Plaque control Flashcards

1
Q

Why is it important to control plaque?

A

important in control of gingivitis and maintaining good oral health, preventing dental caries and periodontal disease

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2
Q

How can we control plaque?

A

mechanical removal via brushing or flossing or prophylaxis using antimicrobials

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3
Q

What is the optimum concentration of fluoride in water supply and why is it used?

A

1 ppm, influences remineralization of enamel, makes it more resistant to acids therefore reduces caries, can inhibit the metabolism (glycolysis) of some plaque bacteria

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4
Q

What is fluoridosis?

A

staining from excess fluoride

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5
Q

Because there is a short contact time in the mouth, what must antimicrobials be able to do?

A

bind to the oral mucosa

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6
Q

Why are antimicrobials formulated into oral health products?

A

Most people cannot maintain oral health using mechanical methods alone

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7
Q

Once antimicrobial agents are adsorbed to the mouth what happens?

A

they are slowly released back into oral environment, re-distributed around the mouth

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8
Q

What is Chlorhexidine?

A

a broad spectrum oral antimicrobial which binds to surfaces well and reduces plaque, caries and gingivitis

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9
Q

What can long term use cause?

A

staining and mucosal irritation

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10
Q

What type of formulation is chlorhexidine added to?

A

mouthwash, gel, varnish

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11
Q

What is Triclosan and how does it work?

A

a broad spectrum antimicrobial, a phenol, it selectively inhibits obligately anaerobic gram-negative bacteria, multiple modes of action: Inhibits acid production, reduces inflammation, inhibits bacterial fatty acid metabolism

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12
Q

How can Triclosan be enhanced?

A

by formulation with a co-polymer or zinc citrate because zinc ions inhibit sugar transport, acid production and protease activity.

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13
Q

What formulation is triclosan used in?

A

paste

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14
Q

What do Dextranases and glucanases do?

A

modify plaque matrix

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15
Q

What does glucose oxidase and amyloglucosidase do?

A

boost salivary peroxidase system (antimicrobial system in saliva)

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16
Q

What does menthol, thymol and eucalyptol do?

A

can penetrate plaque also adds colour and taste

17
Q

Why are oils used in formulations?

A

disrupt cell membranes and inhibit enzymes

18
Q

What do quaternary ammonium compounds do?

A

broad spectrum antimicrobials, cationic, binds to bacterial cell membranes and disrupts integrity, Inhibits glucan synthesis and co-aggregation step of plaque formation

19
Q

QACs can only be formulated as what?

20
Q

What type of metal ions are used in formulations?

A

zinc or stannous salts

21
Q

What do zinc salts do?

A

inhibits bacterial glycolysis (from making glucose), may be synergistic with other antimicrobials

22
Q

What does Zinc lactate do?

A

inhibits VSC (volatile sulfur compounds) production, end product of bacterial anaerobic metabolism (foul smell)

23
Q

What does stannous fluoride do?

A

inhibits caries formation, reduces dental hypersensitivity

24
Q

What surfactant is commonly used in oral health products?

A

SLS, Sodium Lauryl sulfate

25
Why are surfactants used in oral health products?
they have detergent properties therefore disrupts lipids, they are bactericidal and inactivate bacterial enzymes, they foam to coat the teeth and remove organic matter to bulk phase
26
What is a downside to surfactants?
some people may be allergic, foaming can inhibit enzymes from working
27
What happens to arginine when in contact with oral bacteria and what is it used for?
metabolised to ammonia containing end-products by oral bacteria, arginine salts increase pH keeping it above critical caries levels
28
What is an additional use of arginine
As a sensitivity blocker (blocks dental tubules). This use requires a higher conc of arginine
29
What sugar substitutes are used and what is the purpose of using them?
aspartame & saccharin, prevent caries as they are not metabolised by plaque bacteria. Sorbitol, mannitol & lactitol used in sugar free chewing gums
30
What are the potential benefits of using oral probiotics?
potential life-long protection, good patient compliance
31
31. What is the role of pharmacists in oral health?
health promotion, encourage patients to brush twice daily, encourage patients to reduce intake of free sugars, smoking cessation, encourage patients to reduce alcohol consumption