Cariology Part II Flashcards by Austin Shackelford

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

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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

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

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

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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

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

Brushing

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

No significant difference

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

Flossing

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

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

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

resting place

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

DIAGNOSIS

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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

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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

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

1/2

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

THROUGH!!!

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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

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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

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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

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

1/3…1/2

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

DAMAGING (sorry GV Black)

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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!

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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)

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

70%

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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

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

invasive

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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!

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)

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

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

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)

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

CariVu

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

FLUORIDE IS THE BEST WAY TO REMINERALIZE

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

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

glycolysis

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

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

TOPICAL

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

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

smooth surface....enamel & dentine

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

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

15-20%

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

Really young Children don't drink water

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

24%

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

low-risk patients

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

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

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

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

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!!!

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

ROOT

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

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

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

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

1 hour!

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

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!

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

it inhibits bacterial ADHESION!

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)

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!

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

Fluoride

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

last resort

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

70%!!

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

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%

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

40%

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

100%!!!

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

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

treat....effects!