Write your answers down
• We’ll discuss them
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What problems could poor oral health cause?
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Why is oral health important?
Helps prevent Enhances
Build up of plaque and tartar/calculus Communication
Decay Dignity and comfort
Gum disease Chewing/biting
Pain – tooth/abscess/soft
tissue/infection
Wellbeing through being able to eat a
range of foods
Ulcers Disposable income
Denture stomatitis Speech/singing
Bad breath Smiling
Endocarditis/aspiration pneumonia/
stomach ulcers/dementia?
Psychosocial wellbeing
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Teeth are important
Teeth are important because
they:
• Help children to eat and grow
• Keep the shape of the jaws
and face
• Help children speak
• Keep the space for permanent
teeth
• Help children to have a healthy
smile
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So what has oral health got to do with my work?
• Key to oral health
• Access to all socio-economic groups of public
• Cater from a very young age
• Can teach good habits
• Provide help and support to parents / carers
• Monitor the child and parents and refer if required
• Can refer for safeguarding issues
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Child dental health
Findings from the 2015 national dental
epidemiology
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Challenges
• What challenges are there in your role with promoting oral health
care?
• What challenges do your clients face when trying to maintain their
oral health?
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The challenge
• Difficulties in accessing dental care
• May become anxious
• Mental disability –poor cognitive skills memory
• Physical disability – may be tube fed, dysphagia
• Lack of dexterity for brushing
• May have other health problems
• Medication
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Northern Devon Healthcare NHS Trust
Early childhood decay
Is one of the most common diseases…
Might lead to:
• Extractions
• Pain
• Time off nursery/school
• Poor sleeping
• Not wanting to eat
• Crying
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Label the different types of teeth in the mouth
incisor
premolar
canine
molar
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What is enamel?
Enamel is a bit like an eggshell. It
protects the soft part of the tooth inside.
Unlike an egg’s outer layer, it's tough.
It’s the hardest substance in your body.
With good dental care it can withstand
decades of biting, chewing, and
crunching.
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What is plaque?
The mouth contains bacteria that form part of a sticky white substance called
plaque. When we eat or drink something sugary the bacteria absorbs the sugar
and converts it into acid. The acid attacks the teeth and causes
demineralisation; this is where the tooth tissue becomes softer.
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What can cause tooth decay?
• Eating and drinking lots of sugary snacks and drinks
• Not brushing teeth twice a day with fluoride toothpaste
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How teeth decay
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Stages of tooth decay
Starts as whitish lines across the gum See a dental care
professional now
Enamel breaks down
exposing the dentine
If not treated leads to rampant decay
Get URGENT dental treatment
now
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Tooth decay on back teeth
Stained fissure
Shadowing (dark areas on enamel)
becomes visible
Exposed cavities
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Frequently eating sugar leads to decay
• Can lead to obesity
• Can give rise to type 2
diabetes
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Sugar count
Take a few moments to match the
food with the amount of sugar it
contains.
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Sugar count
6
cubes
1
cube
0
cubes
6
cubes
6.5
cubes
5
cubes
4.5
cubes
3
cubes
2
cubes
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How to prevent tooth decay
Eat well Drink well
Clean well
Play well Stay well
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Eatwell
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Impact of sugar on the teeth
Demineralisation
Remineralisation
Oa
tca
ke
Gla
ss o
f w
ate
r
with
an
ap
ple
Gla
ss o
f w
ate
r
with
to
ast a
nd
ch
op
ped
ch
err
y
tom
ato
es
Bre
akfa
st
with
su
ga
r
Lu
nch
with
su
ga
r
Din
ne
r/te
atim
e
with
su
ga
r
Neutral
pH
Alkaline
pH
Acid pH
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Detrimental eating pattern for teeth
Bre
akfa
st
with
su
ga
r
Lu
nch
with
su
ga
r
Din
ne
r/te
atim
e
with
su
ga
r
Bis
cuit
Ca
ke
Me
dic
atio
n
Bis
cuit
Co
ffe
e w
ith
su
ga
r
Cup
s o
f te
a w
ith
su
ga
r
Alkaline
pH
Neutral
pH
Acid pH
Remineralisation
Demineralisation
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Safe snacks
Acknowledgement of graphic source: NSW Department of Health. Early childhood oral health guidelines for child health professionals. Sydney. NSW Department of Health, 2009
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Drink well
Only have tap water between meals. Try a special cup if not keen on
drinking water. Rinsing mouth with water after eating is a good way to
help prevent decay.
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Clean well
• Cleaning between teeth (interdental) with floss or mini bottle brushes
• Brush teeth twice a day to stop decay and gum disease. Last thing at night and at one other time during the day
• Use a small, medium textured bristle toothbrush
• Use fluoride toothpaste > 1350 ppm (see on tube)
• Spit out the toothpaste but don’t rinse
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Toothbrushing • Teach and encourage parents to brush their
children’s teeth until they are at least 7 years old
• Use small headed, soft to medium bristled toothbrush
• Use a dry toothbrush
• Brush two or three teeth at a time, also brush the gums
• Allow the child to spit out but don’t rinse mouth with water
• Rinse brush
• Change toothbrush every 3 months
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Toothbrushes
• Collis curve
• Dr Barman’s Superbrush
• Adapted handle
• Electric brush
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Disclosing tablets
Plaque is the same colour as the teeth and hard to see. Disclosing
tablets can be used to stain the plaque a different colour.
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Disclosing tablets – what happens
plaque
on gums
plaque
between
teeth
plaque
on teeth
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Toothpaste
• Children up to 3 years - use a smear of fluoride toothpaste
containing no less than 1,000ppm
• Children aged 3 to 6years - use a pea size amount of
fluoride toothpaste containing more than 1,000ppm
• Children aged from 7 and adults – use a pea size amount
of fluoride toothpaste with at least 1350ppm
Don’t share toothbrushes
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Toothbrushing
1 2
3 4
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Interdental cleaning
• For reaching in between the
teeth where the tooth brush
does not reach
• Reduces the chances of decay
(in between teeth) and gum
disease
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Stages of gum disease
Healthy Gingivitis
Moderate
periodontitis
Severe
periodontitis
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Oral cancer
If in doubt, get
it checked out!
Risk factors include smoking, alcohol consumption, poor diet and HPV
(human papilloma virus)
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Play well
• Encourage the use of a good
fitting mouthguard for contact
sports
• If you hurt your mouth or teeth get
advice straight away
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Stay well – how you can check for decay
Children should have their
first check up before they are
1 year old
Gently lift the lip to check for
tooth decay
Choose sugar free medicine
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Visit the dentist regularly
Northern Devon Healthcare NHS Trust
How can I find an NHS dentist
Yes
Find a local dentist to register with:
NHS Choices: http://www.nhs.uk/Service-Search/Dentist/LocationSearch/3
or Call: NHS Devon Dental Helpline 0333 006 3300
or Email: [email protected]
Quote NHS1 when responding
Are you registered with a
dentist?
No
Contact your dentist to book an appointment
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Urgent (emergency) care
Yes
Are you registered with a
dentist?
Yes
Contact
dentist Call:
NHS Devon Dental
Helpline 0333 006 3300
or
01392 405700
Are you calling out of
hours?
(evening/weekend/bank
holidays)
No
Call :
NHS Devon Dental
Helpline 0333 006
3300
or
NHS 111 No
Northern Devon Healthcare NHS Trust
Special care dental service
Referral from dentist, GP or other
health/social care professional Forms available on:
http://www.healthyteethdevon.nhs.uk/
Special Care Dental Service
RD&E Hospital (Heavitree) &
Barnstaple Health Centre
Northern Devon Healthcare NHS Trust
Costs
• Entitlements are listed on NHS
choices:
http://www.nhs.uk/NHSEngland/He
althcosts/Pages/Dentalcosts.aspx
• Penalty charge of up to £100, in
addition to the cost of NHS dental
treatment.
If unsure pay, check and claim
it back- keep the receipts
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Finally
• How does good oral health contribute to overall health and
wellbeing?
• What are the consequences of poor oral health?
• What are the key prevention messages?
• How can you find a local dentist?
Northern Devon Healthcare NHS Trust
Oral health improvement team Oral Health Improvement Team
Salaried Dental Service
Third Floor Dental Access Centre
Royal Devon & Exeter Hospital (Heavitree)
Gladstone Road
Exeter
EX1 2ED
Email: [email protected]
Tel: 01392 405705
www.healthyteethdevon.nhs.uk
Northern Devon Healthcare NHS Trust
Questions?