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BDS2 Caries Symposium > 1 > Flashcards

1 Flashcards

1
Q

what caries is most commonly seen in GDH?

A

secondary caries

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2
Q

caries a.k.a.

A

tooth decay

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3
Q

what factors are necessary for caries?

A
  • tooth
  • substance (for bacteria to feed off)
  • flora
  • time
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4
Q

what flora most commonly causes caries?

A

streptococcus mutans

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5
Q

what influences are on the tooth that can effect its rate of getting tooth decay?

A
  • age
  • fluorides
  • morphology
  • nutrition
  • trace elements
  • carbonate level
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6
Q

what is a caries risk assessment?

A

the risk of the patient developing new/progressive disease in furture

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7
Q

what level does caries risk assessment need to be carried out on?

A

individual level
not population

although risk information is used within Dental Public Health to make population level decisions

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8
Q

what 2 categories are there for caries risk factors?

A

general

local

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9
Q

what are general caries risk factors?

A
  • social status (lifestyle, priorities, means of associated care)
  • general health - as has impact on oral health
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10
Q

what are local caries risk factors?

A
  • oral hygiene - barriers to it (disability, age)
  • diet - parental input, social status, easy to make healthy choices
  • fluoride experience
  • past caries experience
  • orthodontic treatment - harder to clean well and takes longer
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11
Q

what is a cariogram?

A

computerised version of caries risk assessment

  • pie chart
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12
Q

7 elements of caries risk assessment

A
  • clinical evidence
  • dietary habits
  • social history
  • fluoride use
  • plaque control (oral hygiene)
  • saliva
  • medical history
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13
Q

how do we assess clinical evidence for caries risk assessment?

A
  • dmft > 5 (primary dentition), DMFT > 5 (permanent dentition)
  • Caries in 6s (1st permanent molars) at 6 - high risk
  • 3 lesions in 3 years = high risk; 3 year caries increment > 3
  • fresh or unrecorded, past restorations with underlying caries,
  • Orthodontics can change as harder to clean
  • Prosthetics – fixed or removable
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14
Q

what does dmft/DMFT stand for?

A

decayed
missing and
filled
teeth

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15
Q

what does dmfs/DMFS stand for?

A

decayed
missing and
filled
surfaces

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16
Q

how do we assess dietary habits for caries risk assessment?

A
  • Greater than equal to 3 sugar intakes per day - concerning. Hidden sugar too
  • Frequency more important than volume
  • Better to eat in one go than over time
  • Highly processed/refined carbohydrate more cariogenic than natural sugars e.g. sucrose more cariogenic than glucose or fructose
  • Natural sugars - still harmful e.g. lactose in early childhood caries

Generic advice doesn’t work that well - so DIET DIARY good as specific to individual

  • 4 days everything eat and drink and times (one weekend)
  • Toothbrushing times too – stephen curve acid attack, only H20 after, 20 mins from last food and brush teeth
17
Q

how do we assess social history for caries risk assessment?

A
  • SIMD category (Scottish index of Multiple Deprivation)
  • Education
  • Employment
  • Work stressors
  • Single parent
  • Violence
  • Inequalities and access to healthcare
  • Dependents
18
Q

how do we assess fluoride use for caries risk assessment?

A
  • Are they getting from toothpaste twice a day consistently?
  • Floriated water area - down south
  • Fluorapatite is more caries resistant than Hydroxyapatite
  • There is some resistant streptococcal strains - upset there adhesion so not necessarily bactericidal
  • Interferes with the adhesion force of bacteria reducing their ability to stick to the surface of the teeth
19
Q

how does fluoride help lower caries risk?

A

Interferes with the adhesion force of bacteria reducing their ability to stick to the surface of the teeth

20
Q

how do we assess plaque control in caries risk assessment?

A
  • Oral hygiene (Technique, irregular brushing (definitely needed at night))
  • unassisted (very young/very old, manual dexterity issues)
  • access to toothbrush/paste,
  • difficulty due to changes in oral cavity (mixed dentition e.g. child’s mouth/orthodontics/gaps/recession)
21
Q

how do we assess saliva in caries risk assessment?

A
  • Role of saliva (amount, flow, buffering capacity, pH, viscosity)
  • Can just have poor saliva buffering quality - more prone to acid erosion
  • Need to be low viscosity so can wash between teeth
  • Xerostomia - dry mouth, congenital, due to medication side effect or intended side effect e.g. cerebral palsy
  • `
22
Q

how to assess medical history in caries risk assessment?

A
  • Inhalers - can make mouth dry or alter pH
  • Sugars in medicine - e.g. liquid medicines for children
  • Lactulose used in children to stop constipation - sugar - used to be taken just before bed but bad time to take
  • Frequency of sugar containing medicine- if medication for long time better to be sugar free or tablet form
  • Recreational drug use/rehabilitation from drug addiction (Methadone - highly cariogenic)
  • Sweets given to ill friends
  • Xerostomia - dry mouth, congenital, due to medication side effect or intended side effect e.g. cerebral palsy
23
Q

typical high caries risk child

A

Social

  • Mother’s education secondary only
  • Poor dental attender
  • Family Unit: single parent, social class, unemployment

Health

  • Poor health/chronic sick
  • Sugar-based medications

Caries Experience

  • dmft > 5, DMFT > 5
  • > 10 initial lesions in primary dentition at first attendance
  • caries in 6’s at 6 years
  • 3 year caries increment > 3

Orthodontics
- Fixed appliance therapy

24
Q

social status of typical high caries risk child

A
  • Mother’s education secondary only
  • Poor dental attender
  • Family Unit: single parent, social class, unemployment
25
Q

health aspect of typical high caries risk child

A
  • Poor health/chronic sick

- Sugar-based medications

26
Q

caries experience of typical high caries risk child

A
  • dmft > 5, DMFT > 5
  • > 10 initial lesions in primary dentition at first attendance
  • caries in 6’s at 6 years
  • 3 year caries increment > 3
27
Q

orthodontics experience of typical high caries risk child

A

has Fixed appliance therapy

28
Q

additional considerations which may be needed for high caries risk infants and toddles

A
  • Advice for mother if she is high for new-born
  • Prolonged nursing habits - stop overnight feeding as soon as
  • Put to bed with bottle - cause caries overnight, frequent small intakes of lactose
  • Cariogenic snacking
  • Breast feeding mothers - prolonged overnight can cause caries
  • Start brushing babies’ teeth - microflora completely changes as soon as tooth erupts - start cleaning straight away - also familiarisers them to it
  • Little fluoride exposure
29
Q

typical caries risk adult

A
  • Level of education
  • Attends only when they identify a problem
  • Social difficulties
  • “Sweet tooth” with poor Oral Hygiene
  • Sugar containing meds or meds affecting saliva

Caries should be a childhood disease

  • Root caries
  • Secondary caries - underneath leaking restoration
30
Q

8 levels of caries prevention

A

Radiographs
- miss majority unless take

Toothbrushing instruction

Strength of F in toothpaste
- can be high strength for some adults

F varnish
- 22800 ppm F 4 times a year – childsmile

F supplementation
- not so common, mouthwash if high risk and age doesn’t allow high F toothpaste

Diet advice

Fissure sealants - younger people

Sugar free medicine

BDS2 Caries Symposium (5 decks)

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