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Flashcards in Dentition Deck (25):
1

primary dentition

teeth start by 6mo

20 teeth by age 3 (8 incisiors +4 canines+ 8 molars = 20)

2

adult dentition

8 incisors + 4 canine + 8 premolars +12 molars
=32 teeth

3

dental caries

cavities

oral pain
poor eating = poor nutrition
missed school
impaired speech development
poor self-esteem
complications: cellulitis/abscess

4

early childhood caries

infectious and transmissible
destroys tooth structure
affects kids under 5

"nursing caries" and "baby bottle tooth decay" previous names

triad:
oral bacteria (ex Mutans strep) break down dietary sugars into acids which eat away the tooth

5

etiology of Bacteria for childhood caries

oral flora estab @6 mo
-mutans strep is vertically transmitted from primary caregiver (usually mom)
-caregivers w/ high bacteria lvls usually have:
-high levels of decay
-poor oral hygiene
-high frequency of sugar intake

Both bacteria and dietary habits are passed to child

6

etiology: sugars

-enamel demineralizes in response to oral acids, then remineralizes as acid is buffered (saliva)
-oral bac produce acids that persist for 20-40 mins after sugar ingestion
-how often sugar is ingested is more imp than how much sugar is eaten at once
-if sugar intake is frequent, demineralization predominates, teeth @ risk

7

white spots in mouth

-white spots indicate acids have demineralized enamel
-first clinical signs of caries
-white spots = risk for developing cavities
-indication for dental referral

8

Preventing ECC

-screening
-oral hygiene: brush 2x daily, help til age 6
-dietary guidance
-fluoride-- systemic and topical
-inform/advise about dental sealants
-encourage an age 1 dental visit
-improve parent oral health/dietary habits

9

Oral cancer and pre cancer

alcohol and tobacco increase risk of oral cancers -- including spit tobacco
-early lesions: may be asx
-sites: lateral tongue, floor of mouth, inside of lips, soft palate

10

Periodontal disease

Etiology:
-chronic plaque at gum line
-bacterial infection
-host inflammatory response

Three types:
gingivitis
chronic periodontitis
aggressive periodontitis

11

gingivitis

mildest form of PD:
mild gum swelling, tenderness, erythema, gums bleed during brushing
can occur acutely with foreign body
reversible

etiologies:
plaque
pregnancy
disease trauma

12

chronic periodontitis

more severe than gingivitis
infec/inflamm induce loss of bone and tooth attachment
rare in children, present in 50% of adults
can start in teen years
smoking = major risk
prevention: good oral hygiene, brush and floss, avoid tobacco

13

aggressive periodontitis

otherwise healthy
rapid attachment loss and bone destruction
amount of microbial deposits inconsistent with disease severity
familial association

14

oral/systemic link

-infective endocarditis
-prosthetic device infection
-diabetes

emerging evidence:
obesity
coronary artery disease
adverse pregnancy outcome (preterm, low weight, preeclampsia), lower respiratory disease

15

diabetes and periodontitis

poor glycemic control assoc with 3x inc risk of periodontitis

diabetics w/ good control? no signif increased risk
chronic infec like periodontal disease complicates glucose control

(pts with periodontal disease 2x more likely to devel diabetes)

16

Obesity

fat tiss releases TNFalpha and IL6 which potentiate inflammation, including periodontal disease

TNFalpha also causes insulin resistance

17

coronary heart disease and stroke

CHD and periodontitis are assoc
inflamm cytokines implicated in atherogenesis are also produced by periodontitis
dental plaque organism have been found in vascular plaque and induce platelet aggregation
systemic antibody response to periodontitis is assoc w/ CHD
smoking assoc w/ both
both share elevated CRP levels

18

Tx in pregnancy?

-tx of periodontal disease in pregnancy is safe
-doesn't alter rates of preterm birth or low birth weight

19

Preeclampsia

women with periodontitis 2x as likely to get preeclampsia
endothelial cell damage due to inflammatory mediators is a proposed mechanism

20

Lower resp disease

-chronic aspiration of oral bacteria:
COPD
acute pneumonia

-hosp/ventilated pts at risk
-->need to provide oral care to reduce vent. assoc pneumonia

21

xerostomia

dry mouth
decreased saliva promotes periodontal disease

many meds:
steroids
antihistamines
diuretics
antihypertensives
anticholinergics
antidepressants

22

Cognitive and behavioral

-self care deficits
-chronic disease burden/multiple meds
-dietary changes
-compliance difficulty: meds, oral hygiene
-dependence on caregivers
-chewing and swallowing diff -- nutrition
-lack of understanding leading to resistance to care

23

most common chronic disease of childhood

dental caries
-5x more common than asthma
-50% in low income children, up to 70% in Native Americans

24

Periodontal ligament

binds teeth to bone

25

What can worsen diabetes?

periodontal disease