3. Periodontal Disease Prevention Flashcards by J L

Healthy Periodontium

____
____ Bone
____
____

gingiva
alveolar
periodontal ligament
cementum

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Periodontal Disease Model

____ burden > ____ host > epithelium, connective tissue & bone ____ > bleeding, pockets, loss of attachment & bone loss

infectious
susceptible
metabolism

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Risk Factors for Periodontal Diseases

____ & ____ Host Factors

____ & ____

innate
acquired
environment
biofilm

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Periodontal Disease Risk Assessment

Innate factors:
____
gender
____
congenital conditions
Acquired Risk Factors:
____
medications
____
income, SES
Environmental Factors:
poor ____
tobacco use
infrequent ____
occlusion

age
race
diabetes/systemic conditions
stress/nutrition
oral hygiene
dental care

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Risk factors for perio disease

Non-modifiable: ____, ____, race, congenital coniditons

Modifiable: ____, poorly controlled diabetes, ____, osteoporosis, low diet ____, stress/inadequate coping

age
gender
smoking
obesity
calcium/vitamin D

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Monitor Health Status

____ routine
____ testing readily available
collaborate with ____
educate patient about ____ to identify & reduce complex interaction of ____

health history
laboratory
primary care providers
risks
risk factors

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Oral Complications in Diabetics

Increased ____ and Periodontitis
____, Xerostomia Enlarged ____ Gland
Caries, Tooth Loss
____ Dysfunction, Burning Mouth

gingivitis
thrush
parotid
taste

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Change Local Environmental Factors

identify & eliminate ____ restorations
eliminate ____ depth
complete ____ therapy
evaluate & adjust occlusion

iatrogenic
pocket
orthodontic

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Quitting Tobacco Essential in Periodontal Care

More than 50% of adult periodontal cases are attributable to ____
In current smokers ____ of cases may be caused by smoking

cigarette smoking

75%

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Gram Negative Anaerobes

Reside ____ in pocket
Very difficult to access & control daily by patient
____
Tannerella Forsythia
____
AA: Aggregatibacter Actinomycetemcomitans

subgingivally

p. gingivalis
t. denticola

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Controlling Microbial Plaque Biofilm

____ Removal
Ø Toothbrush, Interdental Cleaners
Ø Water Pic (Oral Irrigator)

Antimicrobial Rinses & Toothpastes
Ø Rinses: 0.12% Chlorhexidine, ____ or Cetylpyridium Chloride
Ø Toothpaste: ____ or .0454 Stannous Fluoride

mechanical
essential oils
3% triclosan

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Target Bacteria

Mechanical \_\_\_\_ Removal
\_\_\_\_ Rinses &amp; Toothpastes
\_\_\_\_ placed antiseptics or antibiotics (gels or threads)
\_\_\_\_ Antibiotics
\_\_\_\_ Therapy

plaque
antimicrobial
locally
systemic
pocket reduction

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Identify and Increase Patient’s ____ Level

educational

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Use Disclosing Solution To Visualize ____

plaque biofilm

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____ Index
Gingival Bleeding on Probing or Instrumentation

Practice Teaching ____ Skills

Bleeding

Oral Hygiene

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Brush Your Teeth And Gums

Brush ____ a day???
Use a ____ toothbrush
Bass & Modified Bass Method (Sulcular Brushing)
Angle the bristles into the ____, gently wiggle brush against tooth, roll remaining surface
____ stroke
Fones: ____ brushing
Stillmans, Charter
Don’t forget your ____

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twice
soft
gum line
rolling
circular
tongue

Powered Brushing

3 Basic Types

____ Battery Powered
- ____ brush, ____
Rechargeable Battery
- Braun Oral B
Sonice Rechargeable Battery
- Sonicare, Braun Sonic

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AA
spin
actibrush

Power Toothbrushes

removes ____, stain and reduces gingivitis greater than manual brushing
reduce physical & ____ skill needed for brushing
easier to use for ____
easier to brush someone else’s ____

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plaque
cognitive
children
teeth

Power Brushes Remove More Plaque in Same Time

Percentage Reduction of Plaque Over ____

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time

Cochrane Collaboratio, 2003

comparisons difficult to differing research designs
____ (oral B braun) most effective in reducing plaque, gingivitis and bleeding

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rotation oscillation

Floss Between Your Teeth

use floss daily
stretch floss between fingers
glide floss between teeth, slide floss under gums
scrape floss against side of tooth
no difference ____ floss

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waxed/unwaxed

Research base for flossing

cochrane systematic review shows evidence that ____ plus toothbrushing reduced gingivitis, with weak evidence of plaque reduction
____ flossing reduced interproximal caries risk
____ brushes remove more plaque & reduce gingivitis as well as flossing

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flossing
professional
interproximal

Antiseptic Agents Mouth Rinse, Toothpaste

0.12% \_\_\_\_ Rinse
• \_\_\_\_ Mouth Rinse
• 0.454% \_\_\_\_ Fluoride Toothpaste
• .3% \_\_\_\_ Toothpaste,
2% \_\_\_\_ Copolymer, 0.2% \_\_\_\_

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chlorhexidine gluconate
essential oil
stannous
triclosan
gantrez
sodium fluoride

0.12% Chlorhexidine - Anti-plaque, anti-gingivitis

complete ____ kill in 30s with a 15ml rinse 2x a day
controls gingivitis & ____
disrupts ____
substantive for ____ hours
available in ____ free versions, check label

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microbial
candida
cell wall
12
alcohol

0.12% Chlorhexidine -anti-plaque, anti-gingivitis - ____ stain - strong ____ - reduces ____ - interacts with ____ in toothpaste - DO NOT USE in ____, CHX will be rendered inactive

``` brown flavor taste SLS (sodium lauryl sulfate) combination ```

Essential Oil Mouth Rinse - anti-plaque, anti-gingivitis - listerine mouthrinse, & other generic products - thymol, menthol, eucalypotl, methyl salicylate disrupt ____ & function - ____ spectrum antiseptic, also targets ____ from gram negative - ____ alcohol concentration, LISTERINE Zero - Use a 20ml rinse full strength for 30 seconds ____ daily - check label for therapeutic versions

``` cell wall broad endotoxins 21/28% twice ```

Ethanol Mouthrinses & Risk for Oral Cancer: Conflicting Evidence, Consensus: Safe with Caution - Meta analysis revealed no statistically significant association bt EtOH containing mouthrinses & ____ - 10 reviews/6 case control studies against an ____, with 1 review/9 case control studies supporting ____ - conclusion: mouthrinses considered safe - recommendation: use with caution, continue to develop ____ versions

cancer association association non-alcoholic

0.07% CPC - crest pro health rinse, colgate total rinse - Alcohol Free Rinse Makes Anti-Plaque & Anti- Gingivitis Claims, No ____ Seal - “____” Essential Oils in Reducing, Plaque, Gingivitis & Bleeding Garcia, J Evid Based Dent Practice, 2008 - feres, JADA, 2010 - variations in products (crest complete + fluoride)

ADA | at least as good as

Research Base for Rinsing - ____ and ____ effective in reducing plaque and gingivitis (Boyle, 2013) - ____ plus brushing reduces more plaque and gingivitis than brushing & flossing (Sharma, 2004) - ____ equivocal - ____ rinse reduces caries in both children and adults

``` CHX essential oil essential oil CPC sodium fluoride ```

0.3% Triclosan Toothpaste, 2% Gantrez Copolymer, 0.243% Sodium Fluoride - anti-plaque, anti-gingivitis, anti-caries - formulated in toothpaste (colgate total) that is accepted for antiplaque, antigingivitis, anticaries and tartar control claims - anti-bacterial effects - 24% less ____, 57% less ____, 14% ____ - anti-inflam effects - reduces markers of inflammation: ____, IL1b, ____, CRP

plaque biofilm gingivitis caries reduction PGE2 TNFa

0.3% Triclosan Colgate Total - ____ Copolymer Ensures Stability & Twelve Hour Substantivity - Triclosan provides anti____ and anti-____ ____ spectrum action - ____ reduces dentin hypersensitivity and also reduces calculus - reduces decay due to ____

``` PVM/MA septic inflammatory broad zinc chloride sodium fluoride ```

0.454% SnF2 - crest pro health - anti-plaque, anti-gingi, anti-caries - Stannous ion in fluoride stabilized with ____ - ____ reductions vary from -2 to 22.7% - ____ reductions range from 18-22% - ____ reductions 24%

sodium hexametaphosphate plaque gingivitis dentin hypersensitivity

``` Oral Irrigation: Water Flosser? As compared to floss - 50% ____ reduction - Twice as effective reducing ____ - 29% better at ____ reduction ```

gingivitis bleeding plaque

Oral Irrigation Research Best at plaque reduction: irrigation w/ ____ Best as gingivitis reduction: irrigation w/ ____

CHX | essential oils

Role of Antibiotic Agents in Treatment of Periodontal Disease - Topical gels placed ____ - - Minocycline microspheres (arestin) - - doxycycline gel (atridox) - - tetracycline threads (actisite) - - metronidazole (elyzol) - ____ full strength anti's - - tetracyclines, metronidazole, quinolone & macrolid - Systemic low dose antibiotics as ____ - - doxycycline 20mg (periostat)

subgingivally systemic host modulation

Tartar control products - ____ scavengers - reduce new calculus ____ - cosmetic, not ____ - ____ - ____

``` calcium formation therapeutic pyrophosphates zinc chloride ```

Frequent Professional Care Controls Risks For Periodontal Diseases - Periodontal Debridement Reduces ____ & ____ Biofilm and Other Deposits - Scaling and Root Planing Remove all ____ and ____ calculus - Interval Based on Patient’s ____ and Extent of ____

``` supra subgingival supragingival subgingival risks disease ```

3. Periodontal Disease Prevention Flashcards

(37 cards)