presenter · the mouth contains bacteria that form part of a sticky white substance called plaque....

Northern Devon Healthcare NHS Trust

Improving oral health

Presenter


• 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


Why is good oral health important?

• Take a few minutes

• Write your answers down

• We’ll discuss them


What problems could poor oral health cause?


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


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


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


Child dental health

Findings from the 2015 national dental

epidemiology


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?


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


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


Label the different types of teeth in the mouth

incisor

premolar

canine

molar


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.


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.


What can cause tooth decay?

• Eating and drinking lots of sugary snacks and drinks

• Not brushing teeth twice a day with fluoride toothpaste


How teeth decay


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


Tooth decay on back teeth

Stained fissure

Shadowing (dark areas on enamel)

becomes visible

Exposed cavities


Frequently eating sugar leads to decay

• Can lead to obesity

• Can give rise to type 2

diabetes


Sugar count

Take a few moments to match the

food with the amount of sugar it

contains.


Sugar count

6

cubes

1

cube

0

cubes

6

cubes

6.5

cubes

5

cubes

4.5

cubes

3

cubes

2

cubes


How to prevent tooth decay

Eat well Drink well

Clean well

Play well Stay well


Eatwell


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


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


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


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.


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


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


Toothbrushes

• Collis curve

• Dr Barman’s Superbrush

• Adapted handle

• Electric brush


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.


Disclosing tablets – what happens

plaque

on gums

plaque

between

teeth

plaque

on teeth


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


Toothbrushing

1 2

3 4


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


Stages of gum disease

Healthy Gingivitis

Moderate

periodontitis

Severe

periodontitis


Oral cancer

If in doubt, get

it checked out!

Risk factors include smoking, alcohol consumption, poor diet and HPV

(human papilloma virus)


Play well

• Encourage the use of a good

fitting mouthguard for contact

sports

• If you hurt your mouth or teeth get

advice straight away


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


Visit the dentist regularly


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


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


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


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


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?


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


Questions?

presenter · the mouth contains bacteria that form part of a sticky white substance called plaque....

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