Exam 3 Flashcards by Jerica Grim

Foods and beverages that are commercially processed in optimally fluoridated cities can be distributed and consumed in nonfluoridated communities.

This effect can result in increased fluoride intake by individuals living in nonfluoridated communities providing them some protection against dental caries

Halo/Diffusion effect

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Provides the most effective method for dental caries prevention and control

Fluoride

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By way of the circulation to developing teeth

Systemically

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Directly to the exposed surfaces of erupted teeth

Topically

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A nutrient taken into the body by way of fluoridated water, dietary supplements, and found in small amounts in foods.

Tea, fish, and brocolli

F12

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Absorbed by diffusion from the stomach as hydrogen fluoride. Most is absorbed within 60 minutes of ingestion.

F12

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What percentage of the F12 in the body is located in the mineralized tissues(teeth and bones)?

99%

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What part of the body is fluoride excreted through?

kidneys

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The fluoride ion replaces some of the hydroxyl ions of the hydroxyapatite; fluorapatite is the nformed, which is less soluble and more resistant to acid formation.

Also results in the development of shallower occlusal grooves, reducing the risk of pit and fissure caries.

Excessive f12 during enamel formation and tooth development results in dental fluorosis. (The enamel is hypomineralized.)

Pre-Eruptive: Mineralization Stage

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After mineralization is complete and before eruption, f12 deposition continues in the surface of the enamel.

Children who are exposed to fluoride for the first time within the 2 years prior to eruption have the greatest amount of f12 acquired during this pre-eruptive stage.

Pre-Eruptive: Maturation Stage

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Hypomineralized (or decalcified) enamel absorbs f12 ingreater quantites than some enamel

Posteruptive

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Topical fluoride works to:

Inhibit demineralization
Enhance remineralizaton of incipient lesions
Inhibit bacterial activity by inhibiting enolase, an enzyme needed by bacteria to metabolize carbohydrates
Desensitizer
Inhibits erosion

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Continuous use of fluoridated water from birth can result in..

40-65% fewer carious lesions (40% in the primary teeth)

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Led to the conclusion that the level of fluoride in the water optimum for dental caries prevention averages 1ppm in moderate climates

Trendley Dean

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Began his studies to find the cause of “brown stain” which later was called mottled enamel and now is known as dental fluorosis

Fredrick McKay

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A chemist, pinpointed fluorine as the specific element related to the tooth changes that Dr. McKay had been observing clinically

H.V. Churchill

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What is the optimal fluoride concentration used for municipal water supplies to prevent dental caries?

0.7-1.2 ppm (parts per million)

For temperature climates, 1ppmThis

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Absorbs the most fluoride before the other parts of the tooth

Decalcified enamel

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If a patient has a significant concern, such as pain, this need is addressed prior to intiating dental hygiene treatment

Chief complaint

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What is fluoride found in?

pesticides

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Most common for patient on regular hygiene recall intervals

Neutral Sodium Fluoride due to its neutral pH of 7.0

2.0% Sodium Fluoride (NaF) Gel/Foam

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Recommended for high risk carie
Etches porcelain, composite restorative material, and sealants so it should NOT be used on patients with such restorations.

1.3% Acidulated Phosphate Fluoride (APF) Gel/Foam

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Has tricalcium phosphate
Great for use in children due to caries inhibiting effect and great diffusibility
Reduces demineralization in white areas around ortho brackets
Application of choice for dentin hypersensitivity!!!!
Cavity liner

5% Neutral Sodium (NaF) Varnish

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Acute fluoride poisoning is rare

True or False

True

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Certain lethal dose of of fluoride toxicity

Adult 5-10g of NaF taken at one time | Child 0.5-1.0 g, variable with size and weight

What do you do when a patient has ingested too much fluoride?

``` Induce vomiting (manually or with Ipecac syrup) Administer fluoride-binding liquid when patient is not vomiting: milk, milk of magnesium, or lime water ```

What are the parts of a dental hygiene care plan?

Periodontal/Gingival Health -Primary objective is to restore and maintain health of the periodontal tissues Dental Caries Control -Includes fluorides, sealants, and dietary control of fermentable carbs Prevention -Preventive care starts with the patient's personal daily biofilm control and includes interventions such as: tobacco cessation, risk factor reduction, desensitizing exposed dentin, helping with halitosis, etc.

Properties of unwaxed floss

Thinner floss helpful for tight contacts More likely to fray and shred Flossing removes biofilm from proximal surfaces

Prevents soft tissue trauma due to wax coating Resists breaking/shredding Wax gives strength and durability

Waxed Floss

Types of interdental brushes

Small insert brushes with reusable handle | Brush with wire handle

Uses for interdental brushes:

Proximal tooth surfaces with open embrassures Ortho Fixed prostheses Dental implants Space maintainers Any hard to reach area For application of chemotherapeutic agents

End-Tuft brushes

Open interproximal areas Fixed dental prostheses Difficult to reach area

Broad spectrum antibacterial and antigingivitis

Chlorhexadine (CHX)

What does chlorhexadine do?

``` Action: Binds to oral hard and soft tissue Causes cell lysis Prevents biofilm accumulation Substantivity 8-12 hours ``` Availability and Uses: 0.12% solution Preprocedural rinse before/during/after perio debridement Efficacy: Antimicrobial & antigingivitis Considerations: Brown staining Causes heavier calculus formation Altered taste sensation (metallic)

What are local self care methods for delivering chemical agents? What are the benefits?

Toothbrushing Rinsing Irrigating Preventive Therapeutic Cosmetic

Why do we do preprocedural rinses?

To reduce bacterial load before instrumentation producing aerosols

Benefits of oral irrigation:

Reduction of gingivitis & bleeding Reduction of subgingival dental biofilm Reduction of inflammatory mediators Subgingival delivery *The standard jet tip can penetrate below the gingival margin 44% to 71% of the pocket depth

Functions of Chemotherapeutic Agents/:

Remineralization: restore mineral elements Antimicrobial: bactericidal or bacteriostatic Gingival health: reduction and prevention of gingivitis Astringent: shrink tissues Anodyne: Alleviate pain Buffering: reduce oral acidity Deodorizing: neutralize odor Oxygenating: cleansing

Segment connecting the submerged implant body to the prosthetic component Provides a platform for attaching crowns or bridges

Abutment

Capable of existing in harmony with the surrounding biologic environment

Biocompatible

What is fibrous encapsulation?

Layer of fibrous connective tissue between the implant and surrounding bone. Also called fibrous integration; indicative of failed osseointegration

What is osseointegration?

The direct attachment or connection of osseous tissue to an inert alloplastic material without intervening connective tissue

Reversible inflammation of the periodontal tissues around an implant with no subsequent bone loss; similar to gingivitis in a natural tooth

Peri-implant mucositis

Destructive inflammatory process of the periodontal tissues around an implant charcterized by progressive bone loss in addition to soft tissue inflammation with hemmorrhage and/or exudate; similar to periodontitis in a natural tooth

Peri-implantitis

Risk factors for caries:

``` behavioral factors dietary factors low fluoride tooth morphology and position xerostomia genetics developmental factors ```

Risk factors for perio disease:

``` behavioral factors tobacco use systemic condition hormonal considerations nutritional status iatrogenic factors genetic factors ```

Risk factors for systemic infections:

``` infective endocarditis cardiovascular disease and atherosclerosis diabetes mellitus respiratory disease adverse pregnancy outcomes ```

Risk factors for oral cancer:

tobacco use alcohol use sun exposure

Material: titanium or vitallium | Rests over the bone of the mandible or maxilla; complete arch or unilateral

Subperiosteal Implant

Most commonly used for denture patients Material: stainless steel, ceramic-coated materials, and titanium alloy Pt has atrophic endentulous or a congenital or traumatic deformity of the mandible

Transosseous Implant

An implant within the bone to replace a single tooth or provide support for the replacement of complete or partial loss of teeth Most common type to use Material: primarily plasma-sprayed titanium

Endosseous Implant

Indicates failure of osseointegration. Mobility is evident.

Fibrous encapsulation

Implant/Soft Tissue Interface

Soft tissue connection: sulcular epithelium is in contact with the implant surface The long junctional epithelium of an implant is arranged parallel to the fixture, surrounding it, but with no attachment No connective tissue (Sharpey's fibers) exist to hold the attachment as with a natural tooth

Hypersensitivity

Exposed cementum/gingival recession

Gingival bleeding

Biofilm accumulation causing inflammation

Increased caries risk

Previous history of dental caries and consumption of sugar-sweetened beverages frequently throughout each day

Biofilm control record score= fair to poor score

Limited ability to perform oral self-care tasks

Reversible bacterial infection in the soft tissue similar to gingivitis. Mild color change with bleeding may be present

Initial Stage- Mucositis

Inflammation has reached the level of the bone. Edema or hemmorage is present in the surrounding tissues. Probing depths are increased.

Secondary Stage Periimplantitis

Inflammation present but no mobility. Consult surgeon if no response to tx in 2 weeks.

Ailing Implant

Inflammation present. Bone loss has occured and continues. Mobility faintly noticeable.

Failing Implant

Evident mobility. Radiographic changes are evident, often showing a vertical bony defect. Refer pt. immediately back to surgeon.

Failed Implant

What type of instruments are used on dental impants?

Plastic instruments No ultrasonic Only non-abrasive prophy paste is used if any at all

Wedge or v-shaped cervical lesion created by the stresses of lateral or eccentric tooth movements during occlusal function, bruxing, or parafunctional activity resulting in enamel microfractures

Abfraction

Transient pain arising from exposed dentin, typically in response to stimulus

Dental Hypersensitivity

Theory there is fluid movement within the dentinal tubules

Hydrodynamic Theory

What type of fluoride is used with dental implants?

Neutral Sodium Fl is recommended | Avoid acidic fl

APF

Acidulated Phosphate Fluoride

Breakdown of the tooth structure with loss of mineral content, primarily calcium and phosphorus

Demineralization

Decayed, missing, and filled teeth

DMFT

Apatite formed when low concentrations of fluoride react with tooth mineral; at higher concentrations, calcium fluoride is formed.

Fluorhydroxyapatite

Form of enamel hypomineralization due to excessive ingestion of fluoride during the development and mineralization of the teeth

Fluorosis

Occurs when foods and beverages processed in a fluoridated community are imported and consumed in a nonfluoridated community

Halo or diffusion effect

NaF

Neutral Sodium Fluoride

PPM

parts per million

Restoration of mineral elements in a tooth surface

Remineralization

SnF2

Stannous fluoride

Indentification of an existing or a potential oral health problem that a dental hygienist is qualified and licensed to treat

Dental Hygiene Diagnosis