4.8.14

Dental interventions to prevent caries in children. A national clinical guideline

http://www.sign.ac.uk/pdf/SIGN138.pdf

Scottish Intercollegiate Guidelines Network (SIGN). Dental interventions to prevent caries in children. A national clinical guideline. Edinburgh (Scotland): Scottish Intercollegiate Guidelines Network (SIGN); 2014 Mar. 45 p.

Acceso a texto completo

Major Recommendations
Note from the Scottish Intercollegiate Guidelines Network (SIGN) and National Guideline Clearinghouse (NGC): In addition to these evidence-based recommendations, the guideline development group also identifies points of best clinical practice in the full-text guideline document.
The grades of recommendations (A-D) and levels of evidence (1++, 1+, 1-, 2++, 2+, 2-, 3, 4) are defined at the end of the "Major Recommendations" field.
Predicting Caries Risk
Carries Risk Assessment
C - The following factors should be considered when assessing caries risk:
  • Clinical evidence of previous disease
  • Dietary habits, especially frequency of sugary food and drink consumption
  • Social history, especially socioeconomic status
  • Use of fluoride
  • Plaque control
  • Saliva
  • Medical history
D - Specialist child healthcare professionals should consider carrying out a caries risk assessment of children in their first year as part of the child's overall health assessment.
D - Children whose families live in a deprived area should be considered as at increased risk of early childhood caries when developing preventive programmes.
Delivery of Dental Brief Interventions in the Practice Setting
Effectiveness of Dental Brief Interventions
B - Oral health promotion interventions should facilitate daily toothbrushing with fluoride toothpaste.
Format of Dental Brief Interventions
B - Oral health promotion interventions should be based on recognised health behaviour theory and models such as motivational interviewing.
Social Determinants of Oral Health
C - As part of the patient assessment, a social history should be taken which will contribute to dental brief interventions being specific to individuals and tailored to their particular needs and circumstances.
Toothbrushing with Fluoride Toothpaste
Concentration of Fluoride Toothpaste
A - Following risk assessment, children and young people up to the age of 18 years who are at standard risk of developing dental caries should be advised to use toothpastes in the range 1,000 to 1,500 parts per million fluoride (ppmF).
- Following risk assessment, children aged from 10 to 16 years who are at increased risk of developing dental caries should be advised to use toothpastes at a concentration of 2,800 ppmF.
Frequency and Duration of Brushing
Frequency of Toothbrushing
A - Toothbrushing with fluoride toothpaste should take place at least twice daily.
Supervised Toothbrushing
A - Supervision of toothbrushing with fluoride toothpaste is recommended as an effective caries prevention measure.
Toothbrushing Practice
A - Children should be encouraged to spit out excess toothpaste and not rinse with water after brushing.
Topical Anticaries Interventions
Topical Fluoride Varnish
A - Fluoride varnish should be applied at least twice yearly in all children.
Sealants
Use of Sealants
A - Resin-based fissure sealants should be applied to the permanent molars of all children as early after eruption as possible.