Advice Flashcards
(162 cards)
1
Q
when is the main risk period for a child to get dental fluorosis?
A
between 18 months and 3 years.
2
Q
what concentration is in the fluoride varnish used in clinic?
A
??????
3
Q
How does fluoride prevent dental caries?
A
- decreases demineralisation of enamel
- increases remineralisation of enamel
- incorporated in developing enamel
- interferes with metabolism of some plaque bacteria.
4
Q
what is the recommended concentration of fluoride TP for an adult with high caries risk?
A
200 or 5000ppm Fluoride Toothpaste (need to be given under a px)
5
Q
How does fluoride decrease demineralisation?
A
less calcium is lost under acid conditions where fluoride is present.
the demineralised enamel will also take up fluoride.
6
Q
what does pH have to be blow for enamel to dissolve?
A
5.5pH
7
Q
what is needed for enamel to remineralise?
A
- enamel needs calcium and phosphate.
8
Q
where can you get calcium and phosphate from?
A
from saliva, dairy foods and CPP-ACP.
9
Q
what layer/s of enamel does high concentration of fluoride (e.g. fluoride varnishes) reach?
A
surface layers in enamel as its over a short period of time.
10
Q
what layer/s of enamel does lower concentration of fluoride (e.g. water and toothpaste) reach?
A
surface layer and lesion body as it will be over a long period of time.
11
Q
how does fluoride interfere with some bacterial metabolism?
A
fluoride changes the bacterial cell pH to acid conditions. It also interferes with the glycolytic pathway.
12
Q
what is it called when fluoride is condo-orated in developing enamel?
A
fluoridated HAP or fluoropataite.
13
Q
what are some sources of systemic fluorides?
A
- swallowed TP
- water
- Food (e.g. fish and tea)
- tabletes/ drops.
- milk
- salt.
14
Q
what is the % of fluoride in daily Mouthwash?
A
0.05% fluoride
15
Q
what is the % of fluoride in weekly Mouthwash?
A
0.2% fluoride
16
Q
what do you need to consider when prescribing fluoride mouthwash?
A
- age of patient
- appropriate instructions
- alcohol content.
17
Q
how often should a professional topical fluoride be applied?
A
every 3-6 months depending on caries risk.
18
Q
what dental materials provide amount of fluoride release?
A
- GIC
- FS
- Compomers
- some resin composites.
19
Q
when does dental fluorosis occur?
A
when more than trace amounts of fluoride are ingested during tooth development.
20
Q
what teeth arte most at risk of dental fluorosis?
A
permanent anterior theta.
21
Q
what teeth are most at risk of dental fluorosis?
A
permanent anterior theta.
22
Q
when do children learn to spit correctly?
A
3-4 years old.
23
Q
enamel with fluoride has a tighter consent of what? and why is this?
A
protein - because high fluoride prevents the effective removal of the protein matrix during maturation.
24
Q
is dental fluorosis in teeth hyper or hypo mineralised?
A
hyper mineralised.
25
what is most likely the cause of dental fluorosis?
- water with naturally high fluoride levels or eating fluoride toothpaste.
26
what ages should additional systems fluorides be avoided?
before the age of 3.
27
how much toothpaste should be given to a patient under 3?
smear of TP
28
how much toothpaste should be given to a patient under 6?
pea sized amount
29
what is the concentration of fluoride in the plaque, saliva and enamel dependent upon?
- how often fluoride is applied.
- how the fluoride is applied
- the concentration of the fluoride.
30
what does caries need to occur?
- plaque
- time
- tooth surface
- refined carbs
31
what is the main microbe in the plaque biofilm?
streptococcus.
32
after 14 of the plaque biofilm what is the dominant bacterial?
Actinomyces.
33
name 6 professional caries preventative methods?
- diet diary
- nutritional support
- 0 behaviour modification
- engaging patients
- PFS
- OHI
- Topical fluoride
- FS
- fluoride tooth moose.
34
what else should be considered when looking at a patients diet sheet ?
if they have any brothers or sisters and what their diet isa like. Or if they are an adult if they have children and what their diet is like.
35
what patients have the highest risk of developing caries?
- infants (with night drinks)
- its with reduced salivary flow.
- increased carb intake due to medical history
- recreational drug users.
- drinking sports drinks
- food tasters
- special diets.
- young children
medically physically impaired
- low socio-economic groups
- language and cultural barriers.
36
what's the main pieces of diet advice we should be giving too patients?
- confectionary only at meal times.
- only milk or water for children with feeder cups
- reduce soft drinks, only at meal times and to use a straw.
- only water at bedtime.
- sugar intake 4x per day
- sugary food at meal times.
- use sweetness
- non cariogenic snacks.
37
how can plaque deposits be minimised?
- mechanically
- use of fluoride TP (1450ppm)
- chemical plaque control (chlorhexidine)
- assess saliva flow.
38
what causes caries to occur?
cause by the action of sugars on the bacterial plaque covering the teeth, Caries occurs when demineralisation of the tooth structure exceeds remineralisation.
39
what are the steps to dietary counselling?
1) identify higher risk patients
2) take detailed dietary history
3) set goals
4) develop action plan
5) monitor and review.
40
what concentration fluoride TP should a child under 3 have?
1000ppm fluoride.
41
until what ages should a parent brush or supervise a childs toothbrushing?
at least 7 years old.
42
what concentration fluoride TP should a child 3-6yrs have?
1350-1500ppm fluoride,
43
what products could you recommend to help with desensitisation?
- fluoride mouthrinses/ varnish
- fluoride paste - GelKam
- low abrasively toothpaste
- sugar free chewing gum
- dentine bonding agents
- 'Anti-erosion' toothpastes
- tooth mousse.
44
what are the 3 main types of tooth wear?
erosion, abrasion, attrition
45
what is erosion?
progressive loss of dental hard tissue by an acidic chemical process not involving bacteria.
46
what is attrition?
loss of tooth substance or a restoration caused by tooth-to-tooth contact
47
what is abrasion?
abnormal wearing away of tooth substance or a restoration by a mechanical process other than tooth contact.
48
what are the different types of erosion and whats the difference between them?
- intrinsic - acid coming up
| - extrinsic - acid going in
49
what could be some examples of an intrinsic acid that would cause erosion?
- Gastro oesphageal reflux
- vomiting
- ruminant eating
50
An eating for example bulimia nervosa would cause what type of tooth wear?
- erosion from intrinsic acid.
51
what are some examples of extrinsic acids?
- dietry acid sources (soft drinks, alcoholic drinks etc)
- OH acidic products (mouthwash, saliva substitutes)
- medications ( Vit C, asthma inhalers)
52
what are the important factors for dietary erosion?
- amount
- frequency
- method of consumption
- timing of consumption.
53
how does erosion differ from caries?
- caries is from plaque acid leading to demineralisation but the organic matrix is not affected.
- in erosion extrinsic/ intrinsic acid leads to demineralisation and loss of the organic matrix.
54
what other clinical presentations are associated with bruxism?
- tongue scalloping
- cheek ridging
- masseteric hypertrophy in severe cases
55
what can cause abrasion?
- tooth brushing
- abrasive dentifricies
- abrasive food particles
- piercings
- habits (nail biting, chewing, pen chewing, pipe smoking, wire stripping)
- latrogenic (unglazed porcelain)
56
what is the theory behind the cause of abfraction?
occlusal forces cause compressive and tensile stresses, which are concentrated at the cervical region of the tooth and cause micro-fracture of cervical enamel rods - creating a deep v-spaced notch on a single tooth.
57
how do we manage tooth wear?
1) identify presence and severity of tooth wear
2) identify aetiology
3) monitoring
4) prevention
58
how could we monitor tooth wear?
- models
- silicone index
- photographs
- measurements
- review 4-6 monthly then annually.
59
what advice/ treatments can you do to aid in the prevention of erosion?
- diet advice
- avoid brushing immediately after acidic foods.
- control of GPRD/ eating disorders.
- water and sodium bicarbonate mouthwash
- desensitisation and protection.
60
what advice/ treatments can you do to aid in the prevention of attrition?
- patient awareness and education
- splints
- composites
61
what advice/ treatments can you do to aid in the prevention of abrasion?
- patient education and habits
- OHI
- abrasive restorations.
62
what questions would you ask a patient who has abrasive cavities?
- bristle stiffness
- toothbrushing force
- toothbrushing frequency
- paste abrasively
63
when should you intervene with a patient who has tooth wear?
- early rather than late
- protect pulp
- aesthetics
- functional problems
- loss of structures integrity
- prevention of further complex treatment
- patients wishes / cooperation.
64
what is the purpose of binding agents in dentifrices?
holds all the ingredients together and assist in creating the texture of toothpaste
65
what is the purpose of preservatives in dentifrices?
prevent contamination by bacteria and to maintain purity of the product.
66
what is the purpose of colour/flavourings in dentifrices?
mask the flavour of other ingredients (especially SLS) and promotes used compliance.
67
what is the purpose of water in dentifrices?
solvency for some ingredients and provides consistency
68
what is the purpose of inhibitors in dentifrices?
stops the corrosion of the tube especially metal tubes.
69
what is the purpose of humectants in dentifrices?
prevents evaporation of water keeping the toothpaste moist.
70
what is the purpose of detergents/foaming in dentifrices?
lower surface tension and losens debris which assists removal with a toothbrush
71
what is the purpose of polishing/abrasive agents in dentifrices?
cleans and polishes the tooth surface without damaging enamel., keep pellicle thin and prevent accumulation of stain.
72
what is the purpose of buffering agents in mouthwash?
reduce acidity
73
what is the purpose of anodynes in mouthwash?
assist with pain relief
74
what is the purpose of astringents in mouthwash?
shrink tissues and aid in healing.
75
what is the purpose of sodium laureth sulphate in dentifrices?
added to make toothpaste foam.
76
what are the problems associated with SLS in toothpaste?
- can cause skin irritation
- disolves proteins- has been shown to cause damage to oral tissues
- linked to gingivitis, receding gums and recurrent mouth ulcers.
77
you are seeing a patient with recurrent ulcers what would you recommend they change in their OHR?
use a SLS free toothpaste, as these can demising ulcers up to 45%.
78
what are the cosmetic roles of dentifrices and mouthwash?
- feeling of well being (fresh mouth)
- whitening
- removal of plaque and stain.
79
what are the therapeutic roles of dentifrices and mouthwash?
- prevent plaque and gingivitis
- prevent and reduce dental caries
- desensitisation
- relief of some oral conditions.
80
what can cause extrinsic satin on the teeth?
- mouthwash and toothpaste ingrediants.
- medications
- tea and coffee
- red wine
- diet
- poor Oh
- smoking / chewing tobacco.
81
what is the difference between whitening and bleaching the teeth?
whitening = removal of extrinsic stains (abrasive)
bleaching = changes colour of teeth intrinsically.
82
what are the names of some whitening agents in toothpaste?
- sodium bicarbonate
- hydrogen peroxide
- carbamide peroxide
83
what is the purpose of sodium bicarbonate in toothpaste?
- mildly abrasive so removes staining.
| - neutralizes mouth acids and freshens breath.
84
what are the 2 most common fluorides found in toothpaste (525-1450ppm)?
- sodium monofluorophoshate
| - sodium fluoride
85
what are the dangers of using fluoride?
- can cause fluorosis.
86
what is the lethal done per kilo of fluoride?
- 5mg fluoride.
87
what is the purpose of Tricolsan in dentifrices and mouthwash?
- borad spectrum of activity against oral bacterial and yeast. - anticbacterial agent that reduces plaque, inflamed bleeding gums and decay.
88
to increase the effectiveness of tricolsan what can it be combined with?
zinc citrate
89
what is the purpose of arginine and calcium carbonate in dentifrices and mouthwash?
neutralise plaque acid and repair enamel.
90
what is the purpose of cetylpyridium chloride (CPC) in dentifrices and mouthwash?
anticeotic
91
what baceria does cetylpyridium chloride (CPC) work best on?
gram positive bacteria
92
what is the purpose of chlorhexidine digluconate in dentifrices and mouthwash?
abti-calculus.
93
what are the names of desensitising agents in toothpaste?
- strohtium chloride hexahydrate
- potassium citrale
- potassium chloride
- strannous fluoride
- potassium nitrate
94
what is the purpose of strohtium chloride hexahydrate in toothpaste?
promotes the deposition, by odontolblasts, of irregular secondary dentine on the pulpal walls of the dentinal tubulas.
- physically blocks the tubules.
95
what is the purpose of strannous fluoride in toothpaste?
- block tubule holesm
| - helps treat.prevent sensitivity
96
what is the purpose of potassium nitrate in toothpaste?
- interacts at the nerve synapses.
- prevents the nerve from passing the pain signal along the synapse.
- numbs the nerve.
97
what age and below should you not recommend sensitive toothpaste?
12 and below.
98
name 6 things that can cause halitosis...
- food
- tobacco products
- poor OH
- dry mouth
- medications
- infections in the mouth
99
What causes an individuals nutrient requirements to change?
- metabolism
- age
- health
- malnutrition
- body size
- utilisation of food
100
what is the max amount of fat should a male adult be eating per day?
up to 30g.
101
what is the max amount of fat should a female adult be eating per day?
up to 20g
102
what is the max amount of salt should an adult be eating per day?
up to 6g
103
what is the max amount of sugar a 4-6 year old should have per day?
19g per day (5 sugar cubes)
104
what is the max amount of sugar a 6-10 year old should have per day?
24g per day (6 sugar cubes)
105
what is the max amount of sugar a 11+ year old should have per day?
30g per day (7 sugar cubes)
106
what is the main function of protein in the body?
- formation of muscles, bones, blood enzymes and some hormones.
- Cell membrane tissue repair
- regulates water/acid base balance.
107
what is the main function of carbs in the body?
- supplies energy to brain cells, nervous system, blood ad muscles during exercise.
108
what is the main function of fats in the body?
- supplies energy
- insulates and cushions organs
- assists with vit absorption
109
what is the main function of vitamines in the body?
- promotes chemical reaction in cells
110
what is the main function of minerals in the body?
- regulates body functions
- assists growth
- catalyst fir energy release
111
what is the main function of water in the body?
- provides medium for and transports chemical reactions
- regulates temp
- removes waste.
112
what in the your diet provides proteins?
- meat
- fish
- poultry
- eggs
- dairy
- nuts
113
what in the your diet provides carbs?
- grains
- fruits
- veg
114
what in the your diet provides fats?
- saturated = animal fat, milk, cheese, butter, eggs, meant, oily fish.
- unsaturated = veg fat, margarine, veg, oil nuts.
115
what in the your diet provides vitamines?
- fruit
- veg
- grains
- meat
- dairy
116
what in the your diet provides minerals?
- most food groups.
117
what in the your diet provides waters?
- water
- liquids
- fruit
- veg
118
what is an oral manifestation of a Vit A deficiency?
- Leukoplakia
| - hyperkeratosis of oral epithelium
119
what is an oral manifestation of a thiamin B deficiency?
- none.
120
what is an oral manifestation of a riboflavin B2 deficiency?
- angular stomatitis
| - glossitis
121
what is an oral manifestation of a Nicotinamide (niacin B3) deficiency?
- glossitis
- stomatitis
- gingivitis
122
what is an oral manifestation of a Vit B12 deficiency?
- glossitit
| - aphthae
123
what is an oral manifestation of a Vit C deficiency?
- gingival swelling and bleeding
124
what is an oral manifestation of a folic acid deficiency?
- glossitis
- aphthae
- atrophy of lingual papillae
125
what is an oral manifestation of a Vit D deficiency?
- hypocalcification of teeth
| - malformation.
126
what is the main cause of leukoplakia?
smoking
127
what is very brief advice?
- Ask
-Advise
- Act
smoking cessation.
128
why is it important for dental professionals to carry out very brief advice?
- smoking is a secondary risk factor for smoking
- smoking will modify how perio tissues respond to plaque
- smoking reduces saliva flow
- epidemiology shows smokers have greater bone loss and attachment loss.
129
what are some of the effects of smoking on the oral cavity?
- melanin
- fibrotic gingiva
- increased calc and staining
- black hairy tongue
- leukoplakia
130
what is the golden ratio in denistry?
1:6
131
what type of caries is diagnosed most using a bitewing on the permanent dentition, compared to a visual exam?
proximal carious lesions.
132
what is transillumination? and why would it be used?
- shinning light through contact points, to assist with diagnosis of approximal caries.
- dark= caries.
133
describe an active carious lesion
progressive
orange/brown
soft
134
describe an arrested or inactive carious lesion
formed earlier then stopped
dark brown/black
hard
leathery
135
what does ICDAS stand for?
international caries detection and assessment system.
136
what probes are used for a clinical examination? and why?
ball-ended - this is so it will not cause any damage to potential white spot lesions.
137
With ICDAS caries code what is meant by 0?
sound tooth surface
138
With ICDAS caries code what is meant by 1?
1st visual change in enamel
139
With ICDAS caries code what is meant by 2?
distinct visual change in enamel
140
With ICDAS caries code what is meant by 3?
enamel breakdown, no dentine visible
141
With ICDAS caries code what is meant by 4?
dentinal shadow (not cavitated into dentine)
142
With ICDAS caries code what is meant by 5?
distinct cavity with visible dentine
143
With ICDAS caries code what is meant by 6?
extensive distinct cavity with visible dentine
144
what is understood by ICDAS caries codes 1-2?
initial caries
145
what is understood by ICDAS caries codes 3-4?
moderate caries
146
what is understood by ICDAS caries codes 5-6?
extensive caries
147
what are the 4 D's in caries care? Set out by ICDAS
```
1= Determine
2= Detect
3= Decide
4= Do
```
148
what can cause trauma related gingival recession?
- foreign bodies - piercings
- nail picking
- tooth brushing
- partial dentures ( poor design/ poorly maintained)
- direct from malocclusion (gingival stripping)
- chemical trauma (topical cocaine )
149
what is key to recession and gingival inflammation in regards to probable recession?
thickness of the keratinised tissue - thin tissue is pre-disposed to recession in presence of plaque-indiced inflammation or trauma.
150
what are the possible consequences of recession?
- fear of tooth loss
- PRF and bleeding gingiva
- aesthtics
- root caries
- abrasion
151
what type of pain is normally associated with dentine hypersensitivity?
short sharp pain
152
does dentine hypersensitivity get worse or better with age and why?
better as more dentine is deposited in the tubules preventing fluid flow.
153
what can act as a stimuli for dentine hypersensitivity?
- thermal
- osmotic (hypertonic solutions eg sweet, spicy, acid)
- desiccation (drying of lesion)
- electric (galvanic reactions and electric pulp test)
- tactile (touching, probing, TB)
154
what is the hydrodynamic mechanism?
dentine hypersensitivity caused by the movement of dentinal tubules content increased outward fluid flow causing a pressure change across the dentine.
155
what needs to be recorded in regards to recession?
- record extent of recession
- description
- index
- identify etiological factors
156
How can you manage dentine hypersensitivity?
- Tubule occlusion - application of an artificial barrier eg varnish, fills etc.
157
what is the purpose of tubule occlusion?
prevent dentine hypersensitivity.
| promotes formation of new tissue
158
what are the ideal qualities of a barrier material for dentine hypersensitivity?
- retentive
- insoluble
- penetrate tubules
- forms mechanical tags into tubules
- seals the end of the tubules.
159
how can a patient manage dentine hypersensitivity at home?
- TP, gels and mouthwash
160
how can a professional manage dentine hypersensitivity in surgery?
- varnish
- resin bonding systems
- desensitising polishing pasta
- reinforced GIC where there is abrasion cavity progression
161
what advice can you give a patient to aid in the prevention of recession?
- change TB techniques
- smoking cessation
- reduce risk factors - acidic drinks/foods, brushing after acid attack, night splint if brixist etc.
162
what is the treatment plan for root caries?
- x-rays to detect interproximal caries
- prevention, diet and OHI, fluorides.
- recontouring of shallow lesion
- GIC restoration
