Day 4 Lecture 2 Flashcards
Tooth centered
Tooth centered is surgical intervention to eliminate cavitated lesions.
Patient Centered
To use a medical model to control the disease process.
CAMBRA
Caries management by risk assessment
Caries risk assessment to establish risk level. Individual risk indicators, individual risk factors, protective factors, non surgical therapeutics and dental surgical intervention.
Individual risk indicators
Things that you can see or have a history of that show that there has been active mouth disease. You’re sick.
Individual risk factors
Things that encourage decay - Mtn. Dew, coffee. You might get sick.
Protective Factors
Things that discourage decay. Often a balance between individual risk factors and protective factors. Fluoride, healthy diet.
Non-surgical therapeutics
Non surgical = sealants, fluoride treatment, diet intervention
Dental surgical interventions
What it sounds like.
Caries risk assessment
Gather data on current/recent dental history. Interview patients for risk factors. Conduct tests to determine status of saliva, bioload, and other data. Establish risk level for new lesions. Establish treatment plan.
Caries of mother/caregiver
1 indicator for kids less than 6 - mother tests food and gives bacteria to kids.
Special health care needs
Something physical that prevents tooth care.
Bolemia
Maxillary lingual sides.
Gerd
Gastro-esophogeal reflux disease. Difference between Gerd and bolemia - only mandibular teeth usually.
How long it takes for decay to reach dentin
16-24 months.
Xylitol
Gum stimulates saliva, xylitol interferes with early colonization of plaque. Also hard to break down.
Social, economic, education status
Social and economic are not involved directly in disease process. They are important because they affect the expression and management of the caries disease. This is about compliance and behavior. Predictive at population level, not too accurate at individual level.
CRA
Updated 3 months for high risk, 6 months for med risk, year for low risk.
Bacterial biofilm analysis
Shown to be high predictor of pH, but not a great indicator.
Risk considerations for kids under 6
Primary caregiver, nursing bottle (kids go to bed with anything but water).
Factors influencing caries risk
Immunization - if you eliminate a certain bacteria, it really doesn’t matter. Some bacteria are also beneficial, so trying to just eliminate certain bacteria from oral flora. Plus, opportunistic pathogens can move in which could be worse.
Calcium and phosphate compounds
In toothpastes - doesn’t really work.
Look these up - replace 9 with 10 (?)
Sample Preventive Protocol For a High Risk Patient With Cavitated Caries Lesions(Pages 8 – 9 H/O)
Table 2-7 Suggested Risk-Based Interventions for
Adults (Page 10 H/O)
Table 2-8 Health History Factors Associated with
Increased Caries Risk (Page 11 H/O)
Table 2-9 Clinical Examination Findings Associated
with Increased Caries Risk (Page 11 H/O)
Table 2-10 Methods of Caries Treatment by the
Medical Model (Page 12 H/O)
Table 2-11 Treatment Strategies (Page 13 H/O)
Caries control restoration
Operative procedure in which multiple teeth with acute threatening caries are treated quickly by removing infected structure, medicating pulp if needed (calcium hydroxide with GI). This prevents spread.
Root caries management
The first strategy is to try to improve salivary flow rates and increase the
buffering capacity.
The second strategy is to try to reduce the numbers of cariogenic bacteria (S.
mutans) in the oral cavity.
The third strategy is to reduce the quantity and numbers of exposures of
ingested refined carbohydrates.
The fourth is to attempt to remineralize noncavitated lesions and prevent new
lesions from developing.
