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Test 3 Flashcards

1
Q

What are the effect categories with examples of dentifrices?

A

Costmetic - stain removal, freshens breath, inhibits formation of supragingival caluclus

Hygienic - removes plaque and food debris

Therapeutic - fluoride prevents/reverses caries, reduces gingivitis

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2
Q

What is the most widely used rinse for over 100 years?

A

Listerine

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3
Q

Key components to focus on when recommending dentifrices

A

Bioavailability
Levels of abrasivness
Neutral or basic pH
Individual needs
Amorphous Calcium Phosphate (ACP)
Casein Phosphopeptides + ACP
MI Paste
Novamin
Tri-Calcium Phosphate

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4
Q

What is bioavailabilty?

A

Proportion of therapeutic agents available in pharmaceutic substance that produces desired effect when used as recommended

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5
Q

Why is levels of abraisveness important?

A

More than 2% will cause abraison and hypersensitivity

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6
Q

Why is neutral or basic pH important?

A

To promote remineralization

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7
Q

What does amorphous calicum phosphate (ACP) do?

A

Aids in remineralization
Reduces sensitivity
Enhances fluoride delivery

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8
Q

Where can you find ACP?

A

Enamel Pro Fluoride Varnish
Some over the counter dentifrices

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9
Q

What happens when you add ACP with Caesin Phosphopeptides (CPP)?

A

When added together they have stabilizing properties which increase substantivity - helps to remineralize

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10
Q

What is MI paste?

A

It stimulates salivary flow and increases calcium/phosphate in saliva. Increased fluoride.

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11
Q

When to use MI paste?

A

Patients with Xerostomia

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12
Q

What is Novamin?

A

Combination of calicum, sodium, phosphorous, and silica

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13
Q

What does Novamin do?

A

Increases remineralization for caries protection

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14
Q

What is tri-calcium phosphate (TCP) for?

A

Anti-caries

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15
Q

How should an oral rinse or irrigation be used?

A

As an adjunt to mechanical plaque removal, not a replacement

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16
Q

How deeply should an oral rinse or irrigation penetrate?

A

Less than 1-2mm subgingivally

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17
Q

Are all types or rinses able to penetrate the protective slime layer of biofilm?

A

No

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18
Q

When is an oral rinse contraindicated?

A

For current or recovering alcoholics due to alcohol content

If client is using as a substitute to daily brushing and interdental aid

Children under the age of six, unable to expectorate fully

Mentally challenged who are unable to follow instructions

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19
Q

What are the functions of oral rinses?

A

Remineralization - restore mineral elements by including fluroide/caries prevention

Anti-microbial - therapeutic, control and reduction of perio disease

Biofilm control - therapeutic, reduces attachment ability of biofilm in early stage: 1-2 days

Reduction of gingivitis - therapeutic

Astringent - shrinks tissues

Alleviate pain

Buffering - reduce oral acidity

Deodorizing - neutralize odor - cosmetic

Oxygenating - cleansing

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20
Q

Uses of rinses

A

Before professional treatment (PPR) which can reduce micoorganisms by 90%, reduce the amount of micoorganisms avilable to aerosols through handpiece or ultrasonic scaler

Self care - used as part of homecare for specific needs

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21
Q

What is oral irrigation?

A

Delivery of a soultion via an irrigation tip into the gingival sulcus or periodontal pocket

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22
Q

What are the types of stimuli?

A

Tactile - contact and friction
Thermal - temp changes
- cold is most common
Evaporative - dehydration
Osmotic - pressure in tubules
- sugar and salt concentrations
Chemical - acids

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23
Q

What is the incidence of hypersensitivity?

A

Most common in ages 20-40
Experienced by 8-30% of the population
Higher incidence than periodontally involved client
Most common in cervical third of premolar and mandibular anteriors

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24
Q

What type of data collection would be done for hypersensitiviy?

A

Location
Severity
Onset /duration
Aggravating/relieving factors
Dental history

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25
What are the diagnostic tests for hypersensitivity?
Visual Palpation Congestion Occulsion Rads Bite stick STP Air water - cold Endo ice Transillumination Mobilty Thermal/electric pulp
26
What is hydrodynamic theory?
Movement of fluid within the dentin tubules Pressure on nerve endings Larger numbers of widened tubules
27
Treatments for hypersensitivity applied at home
Sensodyne max strength Sensodyne pronamel Sensodyne rapid repair Colgate sensitive pro-relief
28
What level of relief are at home treatments?
Mild
29
Professional applied treatments for hypersensitivity
Restorations Grafts
30
What level of relief are professional treatments for hypersensitivity?
Moderate - severe
31
What are the active ingredients in hypersensitivity treatments?
- Stonium acetate - Arginine - Novamin - Fluroide - Potassium nitrate
32
How does hypersensitivity treatment stonium acetate work?
Occludes tubules and prevents fluid flow
33
How does hypersensitivity treatment arginine work?
Blocks tubules
34
How does hypersensitivity treatment novamin work?
Mends bones and accelerates growth Blocks tubules
35
How does hypersensitivity treatment fluoride work?
Remineralization
36
How does hypersensitivity treatment potassium nitrate work?
Blocks pain signals Blocks synapse
37
How to avoid gingival recession
Soft bristles No long horizontal stroke Don't use too much pressure
38
Signs of acid erosion
Sensitivity Transparency Cracks
39
Treatment for acid erosion
Health diet - limit acidic food, don't frequently snack Regular dental visits Don't brush your teeth right after eating something acidic
40
Natural desensitization types
Sclerosis Secondary Smear layer Calculus
41
How does sclerosis naturally desensitize?
Mineral deposits in tubules deceases diameter Mineralized layer of peritubular dentin
42
How does secondary naturally desensitize?
Gradually deposited on the floor and walls of pulp chamber Insulation Accumulates with age, deceased diameter
43
How does smear layer (inorganic debris) naturally desensitize?
Accumulates after scaling, root planing, use of toothpaste, burr, attrition, abrasion plugs/blocks stimuli
44
How does calculus naturally densenitize?
Acts as a protective coating for exposed dentin
45
Techniques for managing clients with sensitivity
Diet modification Control biofilm Toothbrush techniques Burnishing Eliminate parafunctional habits
46
How to manage tooth sensitivity with diet modification
Limit acidic foods Discourage brushing right after eating Eliminate extreme temps and bad habits
47
How to manage tooth sensitivity with toothbrushing techniques
Soft bristles No long horizontal strokes
48
How to manage tooth sensitivity with burnishing technique
Apply desensitizing pastes to form a smear layer
49
What parafunctional habits to modify to manage tooth sensitivity
Grinding and clenching Stress reduction
50
How to provide denture care instructions
Verbal or written
51
How often does a client with complete dentures need to be seen?
Every 6-12 months
52
How often does a client with partial dentures need to be seen?
Depends on the assessment of the remaining teeth
53
Care instructions for dentures
Attend recall visits Remove overnight or at least 6-8 hours per day Clean them at home - brushing or polident Rinse Check for remaining debris Observe soft tissues Massage tissues with a soft toothbrush or finger before reinserting
54
Oral manifestations from dentures
Ulcerations Denture stomatitis Angular cheilitis Riboflavin Hyperplasia
55
What is denture ulceration caused by and what does it look like?
Ill fitting denture or chemical irritation, looks like a red halo
56
What causes denture stomatitis?
C. Albicans Poor oral hygiene Continuous wear Systemic conditions Chemincal irritation Allergy
57
Where is denture stomatitis usually located?
Under maxillary denture
58
What causes angular cheiltitis?
C. Albicans Staph. Aureus Pooling saliva
59
What does riboflavin look like?
Fissures Encrusted
60
Is riboflavin painful?
Yes
61
What causes hyperplasia?
C. Albicans Low grade trauma
62
Where is hyperplasia usually located?
Under maxillary denture
63
Implant brushing instructions
Brush 2-3x daily 45 degrees apically Soft bristles Chlorhexidine
64
Implant interdental aids
Proxy brush Floss daily (around - crisscrossed)
65
Dentifrices recommended for implants
Low abraisiveness
66
Oral irrigation recommended for implants
Limited areas Water + chlorhexidine
67
Clinical considerations for care of implant
No stainless steel, only plastic or medical grade titanium
68
Define determinate for health risk and health promotion counselling
Something that increases the probability of disease
69
What are the 12 determinats of health listed by the Public Health Agency of Canada?
Income and social status Social support Education Employment/working conditions Social environment Physical environment Child development Genetics Health services Gender Culture Personal health
70
What are examples of social determinats?
Meeting daily needs Education Health care access Quality of education/job training Resource and activities available Transportation access Public safety Support
71
What are modifiable risk factors?
Can be changed with intervention such as: smoking, inadequate plaque removal, diet, pathogens, stress, BOP, low fluoride use, tooth morphology, xerostomia, alcohol use, sun exposure
72
What are non-modifiable risk factors?
Cannot be changed with intervention such as: genetics, age, gender, systemic conditions, medications, osteoporosis, family history, developmental factors
73
What are the three behaviour theories?
Transtheoretical model (TTM) Social determination theory (SDT) Theory of planned behaviour (TPB)
74
What is the transtheoretical model?
Change is process, not an event - stages of readiness: 1. precontemplation 2. contemplation 3. preparation 4. actions 5. maintenance 6. relapse
75
What is the social determination theory?
Focuses on establishing new patterns based on client autonomy, improved self-efficiency
76
What is the theory of planned behaviour?
Dishtinguishes between stages of contemplation and over action. Client more likely to adhere to plan if they were already thinking about making changes
77
How does motivational interviewing work?
Engages with the client Collaborates with the client Informs the client Gives client autonomy Client does most of the talking with DH listens
78
What communication skills are needed for motivational interviewing?
Open ended questions Affirmations Reflective listening Summarizing
79
What does RULE stand for?
Resist the righting reflex Understand client motivation Listen Empower
80
What are the three communication styles of motivational interviewing?
Guiding Following Direction
81
How does guiding work?
DH listens Eye contact Nodding
82
How does following work?
Listening Suspend role as expert Let the client have a say Find motivator
83
How does directing work?
Help those who are stuck Give suggestions
84
What are the vulnerable populations?
Seniors Immigrants Unemployed
85
What does PACE stand for?
Partnership Acceptance Compassion Evocation
86
What is the PACE model for?
A philosphy for establishing client-clinican relationships
87
What does LEARN stand for?
Lsten Explain Acknowledge Recommend treatment Negotiate on plan
88
What is LEARN and ETHNIC for?
Culturally sensitive framework for communicating with cross-cultural environments.
89
What does ETHNIC stand for?
Explanation of illness Treatment tried Healers Negotiate on plan Interventions Collaboration
90
Role of the DH with tobacco or cannibis users
Identify users Oral cancer screenings Cessation counselling
91
Oral manifestations of various tobacco/cannabis products
Oral/pharyngeal cancer Periodontitis Nicotine stomatitis Gingival recession Implant and therapy failure Caries Stain Calculus Halitosis Impaired taste Dry socket Delayed healing Black hairy tongue Xerostomia
92
Nicotines neurochemical effects on the brain
Chronic relapsing brain disorder Decrease appetite Increase pleasure and relaxation feelings Releases dopamine, serotonin, norepinephrine, acetylcholine, vasopressin, and beta-endorphins
93
How long does it take for nicotines effects to hit the brain?
7 seconds
94
What does chronic exposure mean?
Less of an effect over time, a larger dose needed to get the same feeling
95
When does withdrawl hit?
Peaks at 12-24 hours, can last 2-4 days
96
Does recreational cannabis contain more THC?
Yes
97
Smoking cannabis oral side effects
Xerostomia Caries Increased consumption of FC
98
High frequency side effects from cannabis users
Perio Caries Xerostomia Stomatitis Gingival hyperplasia Gingivitis
99
Low frequency side effects from cannabis users
Bone loss Papillomas Squamas cell carcinoma Lung cancer Attachment loss Xerostomia Staining
100
Medical cannabis is used to treatY
MS Epilepsy Anxiety Depression PTSD HIV Chemo-induced nausea Cancer Autism
101
Is CBD an inhibitor of cancer growth?
Yes
102
Types of medical cannabis
Nabilone: capsule, antiemetic Nabiximols: spray, analgesic (pain management)
103
How long must a client have been without using cannabis to be seen in an office and our DH clinic?
Office: 4 hours Clinic: 12 hours
104
What is the percentage of tobacco users that want to quit?
70%
105
What are the relapse numbers for those who try to quit tobacco?
60% relapse within the first week 70% within the first month
106
What are the 3 A's regarding tobacco cessation for a DH?
Ask Advise Act
107
What are the nicotine therapy replacement options?
Nicotine patch Nicotine gum Nicotine nasal spray Zyban Nicotine inhaler Nicotine lozenge
108
Contrindications for nicotine patch
Contact hypersensitivity
109
Condtrindications for nicotine gum
TMD or dentures
110
Contrindications for nicotine inhaler
Bronchospastic disease

Preventative (1 decks)

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