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Flashcards in chemical agents in plaque biofilm control Deck (47):
1

define systemic delivery

administering chemical agents such as antibiotic, in the form of tablet or capsule

2

define local delivery? example?

placing a chemical agent into the mouth or even into a perio pocket
example is toothpaste that contains a chemical agent that can kill bacteria such as stannous fluoride

3

what inhibits calculus formation

pyrophosphates

4

examples of chemical agents used in perio patients

1. therapeutic mouth rinses
2. therapeutic dentifrices
3. subgingival irrigation
4. controlled-release delivery devices

5

what could cause resistance of biofilm to delivery of chemical agents

1. surface of plaque biofilm is covered by an extracellular slime layer
2. slime layer acts as a natural barrier to protect organized bacterial colonies living in plaque biofilm
3. slime layer prevents chemical from contacting and killing bacteria

6

what is a microbial reservoir

secure place that allows periodontal pathogens to live undisturbed during routine periodontal therapy and subsequently repopulate periodontal pockets quickly.

7

is there a chemical agent that can control perio?

no

8

examples of chemical agents

antibiotics, fluorides, metal salts, antimicrobial, phenolic compounds, and antiseptics

9

examples of antibiotics studied for use in perio care

1. penicillin and amoxicillin
2. tetracyclines
3. clindamycin
4. erythromycin

10

T/F: routine use of systemic antibiotics for plaque-induced gingivitis and chronic perio is recommended

false; not recommended

11

why is antibiotics not recommended

bacterial antibiotic resistance and good response to plaque-induced gingivitis and chronic perio can come from NSPT

12

how often would antibiotics need to be taken to control bactiera in mouth?

many many years

13

when is antibiotics indicated?

for patients with aggressive perio and other rarer forms of perio

14

what is microbiologic analysis used for?

used to identify the antibiotic that is effective against the bacterial pathogens present in patient's biofilm

15

use of tetracyclines

1. higher concentrations of the drug concentrate
2. effective against A.A.
3. inhibit action of collegenase

16

how is controlled-release delivery device used in the mouth

1. an antibacterial chemical embedded in a carrier material
2. device is placed directly into perio pockets
3. material dissolves slowing producing a steady release of antimicrobial agent over a period of several days within the perio pocket

17

benefits of controlled-release delivery device

1. result in a small increase in attachment level in perio pocket
2. when used with perio instrumentation they can result in both an improvement in probing depth reduction and a clinical attachment gain

18

mechanisms of controlled-release delivery

1. tetracyclin hydrochloride-containing fibers
2. minocycline hydrochloride microspheres
3. doxycycline hyclate gel
4. chlorhexidine gluconate chip

19

features of tetracycline fibers

-no longer available in US
-gingival retraction cord impregnated with tetracyclin
-fiber laid back and forth all around tooth

20

minocyclin hydrochloride microspheres features

-cannula tip is used to expel microsphere into perio pocket
-within 5-7 days the microspheres dissolve so nothing to remove from pocket

21

reactions from minocyclin

-oral candidiasis
-allergic reaction
-don't use in women who are pregnant or nursing

22

doxycycline gel features

-tetracycline derivate
-antibiotic is delivered in a gel to perio pocket with cannula
-gel solidifies into a waxlike substance
-gel dissolves

23

reactions from doxycycline

-oral candidiasis
-allergic reactions
-do not use in pregnant or nursing mothers

24

chlorhexidine gluconate chip features

-tiny gelatin chip containing the antiseptic chlorhexidine
-can be used in pockets with 5 mm or greater in depth
-chip dissolves
-no risk of antibiotic resistance with the use of gelatin chip

25

what must you have to use gluconate chip? why?

5 mm pocket because if not then the chip will fall out of the pocket

26

uses of cosmetic mouth rinses

used to cover up or mask odors of halitosis
-do not control oral disease such as gingivitis

27

therapeutic mouth rinse purposes

-decrease dental plaque enough to also decrease the severity of gingivitis
-can decrease the risk of dental caries

28

characteristics of an ideal mouth rinse

efficacy, stability, substantivity, safety

29

define efficacy

inhibits or kills perio pathogens

30

define stability

stable at room temp and have a reasonable shelf life

31

define substantivity

retained in the oral cavity and released slowly over several hours with continued effect

32

define safety

does not produce any harmful effects on local tissues

33

define active ingredient

component that produces a benefit for the patient

34

define inactive ingredient

component added to give color or taste, preserve, or keep in a liquid state

35

3 ingredients that have some effect on gingivitis are....

1. chlorhexidine gluconate
2. essential oils
3. cetylpyridinium chloride

36

how much can chlorhexidine reduce the overall severeity of gingivitis by?

by 50 % when used as directed

37

what is chlorhexidine effective against?

gram positive and negative bacteria, very low level of toxicity and shows no permanent retention in the body

38

why is the primary mechanism of action for chlorhexidine

disruption of the integrity of the cell walls of bacteria

39

patients who would benefit from using chlorhexidine

special needs, patients with dental caries, oral piercings, candida infections, and patients in nursing homes

40

chemical agents included in essential oils

thymol, menthol, and methyl salicylate

41

features of mouth rinses containing essential oils

reduces gingivitis by 35%
-less effective than chlorhexidine
-less expensive than chlorhexidine
-pre-procedural rinses reduces bacteria in aerosols by more than 90%

42

quaternary ammonium compounds features

-released so rapidly that is has very little substantivity, limiting its effectiveness
-less effective than chlorhexidine and essential oils

43

povidone iodine as a mouth rinse features. who shouldn't use this?

-used in medical practice as a presurgical scrub for skin disinfection
-safety concerns
-shouldn't be used with patients who have sensitivity to iodine, allergies to shellfish, thyroid dysfunction, or women who are lactating or pregnant

44

what ingredient inactivates chlorhexidine

sodium laurel sulfate

45

side effects of essential oils

burning sensation in mouth, bitter taste, drying out mucous membranes

46

ADA classificiation of dentifrices

-antitartar activity, caries prevention, whitening, gingivitis reduction, plaque formation reduction, tooth sensitivity reduction

47

what ingredients reduce supragingival calculus

pyrophosphates, triclosan, and zinc citrate