Infant Oral Care Model

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Infant Oral Care Model

• Anne Gibbs, RDH, BS

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Infant Oral Care Model
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Infant Oral Care Model

• Caries Risk Assessment
• Parent Interview
• Knee to Knee Exam
• Results
• Appling Fluoride Varnish
• Education to Caregiver
• Self Management Goal Setting

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Caries Risk Assessment
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Caries Risk Assessment

• Three Parts
• Parent Interview
• Knee to Knee Exam
• Results

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Caries Risk AssessmentParent Interview

• Does parent have any questions about childs
  teeth?
• Use open ended questions / conversational
• Make eye contact with the parent
• Keep the child occupied
• Look around! Did the child come with a bottle of
  apple juice??
• Most of these questions you already ask at the
• Well Child Visit ?

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Caries Risk AssessmentParent Interview

• Pediatric Oral Health Screening Form
• Caries Risk Indicators
• Mother/primary caregiver has had active dental
  decay in past 12 months
• Older siblings with history
• of dental decay

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Caries Risk AssessmentParent Interview

• Pediatric Oral Health Screening Form
• Caries Risk Indicators
• Continual use of bottle containing beverages
  other than plain water (nothing added). Bottle
  use gt 12 months old
• Child sleeps with a bottle or nurses on demand
  after any teeth have erupted

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Caries Risk AssessmentParent Interview

• Pediatric Oral Health Screening Form
• Caries Risk Indicators
• Frequent (greater 3X/day total) candy
  carbohydrate snacks, soda, sugared beverages,
  fruit juice

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Caries Risk AssessmentParent Interview

• Pediatric Oral Health Screening Form
• Caries Risk Indicators
• Medical Risks
• Saliva-reducing meds (asthma, seizure,
  hyperactivity, etc.)
• Developmental problems
• History of anemia or iron therapy
• Daily liquid medications

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Caries Risk AssessmentParent Interview

• Pediatric Oral Health Screening Form
• Protective Factors
• Child lives in a fluoridated community AND drinks
  tap water daily
• Teeth cleaned with a fluoridated toothpaste smear
  twice daily

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Caries Risk AssessmentParent Interview

• Pediatric Oral Health Screening Form
• Protective Factors
• Child has a dental home and regular dental care

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Caries Risk Assessment Knee to Knee Exam
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Caries Risk Assessment Knee to Knee Exam

• Analogy Like changing a diaper
• (but not as messy)
• Painless
• Necessary
• Quick
• Child may cry

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Caries Risk Assessment Knee to Knee Exam

• Materials needed
• Parent to help
• Cloth to cover your lap (prevent fl messes)
• Gloves
• Childs toothbrush
• Tooth mirror
• Gauze
• Fluoride varnish

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Caries Risk Assessment Knee to Knee Exam
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Caries Risk Assessment Knee to Knee Exam
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Caries Risk Assessment Knee to Knee Exam
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Caries Risk Assessment Knee to Knee Exam

• Using childs toothbrush, evaluate the teeth for
  obvious plaque /or bleeding gums

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Caries Risk Assessment Knee to Knee Exam

• Using the tooth mirror, look for
• Obvious white spots or decay

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Apply Fluoride Varnish

• DONE WITH KNEE TO KNEE EXAM
• Fluoride Varnish is easy to apply
• No precision needed just get it on the tooth
  surface
• Stuff is sticky!
• Try not to get it on your clothes
• Avoid getting in childs hair

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Apply Fluoride Varnish
Apply thin coat to all erupted teeth
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Caries Risk Assessment Results

• Based on the Risk Assessment
• Verbal Interview Visual Exam Risk
• What is the likelihood that the child will
  develop the disease CARIES?

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Caries Risk Assessment Results

• High Risk
• 3 mos recare (fluoride varnish)
• Knee to knee at every visit
• Refer to dental home
• Low Risk
• 6 mos recare (fluoride varnish)
• Refer to dental home

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Education to Caregiver

• Resulting from the Caries Risk Assessment, what
  are some things the parent can do to improve the
  oral health of their child?

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Education to Caregiver

• Regular Dental Care
• 1st dental visit should be by age 1
• Recommend recare visits as per results of Caries
  Risk Assessment
• Does parent know where to find a
• dental provider?

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Education to Caregiver

• Diet Foods
• Provide healthy foods drinks for your family.
• Eat more fruits, vegetables, milk, and cheese
• Limit number of exposures to sugary foods
  drinks (less than 3 a day)
• After consuming sugary food/drink, the mouth is
  in an acidic/cavity causing environment for 20
  minutes!

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Education to Caregiver

• Brushing
• Clean babys teeth after feedings
• Help your child brush until he can write in
  cursive
• Brush at least morning before bed, using a
  fluoride toothpaste

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Education to Caregiver

• Fluoride
• If the community is fluoridated, suggest drinking
  tap water
• If family wont drink tap water, suggest Nursery
  Water, bottled water
• that contains fluoride

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Education to Caregiver

• Keep Germs to Yourself
• Avoid sharing toothbrushes drinks
• Avoid putting things in your mouth then your
  babys mouth
• Keeping the entire familys teeth healthy keeps
  from spreading cavity causing bacteria.

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Education to Caregiver

• Bottle Sippy Cup Use
• Only water in sippy cup.
• Water only at bedtime.
• Clean babys teeth after feedings.
• No bottle propping!

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Education to Caregiver

• Diet Drinks
• Drink more water, less juice and soda
• Dilute fruit juices with an equal amount of water
• Limit number of exposures to sugary foods
  drinks (less than 3 a day)
• After consuming sugary food/drink, the mouth is
  in an acidic/cavity causing environment for 20
  minutes!

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Self Management GoalSetting

• Part of Motivational Interviewing Counseling
• Successful in change behaviors related to alcohol
  drug addiction
• Research supports that it can help manage
  non-addictive problems ie. diabetes control

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Self Management GoalSetting

• Study published in JADA 2004, suggests that
• Motivational interviewing counseling has an
  effect on childrens health that is greater than
  the effect of traditional health education.
• JADA 2004 135 731-738

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Self Management GoalSetting

• Old School
• YOU MUST FLOSS!

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Self Management GoalSetting
New Philosophy What CAN you do to improve your
childs health?
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Self Management GoalSetting

• Using Self Management Goal Sheet
• Establish a Self Management Goal
• Be sure not to influence the goal with your own
  personal opinion!
• Keep conversation open

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Self Management GoalSetting

• Asking for Self Management Goals
• What is something you could work on to improve
  your childs dental health?
• Here are some ideas of ways to help your child to
  have healthy teeth. What could you do better?
• Sounds like you want to prevent Child from having
  teeth like his siblings. What could you do
  differently this time around?

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Self Management GoalSetting

• Using Self Management Goal Sheet
• Document 1 or 2 Goals
• Identify When ie. during bathtime
• Identify how often ie. twice a day
• Document confidence level (should be 7-9)
• Parent Witness sign
• Give copy to parent
• FOLLOW UP!

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Infant Oral Care Model

• Caries Risk Assessment
• Parent Interview
• Knee to Knee Exam
• Results
• Appling Fluoride Varnish
• Education to Caregiver
• Self Management Goal Setting

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Infant Oral Care Model

• Take Home Message
• CAVITIES ARE 100 PREVENTABLE!

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GoalAvoid Bad Experiences
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Goal Happy, Healthy Children
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Infant Oral Care Model

• Questions?