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1-visual examination detection


1-primary mode of detection for pit/fissure caries, dry field, good lighting, & magnification

2- 0=sound surface
1= first visual change in enamel
2= distinct visual change in enamel
3= localized enamel breakdown, no visible dentin
4=non cavitated surface w/ underlying dark shadow from dentin
5=visible dentin
6=extensive distinctive cavity w/ visible dentin


1-risks for oral health

2- risk indicators

3-protective factors

1-physical= genetic, handicapp, arthritis, mental comp
social= drugs, alc, financial, oral health 
medical= radiation, Rx meds, chemo
dietary= smacks, carb beverages, balance of diet

2-xerostomia, plaque, active caries, hypocalcification, recent fillings= 3 yrs, extractions

3-oral hygiene practices, daily fluoride, sugarless gum (xylitol), saliva, balanced pH, sealants


1-low risk
2-moderate risk
3-high risk
4-extreme high

1-no new cavities, no meds affecting saliva, good home, no snacking, chekups

2-few white spots, no new cavities, no meds w/ saliva, limited snacking, ortho work: prevident

3-1 or more cavities, medications affect saliva, bad home care, no checkups, snacking: prevident 2x, xylitol

4-anterior caries, smooth/root caries, dry mouth meds, no checkups, snakcs
prevident 2x, xylitol, otc toothpaste


1-early childhood caries



1-bottle caries

2-eliminate, reduce, alter effect of microorganisms in oral cavity: fluorides, chlorhexidine, xylitol, remineralize

3-promote tooth remineralization: make enamel decay resistant, inhibit acid creation: toothpaste, varnish, trays, rinses OTC, water


1- office tray range

2-avg toothpaste

3-rx prevident range

4-flouride varnish

5-chlorhexidine gluonate

1-1.23%---> 12,300

2- 0.20%---> 900

3- 1.1%---> 4,950

4- 5%--->22,500

5-alteration of bacterial adsorption, reduction in pellicle formation, and alter bacterial cell wall lysis
reduction in plaque biofilm and gingivitis= teeth staining, and alteration of taste



2-remineralizing pastes

1-prevent caries= lower levels of sucrose & free acid in whole saliva, lower plaque.  lowest lactobacilli saliva
-caries pathogen suppression & caries reduction in high risk

2-recaldent= milk derived= remineralizes teeth and prevents dental caries, stabilizes Ca, P, and fluoride as water soluble 
casein phosphopeptide & amorphous calcium


1-green tea


3-barley tea


1-rich in catechin= antioxidants.  inhibts s. mutans, kills bacteria, combats plaque

2-macelignan.  decrease s mutans levels

3-popular drink, inhibit s. mutans

4-developed safe & effective sugar free herbal pops that kill cavity causing bacteria


what are dental sealants

-caries preventive approach to oral health
-plastic coatings applied to chewing surfaces of teeth on noncavitated
-mainly for kids


dental sealant process

-isolate/pumice clean/rinse
-etch 15 s/ rinse 10 s/ dry
-apply/cure 20 s
-bond/wipe dry/rinse/check occlusion


1-localized hypoplastic enamel 


3-preventive approach

4- most common decay in kids

5-succesful fissure sealing

1-aplastic---areas where no enamel forms

2-varying degrees of surface breakdown

3-low in sugars, brush/floss, toothpaste/rinse, literacy, xylitol gum, dry mouth, dental sealants

4-pit & fissues 

5-prevents bacteria from colonizing, cuts off carb supplies, helps with oral hygiene


1-resin composites

2-resin portion 

3-particle portion

4-resin composite as restorative

5-fluroides vs sealants

6-dental sealants effective

1-combo of inorganic particles surrounded by coupling agent, w/in organic resinous matrix

2-bowens resin---bisphenol

3-inorganic fillers used in resin composites= strengthen + reinforce 

4-need to isolated from salivary mositure, they are sensitive to moisture

5-fluoride isnt as preventive on deep grooves of back teeth

6-when sealed=effective, retention= 85%


1-risk to chemicals in comp of dental sealants

2- risks w/ dental sealants selling in decay

1-sealants have monomers from BPA (bisphenol A)

2-effect of sealing caries: pulp not endangered when placed over small pit & fissure lesions 



2- ergonomics risk factors

3-mitigating risk factors

1-assesses work related factors that may pose musculoskeletal disorders to help alleviate them
involves positioning of patient + provider w/ proper illumination

2-repetitive, forceful, prolonged exertion of hands
prolong awkward postures
vibration + cold
multiple risk factors

3-breaks, stretching, and use of ergonomics


1-ergonomic stats

2- ergonomics

1- 2/3= occupation related pain
1/3 retire early because of musculoskeletal disease 
out of 271 students---by 3rd year 71% = pain in neck/shoulder (female) and lower back (male)

2-postioning of provider/staff/patient, illumination, and use of mirror for safe care


1-provider posture

2-ergonomics & loupes


4-patient positioning

1-back straight, feet flat
height of stool so thighs are parallel to floot
back against backrest

2- taller people= longer working distance than shorter 

3-enhance visuality + posture + comfort
working distance, declination angle & frame size
20 degrees or less neck flexion

4-patient lying with back flat
w/ maxillary, put teeth at 25 degree angle to vertical
support head rest so it supports the neck
mandibular arch the toso should be 30-45 angle to floor
adjust height of chair until patients oral cavity is treated at level of elbow w/ arms at your side and forearms perp.  


1-mandibular posterior occlusal
2-mandibular posterior buccal
3-maxillar posterior occlusal
4-masxillary & mandibular lingual

1-right handed= 7 
left handed= 5

2-right= 9
left= 3


4-right & left= 12



outside illumination

outside switch= on/of 

middle switch= intensity

innermost switch= light from full spectrum white light to decreased spectrum yellow light

ideal distance of light is 27 inches---3 by 6 inch area 

for mandibular arch= position light from straight above
for maxillary arch= light in front of patient


1-direct vision

2-indirect vision

1-anterior arch + mandibular arch...need posture, positioning and illumination

2-use a mirrow, needs good grasp & finger rest and working w/ reversed mirror image

hold mirror as you would a pen, close to head w/ non dom hand
have middle finger extended so pad of finger lies against shank of the mirrow ( modified pen grasp
use ring finger as finger rest