Cariology pp3 Flashcards
(36 cards)
Having any one of the 4 disease indicators place patient automatically in what risk category?
High risk category
Having any one of the 9 risk factors for caries automatically places patient in what risk category?
Moderate risk category
Having any of the protective factors and the absence of disease or risk factors automatically places the patient in what category?
Low risk category
What are the 4 risk assessment procedures?
- Diet analysis
- Plaque pH measurements
- Saliva flow test
- Bacterial test
What 4 things are you looking for when you ask a patient to record a week long diet log or fill out a dietary risk survey?
- Analyze fermentable sugars/carbs
- Find “hidden sugars”
- Frequency of snack time exposures
- Duration of each sugar exposure
Is dietary risk the same as caries risk?
No - high dietary risk put you at moderate caries risk
What are some examples of “hidden sugars”?
- Cereals
- Fructose
- Lactose and baby bottle syndrome
- Sucrose
- Sticky foods (contact time)
When is the bacterial test mandatory in an exam?
Extreme or high risk levels (optional in moderate)
How is plaque pH measured?
Use toothpick to collect plaque from teeth then place on litmus paper, record the pH every minute for at least 20 minutes, and then create a graph
Frequent snacking throughout the day =______ _____ _____ = multiple demineralization periods. _______ occurs between demineralization times.
Multiple acid challenges
Remineralization
How is the saliva flow test done?
Get a small piece of paraffin wax or 2 sticks of sugarless gum and have patient chew at least 3 minutes. Then patients spits into measuring cup and calculate ml/minute
What is the saliva flow that indicates xerostomia?
< or equal to 0.7 ml/min with sugarless gum**
What is the normal saliva flow rate for adults?
> or equal to 1.4 ml/min with sugarless gum***
What are 4 affects of xerostomia?
- Slow clearance of food particles
- Decrease buffering of acids
- Encourage growth of bacteria
- Inhibit remineralization bc Ca and P ions are reduced
5 possible causes of xerostomia
- Many medications
- Radiation therapy to head/neck
- Salivary gland disease
- Diabetes
- Aging
What does a bacterial test like CariScreen test for?
ATP Bioluminescence Activity - high correlation with S. mutans bacteria levels - the reaction is swift and reading must occur with in 1 minute
During a bacterial test where and how do you swab the mouth?
Swab the incisal 2/3rds of the tooth
Do not touch the gingivae or soft tissue
Only go in one direction
Do not re-swab
Why must the CariSceen bacteria test be done before the Saliva Flow Test?
Saliva will wash away some of the bacteria
What are the CHX guidelines?
Use CHX after tooth brushing in the evening
Do not combine CHX and F rinse - at least an hour apart
Use 10ml and swish in mouth for 1 min
Spit out without rinsing
Continue daily use for 7 days and then discontinue
Generally how does CHX work?
CHX attaches to the biofilm and reduces the growth of additional plaque - effective against S. mutans but lactobacilli are resistant in mouth
Drawbacks of CHX?
- Limited efficacy
- Stains teeth with prolonged use (1 week ok)
- Unpleasant taste
- Non-specific for cariogenic bacteria
- 1% gel not available in USA
What should you use twice daily after brushing and flossing. Shake bottle before use, using the measuring cup, combine 5ml of component A and 5ml of component B. Vigorously swish for 1 min and spit out. Do not swallow
Sodium Fluoride 0.05% RInse
Fluoride in saliva at concentrations of ___ -___ ppm can markedly enhance remineralization
0.04-0.1 ppm
Initial high F concentrations from Dentifrice or mouth rinse is produced in whole saliva and plaque which takes __-__ hours to fall to baseline. Baseline concentrations in whole saliva are ____ and maintained at 0.04- 0.1 ppm
1-6 hours
Elevated
