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Northern Devon Healthcare NHS Trust Improving oral health Presenter

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Page 1: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

Improving oral health

Presenter

Page 2: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

• 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

Page 3: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

Why is good oral health important?

• Take a few minutes

• Write your answers down

• We’ll discuss them

Page 4: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

What problems could poor oral health cause?

Page 5: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

Why is oral health important?

Helps prevent Enhances

Build up of plaque and tartar/calculus Communication

Decay Self image

Gum disease Chewing/biting

Pain - tooth/abcess/soft tissuesKeeping the shape and

form of the face

UlcersRetain space for

permanent teeth

Bad breath Singing

Endocarditis/aspiration pneumonia/

stomach ulcersSmiling

Page 6: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

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

Page 7: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

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

Page 8: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

Child dental health

Page 9: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

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?

Page 10: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

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

Page 11: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

Page 12: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

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

Page 13: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

Label the different types of teeth in the mouth

incisor

premolar

canine

molar

Page 14: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

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.

Page 15: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

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.

Page 16: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

What can cause tooth decay?

• Eating and drinking lots of sugary snacks and drinks

• Not brushing teeth twice a day with fluoride toothpaste

Page 17: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

How teeth decay

Page 18: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

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

Page 19: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

Frequently digesting sugar leads to decay

• Can lead to obesity

• Can give rise to type 2

diabetes

Page 20: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

Sugar count

Take a few moments to match the

food with the amount of sugar it

contains.

Page 21: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

Sugar count

6

cubes

1

cube

0

cubes

6

cubes

6.5

cubes

5

cubes

4.5

cubes

3

cubes

2

cubes

Page 22: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

How to prevent tooth decay

Eat well Drink well

Clean well

Play well Stay well

Page 23: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

Eatwell

Page 24: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

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

Page 25: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

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

Page 26: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

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

Page 27: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

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.

Page 28: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

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

Page 29: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

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

Page 30: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

Toothbrushes

• Collis curve

• Dr Barman’s Superbrush

• Adapted handle

• Electric brush

Page 31: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

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.

Page 32: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

Disclosing tablets – what happens

plaque

on gums

plaque

between

teeth

plaque

on teeth

Page 33: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

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

Page 34: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

Toothbrushing

1 2

3 4

Page 35: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

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

Page 36: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

Stages of gum disease

Healthy Gingivitis

Moderate

periodontitis

Severe

periodontitis

Page 37: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

Oral cancer

If in doubt, get

it checked out!

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

(human papilloma virus)

Page 38: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

Play well

• Encourage the use of a good

fitting mouthguard for contact

sports

• If you hurt your mouth or teeth get

advice straight away

Page 39: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

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

Page 40: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

Visit the dentist regularly

Page 41: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

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

Page 42: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

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

Page 43: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

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

Page 44: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

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

Page 45: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

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?

Page 46: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

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

Page 47: Presenter - Healthy Teeth Devon

Northern Devon Healthcare NHS Trust

Questions?