Children insured by a statutory health insurance fund between the ages of six and seventeen are entitled to dental individual prophylaxis (IP) services, known as IP services. These support the parents’ efforts at home to maintain their child’s oral hygiene by addressing the child’s individual characteristics. As a result of good dental health education, many parents have become increasingly aware in recent years that the care of their child’s teeth plays a crucial role from the very first milk tooth. If children learn from the very beginning that brushing their teeth is part of their daily routine, this will benefit not only their baby teeth, but also the health of their permanent teeth and periodontium (the tooth-supporting apparatus) for the rest of their lives.
IP1: As part of the IP1, a so-called oral hygiene status is established:
- To demonstrate bacterial plaque, dental plaque is made visible to the children using plaque revelers (usually staining liquid). They are thus given valuable assistance in recognizing and specifically improving their own oral hygiene deficits. The plaque infestation of the interdental spaces or the smooth surfaces is documented by means of suitable indices (e.g. approximal space plaque index (API) or Quickley-Hein index (QHI)), which are helpful for monitoring the progress of the improvement measures.
- Other indices are collected on the degree of inflammation of the gingiva (gums) (e.g. sulcus bleeding index (SBI) or papilla bleeding index (PBI)).
- The goal of IP1 services is to help parents and children visualize the state of oral health and thereby effect lasting behavioral changes.
IP2: serves to counsel and educate the child and, if necessary, his parents
IP2 serves to advise and educate the child and, if necessary, his parents about the individual status of oral health, causes of disease and their prevention and their relationship to the development of:
- Caries (tooth decay, bacterial destruction of the tooth structure),
- Gingivitis (inflammation of the gums) and
- Periodontitis (inflammation of the periodontium).
The following are topics that should be addressed during IP2:
- Oral hygiene counseling involves both the children themselves and their parents, who are encouraged to rebrush their child’s teeth until they learn fluent handwriting at elementary school age, after they have initially tried brushing their own teeth to gain routine.
- Oral hygiene counseling is based on the findings and questions the individual difficulties with oral hygiene at home.
- The oral hygiene consultation also includes explanations of basic prophylaxis with fluorides in toothpaste and table salt, as well as extended fluoridation options for high caries risk.
- The practical and, if necessary, playful demonstrations of age-appropriate toothbrushing technique on the model is followed by independent practice of the child under the guidance of the prophylaxis assistant.
- Kindergarten children and young school children are taught a systematic approach by means of the KAI technique (occlusal surfaces-outer surfaces-inner surfaces). With increasing motor and cognitive abilities, the most difficult to reach with the brush inner surfaces receive more emphasis (IAK).
- If the child masters the fluent handwriting, the modified bass technique can be trained.
- At the latest after the eruption of the first permanent molars, the so-called six-year molars, the interdental spaces (interdental spaces) should be cleaned with the help of dental floss to prevent the development of approximal caries.
- The recommendation of interdental brushes as a further aid to daily oral hygiene is made for open interdental spaces and for the care of fixed orthodontic appliances.
- In addition to proper oral hygiene and basic fluoride prophylaxis, nutritional counseling is a third important pillar of prevention (preventive measures).
IP4: Local (local) fluoridation of the teeth
Through various mechanisms of action on the tooth structure and bacterial metabolism, fluoride has a caries-protective effect (protective against caries). A calcium fluoride top layer forms on the tooth surface after fluoride application.Acting as a depot, it releases fluoride to the tooth surface when exposed to acid, thus reducing its acid solubility and demineralization (softening by dissolving out mineral particles). Regular fluoridation in the dental practice thus represents a very sensible measure – even beyond the billing period of 6 to 17 years – to keep caries growth as low as possible or, in combination with home prophylaxis, ideally to prevent it altogether.
- Highly fluoride-containing varnishes such as Duraphat and Bifluoride 12 are applied to dry teeth using brushes or minibrushes (mini brushes). Alternatively, jellies such as Elmex Gelée or Sensodyne ProSchmelz Fluoride Gelée can be applied using fluoridation trays.
- IP4 is performed twice a year, up to four times for children at high risk of caries.
- The IP4 is an exception to the age rule, as it can be performed from 30 months of age in cases of high caries risk.
Indication (indications): fluoride varnishes are indicated in children and adolescents with increased caries risk.
IP5: Fissure sealing
Fissure sealing is available as an IP service on caries-free fissures of the permanent molars (large, posterior molars). The first to be affected is the so-called six-year molar. Sealing can also be useful on premolars (small anterior molars) or deep pits of the incisors; in these cases, however, IP5 cannot be used for billing purposes. Take advantage of these preventive and treatment options for your child to keep their baby teeth healthy for a long time and protect their permanent teeth from decay and gum disease right from the start.
