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 compare to other children (1)

3. Poverty • Approximately 40% of India lives below the poverty line (2)

4. How does this affect the children? • About 46% of Indian children suffer from malnutrition (3)

5. How does this affect the children? • About 46% of Indian children suffer from malnutrition (3) • Less likely to get medical attention

6. Awareness/emphasis on oral health • Less than 20% of the interviewed Indian Dentists them followed recommended oral self care (4) • Up to 90% of some sub populations (States) in India have untreated dental caries (5)

7. Language barriers • Approximately 35% of immigrants possess the necessary literacy levels to function adequately in a modernised, knowledge based economy (6)

8. How does it affect the children? • Firstly, it makes it more difficult to convey important information about taking care of their teeth • Discourages parents to seek help“on occasions, parents did not seek medical help due to language difficulties” (7)

9. diet and other cultural related behaviours • E.g. Tobacco chewing • These behaviours are reinforced into the children

10. Disease • A study found that there is a growing minority of Indian children with type II diabetes (8) • Decreased alveolar bone (9)

11. Why is the oral health status of immigrant children important? • Everyone deserves a chance

12. 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

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

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

15. 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

16. 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

17. 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

18. FLUOROSIS Got Fluorosis? What is it?

19. 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

20. whaT’S THE “OPTIMAL” DOSE? • widely accepted for decades as between 0.05 and 0.07 mg fluoride per kilogram of body weight • Problems • Hard for parents to quantify this amount • Sources of Fluoride • Fluorinated drinking water, Toothpaste • Toothpaste brands don’t all follow these units • How to convert?

21. 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 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]

22. 4-5 1-2 3 3-6 1-2 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]

23. 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

24. Form of Food and Delivery • Sticky Foods • Long-Lasting Foods • Liquids Touger-Decker R and van Loveren, S. Sugars and dental caries, Am J ClinNutr 2003;78(suppl):881S–92S. 2003

25. Frequency of Consumption • Sugars exposure • Higher frequency and High Amounts is Bad • Plaque • Number of Meals every Day Touger-Decker R and van Loveren, S. Sugars and dental caries, Am J ClinNutr 2003;78(suppl):881S–92S. 2003

26. 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 1. 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 2. Better Health Channel, Milk: Facts and Fallacies. Accessible at: http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Milk_the_facts_and_fallacies

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

28. the balancing act Touger-Decker R and van Loveren, S. Sugars and dental caries, Am J ClinNutr 2003;78(suppl):881S–92S. 2003

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

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

31. 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

32. why did we think it was important • Higher rate of dental trauma among Immigrant Children • Parents may not know what to do • Can save their tooth !

33. what to do if your tooth falls our It depends... • Permanent tooth e.g. Upper incisors of an 10-year-old.Wash with milk – Do NOT scrub or wash with water Milk has a similar osmolality to the environment of the periodontal ligamentPut back in socket and see the dentist !

34. 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

35. if you hit your tooth and it falls our, put it in milk and see your dentist as soon as possible. • The milk will preserve the ligament • The dentist will decide what to do

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

37. 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

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