Cariology Part II Flashcards Preview

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Flashcards in Cariology Part II Deck (65):
1

Guiding Principle #1 Assess Caries Risk: Oral Hygiene--THIS WILL ROCK YOUR F---ING WORLD: There is no evidence that removal of plaque by ______ (with a non-F toothpaste) or _______ decreases the incidence of caries.

brushing...flossing

2

Guiding Principle #1 Assess Caries Risk: Oral Hygiene--Daily oral hygiene does help to control _____ disease and is necessary for the application of ______ toothpaste.

gingival...fluoride

3

Guiding Principle #1 Assess Caries Risk: Oral Hygeine--WHAT IS THE #1 Factor with Caries????

SALIVARY [S. Mutans]!!!!!!

4

Guiding Principle #1 Assess Caries Risk: Oral Hygeine--BUT WHY is there no evidence that brushing doesn't do shit against caries?????? Plaque indices designed for studies of ________ disease not caries... Plaque indices don’t measure _______...don't worry, plaque removal is still important though

periodontal....microbes

5

Guiding Principle #1 Assess Caries Risk: Oral Hygeine--_____ is the best way to remove plaque BY A LANDSLIDE!

Brushing

6

Guiding Principle #1 Assess Caries Risk: Oral Hygeine--Which is better a motorized or old school tooth brush?

No significant difference

7

Guiding Principle #1 Assess Caries Risk: Oral Hygeine--ONLY introduce ______ when brushing has been mastered.

Flossing

8

Guiding Principle #1 Assess Caries Risk: Oral Hygeine--How often should I floss?

we don't know :) every few days, once a week

9

Guiding Principle #2 Diagnose the Disease EARLY: A Caries diagnosis is "a mental ______ on the way to intervention!"

resting place

10

Guiding Principle #2 Diagnose the Disease EARLY: Avoid lawsuits and ALWAYS WRITE DOWN YOUR _______

DIAGNOSIS

11

Guiding Principle #2 Diagnose the Disease EARLY: What are the 4 prereqs for detection?

1.Clean the teeth 2.Dry the Teeth 3.Magnification 4.Light

12

Guiding Principle #2 Diagnose the Disease EARLY: When dried, ____ replaces _____ in enamel! The refractive index is farther away, making lesions easier to see!

air...water

13

Guiding Principle #2 Diagnose the Disease EARLY: White-spot lesions visible when DIRED have penetrated about ____ of the enamel!!!

1/2

14

Guiding Principle #2 Diagnose the Disease EARLY: White/brown lesions visible when wet have penetrated ______ the enamel.

THROUGH!!!

15

Guiding Principle #2 Diagnose the Disease EARLY: At what age should you be using magnification? (dentist above this age frequently fail vision tests)

over 45 years of age

16

Guiding Principle #2 Diagnose the Disease EARLY: Detection of _______ lesions is no longer an appropriate diagnosis of dental caries...BECAUSE If detected before this point, caries is _______!!!!

cavitated....REVERSIBLE

17

Guiding Principle #2 Diagnose the Disease EARLY: The problem with the explorer- Instruments currently available for the diagnosis of carious lesions do not detect lesions _____ and _______...

early and quantitatively

18

Guiding Principle #2 Diagnose the Disease EARLY: We can't detect caries until its ____ to ____ through the enamel.

1/3...1/2

19

Guiding Principle #2 Diagnose the Disease EARLY: Teaching the use of the explorer to diagnose carious lesions may be potentially ______.

DAMAGING (sorry GV Black)

20

Guiding Principle #2 Diagnose the Disease EARLY: What are the 3 possible problems with diagnosing with an explorer can cause?

1.Damage to Newly Erupted Teeth 2.Create a Cavity 3.Transmit Bacteria!

21

Guiding Principle #2 Diagnose the Disease EARLY: Probing Newly Erupted 3rd molars with an explorer in the pits and fissures ___% had tissue loss!

60% (compared to 7% w/o probing)

22

Guiding Principle #2 Diagnose the Disease EARLY: Explorers transmit bacteria-- ____% of probed fissures had S. Mutans compared to 0% that were not probed.

70%

23

Guiding Principle #2 Diagnose the Disease EARLY: IF you are going to use an explorer to check a lesion, how hard do you push?

enough pressure to blanch your finger nail

24

Guiding Principle #2 Diagnose the Disease EARLY: radiographs are an _______ procedure that should be used with caution

invasive

25

Guiding Principle #2 Diagnose the Disease EARLY: "accuracy of radiographs"--the study where 86 dentists looked at the same x rays: % of teeth decayed ranged from __-__%

15-75% WOW!

26

Guiding Principle #2 Diagnose the Disease EARLY: NEW School Tech- What am I? Decay scatters and absorbs more light than healthy tissue, Decay near the imaged surface appears as a darker area, images can indicate the presence of early decay before either film or digital radiography. _______ can detect incipient or recurring caries before they are visible on x-rays!!!

DIFOTI (digital imaging fiber optic trans-illumination)

27

Guiding Principle #2 Diagnose the Disease EARLY: NEW School Tech- A laser diode provides pulsed light that is directed onto the tooth. When the light meets a change in tooth substance, it stimulates fluorescent light of a different wavelength. This is translated through the handpiece into an acoustic signal, and the wavelength is then evaluated by an appropriate electronic system in the control unit.

DIAGNOdent

28

Guiding Principle #2 Diagnose the Disease EARLY: NEW School Tech- _______ (laser diode) should not be relied on as a clinician’s primary diagnostic method

DIAGNOdent

29

Guiding Principle #2 Diagnose the Disease EARLY: NEW School Tech- Tooth is illuminated with blue-green light, Fluorescence of enamel is observed, Demineralized areas appear dark

QLF (quantitative light-induced fluorescence)

30

Guiding Principle #2 Diagnose the Disease EARLY: NEW School Tech- What was the NEAR-infrared detector out of UCSF??

CariVu

31

Guiding principle #3-Treat the disease, Remineralize, Control Infection--WHAT IS THE BEST WAY TO REMINERALIZE?

FLUORIDE IS THE BEST WAY TO REMINERALIZE

32

Guiding principle #3-Treat the disease, Remineralize, Control Infection-- F concentrates in dental _____...F is released from plaque when _____ is lowered...F is taken up more readily by _______ enamel than by sound enamel

plaque...pH is lowered...demineralized

33

Guiding principle #3-Treat the disease, Remineralize, Control Infection--Interesting!!! Plaque fluoride inhibits bacterial _______!

glycolysis

34

Guiding principle #3-Treat the disease, Remineralize, Control Infection--What are the two forms of F- that make it back into enamel?

Fluor-Apatite & CaF2

35

Guiding principle #3-Treat the disease, Remineralize, Control Infection-- the PRIMARY Cariostatic effect of F- is _______.

TOPICAL

36

Guiding principle #3-Treat the disease, Remineralize, Control Infection-- Best effect of F- is _______ exposure to LOW concentrations, Exposure about every ___ hours

frequent...4 hours

37

Guiding principle #3-Treat the disease, Remineralize, Control Infection--Fluoride prevents ________ caries. Fluoride arrests _____ & _______ caries.

smooth surface....enamel & dentine

38

Guiding principle #3-Treat the disease, Remineralize, Control Infection--What is the MOST EFFECTIVE Fluoride Delivery Vehicle? What is usually put in the Pedo Trays?

Varnish...APH-AcidulatedPhosphoFluoride (the low pH destroys

39

Guiding principle #3-Treat the disease, Remineralize, Control Infection--Community Water Fluoridation reduces caries by ___-___%!!!!

15-20%

40

Guiding principle #3-Treat the disease, Remineralize, Control Infection--What is the main Disadvantage of water fluoridation?

Really young Children don't drink water

41

Guiding principle #3-Treat the disease, Remineralize, Control Infection--Self-Applied Fluorides like tooth paste prevents ___% of caries.

24%

42

Guiding principle #3-Treat the disease, Remineralize, Control Infection--Self-Applied Fluorides are not appropriate for _______.

low-risk patients

43

Guiding principle #3-Treat the disease, Remineralize, Control Infection--DO NOT USE gels/foams in children ___ years and younger.

5

44

Guiding principle #3-Treat the disease, Remineralize, Control Infection--Which has more F-? Gels/Foams or Varnish?

GELS/FOAMS 35mg...varnish-5mg

45

Guiding principle #3-Treat the disease, Remineralize, Control Infection--FLUORIDE 1. Patients at ____ risk of caries on smooth surfaces 2. Patients at high risk of caries on _____ surfaces 3. Special patient groups such as:
_______ patients, Patients undergoing head and neck ______, Patients with decreased ______ flow
4. NOT recommended for patients at ____ caries risk

high...root...Orthodontic...raditation...salivary...low

46

Guiding principle #3-Treat the disease, Remineralize, Control Infection--So F- VARNISH is the best huh? Then what % of teeth had disease prevented? WAIT! What is CHX's %???

46%! ok, not bad :) SAME AS CHX!!!

47

Guiding principle #3-Treat the disease, Remineralize, Control Infection--Again, F- is very effective against _____ caries (surface)

ROOT

48

Guiding principle #3-Treat the disease, Remineralize, Control Infection--THIS IS BIG- What are the 4 ChemoTheraputic Treatments?

1.Fluoride-remineralize 2.Baking Soda-buffer 3.Chlorhexidine-anti-microbial 4.Xy-lit-ol---non-fermentable sugar

49

Guiding principle #3-Treat the disease, Remineralize, Control Infection--YOUR VERY OWN Baking Soda Prescription Cheat Sheet! Dissolve 1 _______ in tumbler of water Rinse vigorously & spit, swallowing will cause _____ discomfort, _______ unused water at end of day, make new batch each day

teaspoon...gastric...discard

50

Guiding principle #3-Treat the disease, Remineralize, Control Infection--How long is the CHX treatment? What is the only form available in the US?

14 days...mouthwash

51

Guiding principle #3-Treat the disease, Remineralize, Control Infection--How long do I wait when doing CHX & F- in between the 2?

1 hour!

52

Guiding principle #3-Treat the disease, Remineralize, Control Infection--What is a great Chemo-Theraputic for mothers during the child's window of infectivity?

CHX

53

Guiding principle #3-Treat the disease, Remineralize, Control Infection--What was the best chemo-theraputic treatment on patients undergoing head and neck radiation?

The F- and CHX combo!

54

Guiding principle #3-Treat the disease, Remineralize, Control Infection--What is the most important aspect of Xy-lit-ol gum?

it inhibits bacterial ADHESION!

55

Guiding principle #3-Treat the disease, Remineralize, Control Infection--Doctor, what age do you recommend my kid starts chewing Xylitol gum?

at about 5 (1 year before permanent teeth erupt)

56

Guiding principle #3-Treat the disease, Remineralize, Control Infection--How many grams of Xylitol do you need in adults for effectiveness?

100g!! thats a shit ton!

57

Guiding principle #3-Treat the disease, Remineralize, Control Infection--Sealants should be used with _____.

Fluoride

58

GUIDING principle #4-Delay or Avoid Operative Intervention: The surgical management of noncavitated carious lesions should be the treatment of _______.

last resort

59

GUIDING principle #4-Delay or Avoid Operative Intervention: ____% of fillings are replacements of existing fillings.

70%!!

60

GUIDING principle #4-Delay or Avoid Operative Intervention: What % of lesions are caveated when there is radiolucency in the outer half of enamel?

0%

61

GUIDING principle #4-Delay or Avoid Operative Intervention: What % of lesions are caveated when there is radiolucency in the inner half of enamel?

10.5%

62

GUIDING principle #4-Delay or Avoid Operative Intervention: What % of lesions are caveated when there is radiolucency in the outer half of dentin?

40%

63

GUIDING principle #4-Delay or Avoid Operative Intervention: What % of lesions are caveated when there is radiolucency in the inner half of dentin?

100%!!!

64

GUIDING PRINCIPLE NUMERO 5: Restore active caries only!--What are the three stages of caries for monitoring?

1.Progressing 2.Arrested 3.Shifting to Remineralization

65

GUIDING PRINCIPLE NUMERO 5:Filling teeth does not _____ the disease of dental caries....Filling teeth simply restores the ______ of the disease.

treat....effects!