Indian children in our community

1. Indian children in our community

2. Oral Health of immigrant children • 80% more decay in their baby teeth • 30% more decay in their adult teeth compared to the average population

3. Poverty • Approximately 40% of India lives below the poverty line

4. How does this affect the children? • About 46% of Indian children suffer from malnutrition • Less likely to get medical attention

5. Language barriers • Difficult to communicate • Discourages parents to seek help“on occasions, parents did not seek medical help due to language difficulties”

6. Disease • A study found that there is a growing minority of Indian children with type II diabetes • Decreased alveolar bone

7. Why is the oral health status of immigrant children important? • Everyone deserves a chance • Money doesn’t have to be spent on preventable oral diseases

8. brush your teeth 2 times a day In the morning At night before bed Hold the brush against your teeth, press gently, and jiggle the toothbrush back and forth

9. floss every night before you brush your teeth at bed time Slide the floss between your teeth using a “c” shape Hold the floss between your fingers

10. what is DENTAL CARIES? http://www.southasianforumpsychiatry.com/recognize-early-dental-caries/

11. DENTAL CARIES: RISK FACTORS • Physical risk factors • Behavioral risk factors • Other factors

12. DENTAL CARIES: PREVENTION • Trend towards less operative intervention and focus on prevention of caries • Relies on accurate dental diagnosis • Relies on patient’s self-administered care • Regular brushing and flossing

13. FLUOROSIS Got Fluorosis? What is it?

14. WhY WORRY? • Increased enamel porosity • Self-esteem and confidence • Evidence that children with fluorosis have higher rates of bone fracture compared to children with no signs of fluorosis

15. whaT’S THE “OPTIMAL” DOSE? • Problems • Hard for parents to quantify this amount • Sources of Fluoride ? • Toothpaste brands don’t all follow these units • How to convert?

16. what is a healthy diet? Variety of foods: • Fruits • Vegetables and Legumes • Lean Meat, fish, poultry, eggs, nuts • Breads, cereals, rice, pasta and noodles Milk, yoghurt and cheese

17. 4-5 1-2 3 3-6 1-2

18. cariogenicity of foods • Form of Food and Delivery 2. Frequency ofConsumption 3. Nutrient composition and Saliva Stimulation 4. Fluoridation of Water and Substituting Bottled Water and Sugary Drinks

19. Form of Food and Delivery • Sticky Foods • Long-Lasting Foods • Liquids

20. Frequency of Consumption • Sugars exposure • Higher frequency and High Amounts is Bad • Plaque • Number of Meals every Day

21. nutrient composition and saliva stimulation • Fermentable Carbohydrates • Consuming dairy with snacks or meals • Dairy stimulates saliva production • Milk, flavoured milk. • Cheese effect on bacteria. • Components that affect tooth decay

22. importance of drinking fluoridated water and substitution • Fluoride is proven to prevent Tooth Decay. • A 1992 Blue Mountains study E • What Happens after Fluoridation ends? • Why encourage change/substitution?

23. the balancing act

24. Paan and gutka is bad for your oral health! • What is Paan and Gutka? Tobacco Areca Nut Spices

25. why is it bad for oral health? Tobacco Carcinogens OralCancer Areca Nut Submucous Fibrosis Abrasion (1)

26. if your tooth falls out, put it in milk and see your dentist as soon as you can What is dental trauma?A physical injury to the tooth

27. why did we think it was important • Higher rate of dental trauma among Immigrant Children • Can save their tooth !

28. what to do if your tooth falls ouT It depends... • Permanent tooth e.g. Upper incisors of an 10-year-old. • Wash with milk – Do NOT scrubMilk has a similar osmolality to the environment of the periodontal ligament

29. what to do if your tooth falls out It depends... • Baby tooth e.g. A 7 year old’s upper incisors • Best to leave it out

30. losing baby teeth • -Age of losing baby teeth • - Between 6~7 • Losing baby teeth • Painless • gum discomfort • Proper care • Diet • OHI

31. oral cancer • Statistics • 70,000 new cases/year in US • 15,500 death/year in US • Prevention • no smoke • wear lip balms • wear lipsticks • Products • colour vs. transparent

32. regular visits to the dentist are important to keep your teeth and gums healthy. It is a team effort – let’s work together!

33. Reference • Poul Erik Petersen, The World Oral Health Report 2003 : continuous improvement of oral health in the 21st century – the approach of the WHO Global Oral Health Programme. Volume 31, Issue Supplement s1, pages 3–24, December 2003 • Economy Watch : Poverty in India 20011, accessible at: http://www.economywatch.com/indianeconomy/poverty-in-india.html World Bank. Inclusive growth and service delivery: Building on India’s success. 2006 • Gopinath V. Oral hygiene practices and habits among dental professions in Chennai. 2010 • Shah N. Et al. Oral Health in India : A report of the multicentric study. 2007 • Chak S. Et al. Primary Health Care for Indo-Chinese children in Australia. 2008 • Gopta PC. Et al. Oral Mucosal lesions associated with areca nut and tobacco chewing habits. 1999 • Bennett PH. Et al. Increasing prevalance of Type II diabetes in American Indian children. 1998 • Becker MP. Et al. Gylcemic control and alveolar bone loss progression in type 2 diabetes. 2008 • Sekwitz, R.H., Ismail, A., Pitts, N.B. Dental Caries Review. The Lancet. Vol 369. 2007. • Fejerskov O. Changing paradigms in concepts on dental caries: consequences for oral health care. Caries Res 2004; 38: 182–91. • De Grauwe A, Aps JK, Martens LC. Early Childhood Caries (ECC): what’s in a name? Eur J Paediatr Dent 2004; 5: 62–70. • Featherstone JD, Adair SM, Anderson MH, et al. Caries management by risk assessment: consensus statement, April 2002. J Calif Dent Assoc 2003; 31: 257–69 • Pitts NB. Are we ready to move from operative to non-operative/preventive treatment of dental caries in clinical practice? Caries Res 2004; 38: 294–304

34. Fluoride action network health effects: fluorosis 2011, accessible at: http://www.fluoridealert.org/health/teeth/fluorosis/ • Yadav JP, Lata S, Kataria S K, Kumar S. Fluoride distribution in ground water and survey of dental fluorosis among school children in the villages of the Jhajjar District of Haryana,India. Environ.Geochem.Health. 2009; 31:431-438. • Warren JJ, Levy SM, Broffitt B, Cavanaugh JE, Kanellis MJ, Weber-Gasparoni K. Considerations on optimal fluoride intake using dental fluorosis and dental caries outcomes—a longitudinal study. 2009 J Public Health Dent 69:111–115 • Macpherson, L. Conway, D.I., Gilmour, W.H., Petersson, L., and Stephen, K. Photographic assessment of fluorosis in children from naturally fluoridated Kungsback and non-fluoridated Halmstad, Sweden. ActaOdontologica Scandinavia, 2007; 65: 149-155 • Nutrition and Healthy Eating – Australian Guid to Healthy Eating 2008. Accessible at [http://www.health.gov.au/internet/main/publishing.nsf/content/health-pubhlth-strateg-food-guide-guide2.htm] • Better Health Channel, Food Variety and a Healthy Diet, 2010. Accessible at: [http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/food_variety_and_a_healthy_diet] • Touger-Decker R and van Loveren, S. Sugars and dental caries, Am J ClinNutr 2003;78(suppl):881S–92S. 2003 • Edward L. Herod MS, The effect of cheese on dental caries: A review of the literature. Volume 36, Issue 2, pages 120–125, April 1991 • Evans, R W. Hsiau, A C Y. Dennison, P J. Patterson, A. et al. Water fluoridation in the Blue Mountains reduces risk of tooth decay. Aust Dent J. 54(4):368-73, 2009 Dec. • Maupome, G. Clark, D C. Levy, S M. Berkowitz, J. Patterns of dental caries following the cessation of water fluoridation. Community Dent Oral Epidemiol. 29(1):37-47, 2001 Feb. • New Parents Guide, 2009. Accessible at: [http://www.thenewparentsguide.com/baby-teething.htm] • Oral Cancer Foundation, 2011. Accessible at: [http://www.oralcancerfoundation.org/facts/index.htm]

35. Thank you!