Dental care Flashcards
(59 cards)
1
Q
What is the current status of oral health in NZ?
A
- prevalence of total tooth loss has decreased since 1976
- among children, the percentage of 12-13 year olds who are caries-free has doubled since 1988
- dental decay still a problem
- in 2009, 1 in 3 adults had untreated coronal decay, and 1 in 10 had root decay
2
Q
What are the three main layers of the tooth?
A
crown, neck, root
3
Q
What is the enamel?
A
outer most shell
4
Q
What is the dentine?
A
layer behind the enamel
5
Q
What is the pulp?
A
layer under the dentine.
this contains the blood vessels and nerves
6
Q
What is the gum (gingiva)?
A
structure which holds the tooth in place.
7
Q
What is the bone?
A
structure below the gum
8
Q
What is the peridontal membrane?
A
membrane between bone and the cementum, in the root part of the tooth
9
Q
What is the cementum?
A
layer which holds the tooth in place in the gum
10
Q
What is the root canal?
A
leads up to the pulp
11
Q
What does appropriate dental care consist of?
A
- appropriate brushing
- flossing
- fluoride intake
- regular check ups
- reduce sugar intake
12
Q
What are dental caries?
A
- caused by bacteria in plaque metabolising sugars
- acid produced from metabolism causes demineralisation of enamel and dentine
- sucrose and glucose implicated
- individual predisposition varies
- genetic, saliva flow, tooth composition plays a larger factor than nutrition
- fluoride can increase resistance to caries process
13
Q
What is the role of fluoride in dental care?
A
- some areas fluoridate water, usually around 1ppm.
- strongly supported by ministry of health
- said to prevent and reduce tooth decay across the whole population.
- most tooth decay is preventable and fluoridation is a good way to prevent it
14
Q
How else is fluoride available?
A
- tooth paste
- fluoride varnishes
- fluoride mouth rinse
- topical fluoride gels and foams
- fluoride supplements only used when recommended by dentist or dental therapise
15
Q
What are the requirements of fluoride in toothpaste?
A
- should be labelled in ppm fluoride
- toothpaste of at least 1000ppm is recommended for all ages and should be used bd.
- smear of fluoride toothpaste is recommended until 5 years old
- from 6 years pea-sized amount should be used
- under 6 years living in fluoridated areas, at low risk of dental caries, can consider fluroide toothpaste less than 1000ppm to reduce total fluoride intake
- children supervised when using toothpaste (should not be eaten)
16
Q
what can fluoride enriched teeth withstand?
A
acid attacks from metabolised sugar
17
Q
What increases risk of dental caries/
A
- eating sugars between meals
- natural sugars like fructose, honey, fruit juice can also cause caries
18
Q
What can help with dental caries?
A
- snacking on sugar free things, savoury items
- sugar free cewing gum may help to remineralise damaged enamel by encouraging saliva flow (rich in Ca and P)
19
Q
What is toothache?
A
pain due to tooth - may not necessarily be in the mouth
- commonly presented in pharmacies
- generally caused by caries
- may be accompanied by swelling of gum or face, bad breath or bad taste in mouth
20
Q
What questions should be asked regarding toothache?
A
- where is the pain
- how long have you had the pain?
- describe the pain?
- is there any swelling?
- is there an unpleasant taste in the mouth?
- when did you last see the dentist
21
Q
How can toothache be managed?
A
-will require treatment from dentist, but symptomatic relief can include analgesic or clove oil.
(clove oil might cause irritation)
22
Q
What can gum disease cause?
A
- bleeding gums
- unsightly appearance of gums
- bad breath
- premature tooth loss - can affect appearance, eating, speaking
23
Q
What is the mildest form of gum disease?
A
gingivitis
24
Q
What is gum disease?
A
- caused by bacteria in plaque
- bacterial metabolism irritates the gums
- gums are red, swollen and bleed easily
- there is little/no discomfort at this stage
- reversible with professional treatment and good at home oral care
25
What happens if gingivitis is left untreated?
peridontitis can occur
26
What is peridontitis?
- pockets of bacteria form where gums fall away from teeth
- begins to destroy bone and tissue that support the teeth
- changes the way teeth fit together
27
What dental care advice can pharmacists give?
- brush teeth regularly to remove plaque
- dont use hart brush
- floss daily
- regular dentist and teeth cleaning
28
What treatment is available for gingivitis?
chlorhexidine mouth wash- kills bacteria but is not a suitable substitute for brushing
-may stain teeth temporarily
29
What is the prevalence of ulcers?
~25% people have an ulcer at some time
| -often no cause and not infectious
30
What are the most common causes of ulcers?
- trauma to mucosa.
| - see health professional if it does not resolve within 7-10 days
31
What can ulcers be treated with?
- chlorhexidine mouthwash and local anesthetic gel or Orabase
- corticosteroid paste
- pain killers
32
When should ulcers be referrred?
- ulcers that don't heal after 2 weeks
| - recurrent ulcers where no cause has been identified
33
Can ulcers be recurrent?
- yes, often occurring in crops although sometimes singly,
- not always in the same place
- may be related to dentures which may require re-adjusting
34
What pharmacist only preparations can be used to treat ulcers?
Triamcinolone 0.1% in an emollient dental paste (Oracort)
35
What general sale preparation can be used to treat ulcers?
Choline salicylate 87g/g (Bonjela)
36
What is hypersensitivity?
- occurs when dentine is exposed due to receding gums/nerves
| - teeth may be sensitive to hot, cold and touch
37
How can hypersensitivity be treated?
-desensitising toothpaste can help
-strontium can be used to seal the surface
-potassium containing products can reduce transmission on nerve impulse
fluoride toothpastes can offer protection
38
What may bleeding gums indicate?
- trauma
- gingivitis
- vitamin C deficiency
- may be more evident during pregnancy due to hormonal changes
- refer if unresolved
39
What is halitosis?
- extensive tooth decay
- peridontal disease occurs in pockets where the gum is loose
- may be due to oral infections, cancers
- bacteria produce sulfides
- some medical conditions can precipitate this
40
What can help with halitosis?
- advise improved dental hygiene
| - visit dentist if it continues to rule out infection
41
What is trenchmouth?
a painful form of gingivitis which is rare
- seen in younger adults
- may be assoc with stress, smoking, poor dental hygiene
42
What are the symptoms of trenchmouth?
- painful gums
- profuse gum bleeding in response to any pressure or irritation
- gums appear reddened and swollen
- greyish film on gums
- crater-like ulcers in between the teeth on the gum papillae
- foul taste in the mouth
- bad breath
43
What can trenchmouth be treated with?
- mouthwash
- dental hygiene
- scaling
- antibiotics
44
What is xerostomia?
- dry mouth
- can be caused by drugs (anticholinergics, antidepressants, opiods)
- do not suck on sugary foods to stimulate saliva
45
What can be used to help with xerostomia?
- oral lubricants
| - sugar free gum
46
When is oral candida infection common?
in young children and elderly
| -often assoc with denture use
47
What helps with oral candida infection?
-careful cleaning of dentures
-antifungal treatments like Daktrin gel (Miconazole) which is a restricted medicine,
Nystatin suspension (restricted medicine)
48
What is the prevalence of cold sores?
between 20-40% of people have had a cold sore at some time
49
What events might precipitate a cold sore?
```
physical trauma
strong sunlight
mensturation
emotional stress
illness (e.g. cold)
```
50
What are the characteristics of cold sores?
- tend to recur at the same sites
- mostly involve lips,
- the nostrils may be involved but this is less common
51
What are the different stage of the cold sore?
Prodrome stage:
Day 1-2: tingle
Day 2-3: blister
Ulcer stage:
Day 4: weeping stage- this is most painful and contagious
Day 5-8: crusting
Day 9-12: final healing stage
52
What are the complications of cold sores?
herpes simplex virus can cause:
1. herpetic whitlow which is a painful infestation of the fingers
2. eye infection which can result in corneal blindness
-always wash your hands after handling or applying medicine to cold sores
53
What are the treatments for cold sores?
Aciclovir- best used at tingling stage
numbig agents for cold sores e.g. benzocaine, lidocaine, benzyl alcohol, camphor and phenol
Products which limit cod sore formation/promote their healing: zinc, lysine, phenol, tannic acid.
antibacterial agents to prevent secondary bacterial infection
medications which moisturise and soften cold sores e.g. petrolatum and allantoin
medications which provide sunscreen protection (SPF lip balm?)
54
Who does acute herpetic gingivostomatitis (AHGS) mostly affect?
- most likely in kids, but can be in in adults too
- often confused with teething
- very painful
- vesicles in the mouth burst and become ulcers
- can result in secondary infection
- referral is needed
55
What happens in teething?
- localised inflammation of the gum
- will want to bite on things to relieve the pain
- commonly assoc with red hot cheeks, crying, diarrhoea,
56
How is teething treated?
by treating symptoms - bonjela teething gel
| -if diarrhoea or fever is severe, refer
57
Which dental conditions need referral?
- intractable toothache
- swelling
- gingival overgrowth
- gingivitis plus foul breath
- bleeding gums- for several days
- severe ulceration
- ulcers that don't heal after 2 weeks
- burning mouth
- abscesses
- AHGS
58
What are the teeth cleaning techniques that should ideally be implented?
- hold brush at 45 degrees to gum and brush side to side along gum line
- brush 2x day for 2 mins each time
- new tooth brush every 3 months
- use soft/medium brush
- use correct size brush
- clean tongue gently
59
What teeth cleaning techniques should be avoided?
- brushing too vigourously, too often
- brushing after eating acidic food or drink (should wait half an hour)
- using hard toothbrush
- using abrasive toothpastes
- smoking
