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ICS1 > MIDTERM 1: cariology/products > Flashcards

MIDTERM 1: cariology/products Flashcards

1
Q

what is the pH of saliva, what minerals are in it

A

greater than 5.5, HCO3 (Ca2+., PO3-)

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2
Q
A
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3
Q

what is the critical dentin ph

A

6.2-6.8

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4
Q

what are the protective factors for caries ON TEST!

A

SAFER

saliva and sealants

Antibacterials

Fluoride,ca, po4

effective lifestyle habits

risk based reassessment

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5
Q

what are the risk factors for caries (ONTEST)

A

BAD

bad bacteria

absence of saliva

destructive lifestyle habits

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6
Q

what are disease indicators for caries (ONTEST)

A

WREC

white lesions

restorations less than 3 yrs

enamel lesions

cavities/dentin

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7
Q

what is the clinical presentation of ICDAS 1/ ICDAS 2?

A

earliest clinically detectible lesions. indicates mild demineralization. lesion limited to enamel or to shallow demineralization of cementum/dentin. mildest forms are only detectable AFTER DRYING!!!! when established and active, may be white or brown and enamel has lost its normal gloss. (icdas2)

-infected dentin is UNLIKELY.

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8
Q

whats the clinical presentation of ICDAS 3 and ICDAS 4

A

moderate

visible signs of enamel breakdown or signs dentin is moderately demineralized. established, early cavitated, shallow cavitation or microcavitation. dentin demineralization is pOssible!!

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9
Q

whats the clinical presentation of ICDAS 5 or 6

A

advanced

enamel is fully cavitated and dentin is exposed. dentin lesion is deeply/severely demineralized. spread/disseminated, late cavitated or deep cavitation.

-dentin demineralization for sure

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10
Q

when on icdas scale do you never do surgical intervention?

A

0,1, and 2

-chemical treatment only!

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11
Q
A
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12
Q

how do E1, E2 and D1 come up on radiograph

A

or ra1, ra2, ra3

-radiolucency may extend to dentinoenamel junction or outer one third of dentin.

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13
Q

how does d2 come up on radiograph

A

or rb4

radiolucency extends into middle one third of the dentin

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14
Q

how does d3 come up on radiograph

A

or rc5. radiolucency extends into the inner one third of the dentin

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15
Q

which radiographic groups require no surgical treatment

A

e0,e1,e2,d1

d1 SOMETIMES depends..

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16
Q

when (radiograph classification) is surgery required

A

d2 and d3

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17
Q

what are the 5 overall strategies /treatments for caries management (not surgical)

A
  • pH neutralization (reduces growth/acid production of cariogenic bacteria- supports healthy bacteria)
  • antibacterial
  • fluoride (aids in remineralization, inhibits acid production of cariogenic bacteria)
  • xylitol -reduces growth and acid production of cariogenic bacteria
  • nano HA (Ca PO4) aids in remineralization w nano particles of hydroxyapatite
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18
Q

what does chlorhexidine rinse do

A

antibacterial but does not work against lactobacillus!!!! so more for periodontal disease!

(twice a day for 1 week per month. mau cause staining and increased calculus)

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19
Q

what does carifree treatment rinse do

A

ctx4 gel - antibacterial, pH neutralizer

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20
Q

what does carifree maintenance rinse do

A

ctx3, pH neutralizer and xerostemia

(daily to prevent dental caries infection from returning. rinse w 10 ml for 1 minute, usually twice a day. more frequently for xerostomia)

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21
Q

what does fluoride rinse do

A

ACT- remineralization

22
Q

what does carifree bost spray do

A

ctx2, pH neutralizer, xerostemia

23
Q

what does baking soda toothpase and or rinsing do

A

pH neutralizer and xerostemia

24
Q

what do xylitol mints /gum do

A

xerostemia (salivary flow stimulant) and antibacterial, and pH neutralizer

25
Q

what is MI paste or MI plus paste and what does it do

A

fluoride varnish!!! desensitizer, remineralization

26
Q

what does 5000 ppm fluoride toothpaste do?

A

remineralization

27
Q

for a low risk person ; what is the home care rec, recare interval, and radiograph interval (Pacific protocol)

A

oral hygiene, individualized diet modification, frequency and exposure, OTC fluroide toothpaste

recare: 12 months
radiographs: 24-36 months

28
Q
A
29
Q

for a moderate risk person ; what is the home care rec, recare interval, and radiograph interval (Pacific protocol)

A

Everything from low risk +

    1. xylitol gum/mints throughout the day
      1. .05% NaF rinse after meals if possible

Alternative therapy would be to use a 5000 ppm F toothpaste twice daily instead of OTC toothpaste and no mouth rinse’

recare: 4-6 months
radiographs: 18-24 months

30
Q

for a highrisk person ; what is the home care rec, recare interval, and radiograph interval (Pacific protocol)

A

everything from low and moderate +

  • 5000 ppm toothpaste instead of OTC F toothpaste morning and night
  • antibacterial /pH neutralizer (CTx4 treatment rinse) before bedtime
    recare: 3-4 months
    radiographs: 6-18 months
31
Q

for a extreme risk person ; what is the home care rec, recare interval, and radiograph interval (Pacific protocol)

A

everything from now, moderate and high +

  • pH neutralization (boost spray) throughout the day
  • Ca/PO4 supplementation (MI paste) throughout the day and right before bedtime
    recare: 3 months
    radiographs: 6 months until no new caries lesion
32
Q

how do you use treatment rinse (carifree ctx4) , what is its pH , ingredients?

A

mix equal amounts of A and B (about 10 mL total) and swish for 1 minute once or twice a day

  • pH 10-11 , makes biofilm inhospitable for acid loving bacteria
  • ingredients: (active)- sodium hydroxide and sodium hypochlorite
  • also has fluoride and 11% xylitol

alcohol free

33
Q

how do u use chlorhexidine gluconate , whats its pH and ingredients, brands

-whats the treatment plan with it?

A

rinse w 1/2 ox (15 ml) for 1 minute twice a day for one week

  • use a fluoride product for the next 3 weeks.
  • repeat each month

pH 5-7

ingredients= .12% chlorhexidine gluconate, 12% alcohol or alcohol free.

brands: peridex and periogard. (paroex is alc free)
- DONT USE WITH FLUORIDE!!!!!!!
- use until caries control is completed and bacterial counts are low (all antimicrobials)

meant to be intensely used, short term, therapeutic endpoint.

-set a caries recall dpeendent upon what you have described and patient motivation. usually want another ATP measure at 1 month. repeat as frequently as you feel adequate

34
Q

what should you not mix w fluoride

A

chlorhexidine rinse

35
Q

how should antimicrobials be used

A
36
Q

whats the chlorhexidine rinse protocol/treamtent

A

-use until caries control is completed and bacterial counts are low (all antimicrobials)

meant to be intensely used, short term, therapeutic endpoint.

  • set a caries recall dpeendent upon what you have described and patient motivation. usually want another ATP measure at 1 month. repeat as frequently as you feel adequate
  • twice a day for 1 week per month. doesnt work against lactobacillus. may cause staining, increased calculus formation.
37
Q
A
38
Q

whats the carifree ctx4 treatment

A

antimicrobial

2x a day till gone

39
Q
A
40
Q

what is the iodine treatment

A

antimicrobial, its hospital dentistry. requires long contact time.

41
Q

how should carifree ctx3 be taken, whats its ingredients. does it have alcohol?

A

maintenance rinse-

  • daily to prevent dental caries infection from returning.
  • rinse with 10 ml for 1 minute (usually twice a day, for xerostemia- use more frequently, especially after snacking)
  • pH 8.0

active ingredients - .05% NAF

other ingredients; 25% xylitol

-alcohol free

42
Q
A
43
Q

how is high fluoride toothpaste used

A

5000 ppm

1.1% Na fluoride

pea sized amount twice a day

NOT for young children.

OTC is like 1k-1200ppm, much more.

44
Q

whats the ingredients in MI paste,how is it used

-paste vs ONE

A

active ingredient: recaldent (CPP-ACP) a complex of casein phosphopeptides (CPP) and amorphous calcium phosphate (ACP)

  • DONT rx for someone with a milk protein allergy (caesin IgE)
  • helps remineralization, root sensitivity, and pH neutralization. (pH 7.8)
  • xerostemia/salivary gland hypofunction use. rub on cotton swab or clean finger several times a day and/or use a bleaching tray overnight.
  • apply w/toothbrush is not recommended its sticky.

MI Paste plus- with fluoride

MI paste one- can brush teeth w it.

45
Q

whats in fluoride varnish, how does it work and when used

A

white or clear usually

-5% NA fluoride= 22,600 ppm!!!!

time released fluoride for months

safe for infants and children.

should be considered after cleanings.

46
Q

how does xylitol gum/mints work and what is it

-recommended dose for gum/mints

A

naturally occuring sugar. slowly absorbed so lower caloric intake than other sugars. doesnt require insulin for metabolism. maintains neutral oral pH.

decreases adhesion of bacteria to teeth.

bacteria cant metabolize it. -strongly anti-acidogenic bacteria and decay

dosing:

gum: each piece is 1 gram of xylitol, recommended 6-10 grams (pieces) a day
mints: each piece is .5 grams of xylitol. 12-20 pieces each day is ideal.

47
Q

what is boost spray recommended for, whats it made of, pH, and how should it be used (how it works)

A

Rec for xerostemic patients!

  • calcium hydroxide w/9 pH
  • 35% xylitol, glycerine also
  • 2-3 sprays as often as needed
  • raises pH and prevents demineralization.

fits in pocket.

48
Q

what are products that are good for xerostemia?

A

MI paste, xylitol gum, boost spray, baking soda toothpaste etc.

49
Q

ADA caries classification: what is low caries risk

A

no incipient or cavitated primiary or secondary lesions in past 3 years and no risk factors

50
Q

ADA classification what is moderate caries risk under and over 6 yrs old

A

under 6: no lesions in last 3 years but at least 1 risk factor

over 6: 1 lesion in past 3 years or at least 1 risk factor

51
Q

ADA classification high caries risk under and over 6 yrs old

A

-under 6: any of the following- any lesion in past 3 years, multiple risk factors, low socioeconomic status, suboptimal fluoride exposure, xerostemia

over 6: any of the following: 3 or more lesions in past 3 years, multiple risk factors, suboptimal fluoride exposure, xerostomia

ICS1 (23 decks)

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