Exam 4 Flashcards
(120 cards)
1
Q
When were the first communities fluoridated?
A
1945
2
Q
Who was a dentist in the early 20th century?
A
Dr. Frederick S. McKay
3
Q
When is the mineralization & maturation stage?
A
Pre-eruption
4
Q
When does primary teeth formation begin?
A
In utero
5
Q
When do first permanent molars begin mineralizing?
A
At birth
6
Q
What does Hydroxyapatite become?
A
Fluorapatite
7
Q
How does fluoride uptake after tooth eruption?
A
-First year after eruption
-Through surface exposure
-Drinking water
8
Q
What is associated with levels over 2 ppm ?
A
Fluorosis
9
Q
Adjustment of fluoride content in a water supply to the optimal concentration
A
Fluoridation
10
Q
Chemical systems to remove excess fluoride
A
Partial defluoridation
11
Q
How is fluoride absorbed?
A
GI tract
12
Q
When does less absorption of fluoride in the GI tract take place?
A
When taken with milk or food
13
Q
Fluoride not absorbed by the stomach will be absorbed in the ___
A
Small intestines
14
Q
When is the maximum levels of fluoride in the blood stream reached?
A
Within 30 minutes of intake
15
Q
What is the concentration in saliva after fluoride is absorbed?
A
0.01-1.04 ppm
16
Q
Where is 99% of fluoride in the body stored?
A
Mineralized tissue such as bones & teeth
17
Q
What does fluoride have a strong affinity for?
A
Calcified tissues
18
Q
When teeth are fully matured, what can fluoride treatment be altered by?
A
Caries
Erosion
Mechanical abrasion
19
Q
Where is most fluoride excreted through?
A
Urine
20
Q
What is the limited transfer through for the excretion route?
A
Plasma to breast milk
21
Q
What are the topical effects of fluoride?
A
o Inhibition of demineralization & bacterial activity
o Enhancement of remineralization
22
Q
Where may the level of fluoride be greater in?
A
Dentin
23
Q
Where is the level of fluoride high and increases with exposure?
A
Cementum
24
Q
What bacterial activity does fluoride inhibit?
A
Enolase
25
An enzyme needed for bacteria to metabolize carbohydrates
Enolase
26
A result of acids produced by metabolism of fermentable carbohydrates by bacteria
Demineralization
27
o Saliva buffers and neutralizes the acid
o Calcium and phosphorus are returned to the enamel
Remineralization
28
What is the percentage of reductions in caries due to water fluoridation alone among adults of all ages?
27%
29
With fluoridation from birth, the caries incidence is reduced up to ___ in the primary teeth
40%
30
What are the dry compounds of fluoride?
sodium fluoride
sodium silicofluoride
31
What is the liquid compound in fluoride?
hydrofluorosilic acid
32
What are the delivery methods of fluoride to teeth?
Topical application
Systemic
33
diffuses into the surface of the enamel of an erupted tooth
topical application
34
delivered through circulation incorporation into enamel during tooth development
Systemic application
35
When were optimum fluoride levels 0.7 ppm. in warmer climates to 1.2 ppm in colder climates?
1962
36
When did The U.S. Department of Health and Human Services recommend the lower level of 0.7 ppm due to many sources available to the general population?
2015
37
How is fluoride delivered systemically?
Water
Food
Supplements
Mouth rinses
Dentrifrices
38
Teeth exposed to an optimum or slightly higher level of fluoride appear how?
White
Shiny
Opaque
Without blemishes
39
What are the food sources of fluoride?
Meat
Eggs
Vegetables
Cereal
Fruits
40
What food/drinks have higher levels of fluoride?
Tea
Fish
41
Where is fluoridated salt available?
Europe
42
increased fluoride intake by individuals living in non-fluoridated communities, providing them with some protection against dental caries
Halo/diffusion effect
43
What are the sources of water?
Well water
Bottled water
Filtered water
44
What removes fluoride from water?
Reverse osmosis & distillation
45
What does not remove fluoride from water?
Water softeners
46
What are taken to compensate for the fluoride-deficient drinking water?
Dietary fluoride supplements
47
What age are dietary fluoride supplements recommended for with a high risk of caries?
6-16
48
What are the prescribed sodium agents?
Drops
Lozenges
Tablets
49
What ages are no supplementation recommended?
birth-6 months old
50
No more than how much sodium fluoride should be dispersed per household?
264 mg
51
What should not be taken with sodium fluoride and why?
Dairy products because fluoride can combine with calcium and be poorly absorbed
52
What are the professional topical fluoride applications?
2.0% NaF - Sodium fluoride
1.23 APF - Phosphate fluoride
5% NaF - Fluoride varnish
53
How many fluoride ions are in 2.0% NaF?
9,050 ppm
54
How many fluoride ions are in 1.23 APF?
12,300 ppm
55
What is the concentration of fluoride varnish?
22,600 ppm
56
What does fluoride varnish do?
Reduces demineralization of white spots on lesions
57
What are the contraindications of topical applications?
-Cost
-Rosin
58
Who should not use topical applications with rosin?
People with tree nut allergies
59
o Only professional topical Fl to be used for children under 6 years old
o Can be applied at age 1
Fluoride varnish
60
To arrest or reverse non-cavitated carious lesions on the occlusal surfaces of teeth
2018 ADA recommendations
61
Where is 5% NaF varnish every 3-6 months
Proximal surfaces
62
How is fluoride varnish applied?
o Apply to dry teeth
o Avoid eating for 30 minutes
o Avoid rough foods and brushing for 4 hours
63
o Used “off label” for caries arrest and prevention in high-risk patients
o State practice act determines who can use it
o 2x year application
o FDA approved as a desensitizing agent for dentinal hypersensitivity
38% silver diamine fluoride
64
What are some indications & advantages of silver diamine fluoride?
o Extreme caries risk
o Treatment challenged by behavioral/medical management
o Patients with carious lesions that may not be treated in one visit
o Patients with no access to dental care
o Noninvasive
o Cariostatic agent
o Reduces hypersensitivity
65
What are the contraindications of silver diamine fluoride?
o Allergy to silver
o Pregnancy/breastfeeding
o Painful sores or raw areas on gingiva
o Teeth with pulpal involvement
66
What is informed consent needed for?
Radiographs
Fluoride
67
What are the limitations and risks for silver diamine fluoride?
o Consent
o Applied 1-2 times at separate visits
o Stain black permanently
o Brownish stain if in contact with gingiva or skin
o Metallic/bitter taste
68
o Available as over the counter or prescription
o Not recommended for children under age 6
o High-risk preteens and adolescents
o Used for patients with demineralization, root exposure, orthodontics, xerostomia, hypersensitivity
o Applied from toothbrushing or rinsing
Self-applied fluoride mouth rinses
69
How much fluoride dentifrice should be used for a child 3 years or younger?
a smear (grain of rice) 2x/day
70
How much fluoride dentifrice should be used for a child 3-6 years old?
pea size 2x/day
71
How much fluoride dentifrice should be used for adults?
½ inch 2x/day
72
What is the lethal dose of sodium fluoride?
5-10 g
73
What is the safe dose of sodium fluoride?
1.25-2.5 g
74
What are signs & symptoms of an acute toxic dosage?
o Symptoms begin within 30 minutes of ingestion
o Nausea, vomiting, diarrhea, increased salivation & thirst
o Convulsions, cardiovascular & respiratory depression resulting in death in a few hours
75
What are the chronic toxicities?
-Skeletal fluorosis
-Dental fluorosis
-Mild fluorosis
76
What are the emergency treatments for a toxic dosage?
o Induce vomiting
o Call EMS
o If no vomiting: fluoride binding liquid (milk, lime water)
77
What type of documentation needs to be taken for fluoride?
o Type
o Concentration
o Delivery
78
What are the parts of a toothbrush?
Handle
Shank
Working end
Brush head
Brushing plane
79
What are the factors to toothbrush selection?
Patients ability
Position of teeth
Gingiva
Compliance
Bristles
Type
80
What are the guidelines for toothbrushing instructions?
Grasp
Sequence
Frequency
Duration
Force
General instructions
81
o Removes biofilm from adjacent to and directly beneath the gingival margin
o Cervical/proximal areas, open embrasure
o Exposed root surfaces
o Abutment teeth of foxed partial dentures & orthodontic appliances
The bass and modified bass methods
82
False teeth between a bridge
Pontics
83
Designed for cleaning the sulcus, cervical areas, and massaging the gingiva
The stillman and modified stillman methods
84
o Removes biofilm from teeth without emphasis on the gingival margin
o Recommended for children
Rolling stroke method
85
o Removes biofilm from proximal surfaces
o Massage marginal &interdental gingiva
o Adapts to cervical areas below the height of contour
o To clean under margins of a fixed partial denture (bridge)
o Orthodontic appliances
Charter method
86
Who is considered the father of dental hygiene?
Alfred Fones
87
o Toothbrush placed at a 90-degree angle to the long axis of the teeth
o Circular motion
Fones method/circular
88
o Horizontal scrubbing motion with bristles at a 90-degree angle to teeth
o Consider detrimental
o May produce toothbrush abrasion
The horizontal (scrub) method
89
o May work well with small children
Brush teeth edge-to-edge
90-degree to long axis of teeth
Leonard’s (vertical) method
90
o Facilitate mechanical removal of biofilm
o Found to be more effective than manual brushes
o Research proves a reduction in calculus & removes more stain
Power toothbrushes
91
Who is recommended to use a power toothbrush?
o Any patient
o Orthodontics
o Dental implants
o Aggressive brushers
o Disabilities/limited dexterity
o Use by caregivers
92
What does brushing the tongue reduce?
Bacteria
Halitosis
Coating & staining from smoking and tea
93
How does toothbrushing work for acute oral inflammatory or traumatic lesions?
Clean areas unaffected and use saline solutions and or chlorhexidine
94
How does toothbrushing work following periodontal surgery?
Oral care
Rinsing/brushing 24 hours after
Gingival graft: no brushing until instructed
Chlorhexidine
95
How does toothbrushing work following dental extraction?
Brush areas not affected
Saline solution rinse 24 hours after
96
What are soft-tissue lesions from toothbrushing?
Gingival abrasions
97
What are hard-tissue lesions from toothbrushing?
Dental abrasions
98
What are the adverse effects of toothbrushing?
Soft & hard tissue lesions
Bacteremia
99
How do you take care of toothbrush?
-Replacement every 2-3 months
-Soak in hydrogen peroxide/listerine
-Store in dry area
100
What's the documentation for initial toothbrush instructions?
-Type of brush
-Recommended changes
-Soft tissue & toothbrush edu.
-Tongue cleaning
101
What are the factors to teach patients on toothbrushing?
-Effects biofilm has on gingiva & teeth
-Daily removal of biofilm
-Ideal brush
-Hands-on instructions
-Proper care
-Tongue cleaner
102
What is a type I embrasure space? What is used?
-No gingival recession
-Floss
103
What is a type II embrasure space? What is used?
-Moderate papillary recession
-Intermediate brush
104
What is a type III embrasure space?
-Complete loss of papillae or extensive recession
-Unitufted brush
105
When/what would floss be used on?
* Healthy sulcus
* Good dexterity
* Ability to slide through contacts
106
When/what would a floss holder be used on?
* Healthy sulcus
* Dexterity problems
* Ability to slide through contacts
107
When/what would a water flosser/irrigation be used on?
* Gingivitis
* Implants
* Orthodontic deeper pockets
108
When/what would a interdental brush be used on?
* Embrasure spaces II & III
* Perio patients
* Exposed root surfaces
109
When/what would a wood stick be used on?
* Embrasure spaces II & III
* Perio patient
* Exposed root surfaces
110
What are the indications for use of interdental care?
o Proximal spaces adjacent to open embrasures
o Orthodontic appliances
o Fixed prosthesis
o Implants
o Exposed furcation
o Application of chemotherapeutic agents
111
Most frequently recommended for interdental cleaning of type I embrasures
Dental floss and tape
112
o Single precut or in a roll: super floss
o Removal of biofilm from teeth adjacent to wide embrasure spaces – loss of papilla
Tufted dental floss
113
o Proximal surfaces of widely spaced teeth
o Tooth surfaces next to an edentulous area
Gauze strips
114
What are the flossing aids?
o Power flossing aids
o Floss holders
o Floss threaders
115
o Conical flexible rubber plastic tip
o Cleans interdental area at and just below gingival margin
Interdental tip
116
o Bass or birch wood stick
o Triangular in cross section
Wooden interdental cleaner
117
Perio-aid: round toothpicks
Toothpick holder
118
Targeted application of pulsated or steady stream of water or other agent for preventative or therapeutic purposes
Oral irrigation/water flosser
119
o Reduction of gingivitis and bleeding
o Reduction/alteration of biofilm
o Subgingival access to pathogenic microorganisms
o Subgingival delivery of antimicrobial agents or just water
o Some research supports the claims listed above; however, most funding is from a single manufacturer. (Bias)
Oral irrigation benefits
120
What are other indicators for oral irrigation?
o Orthodontics
o Crowns and bridges
o Removes food debris
