1 Chances of that happening? Flashcards
What are the factors necessary for caries?
Tooth
- age
- fluorides
- morphology
- trace elements
- carbonate level
Substrate
- oral clearance
- oral hygiene
- salivary stimulants
- frequency of eating
- carbohydrate (type,concentration)
Flora
- strep, mutans
- oral hygiene
What is a caries risk assessment
the risk of the patient developing new/progressive disease in the future
Should caries be treated as an individual or population assessment
individual (although risk information is used within dental public health to make population level decisions
What are the general and local caries risk factors
General
- social
- general health
Local
- oral hygiene
- diet
- fluoride experience
- past caries experience
- orthodontic treatment
What are the 7 elements of caries risk?
- clinical evidence
- dietary habits
- social history
- fluoride use
- plaque control
- saliva
- medical history
(all 7 elements = determination of caries risk)
What is the role of clinical evidence in caries risk?
Caries experience
- dmft >5 (primary dentition), DMFT >5 (permanent dentition)
- caries in 6’s at 6 years
- 3 year caries increment >3
Orthodontics
Prosthetics
- fixed or removable
What is the role of diet in caries risk?
- > 3 sugar intakes per day
- high frequency
- highly processe/ refined carbohydrate more cariogenic than natural sugars (e.g. sucrose more cariogenic than glucose and fructose)
- natural sugars still cause harm e.g. lactose in early childhood caries
how many days should you take a diet diary for
4 (?)
at least one day should be a weekend
What is the role of social history in caries risk?
- SIMD category
- education
- unemployment
- work stressors
- single parent families
- violence
- inequalities and access to healthcare
- dependents
What is the role of fluoride in caries risk?
- infrequent use F toothpaste
- no F in water supply
What does fluoride do?
- Incorporation into enamel crystal to form flurorapitite which is more caries resistant (resistant to demineralization) than hydroxyapatite
- Bacteriocidal? Resistant streptococcal strains
- Interferes with the adhesion force of bacteria reducing their ability to stick to the surface of the teeth
What is the role of plaque control in caries risk?
Poor technique
- Irregular brushing
- Unassisted (very young/very old, those with manual dexterity issues)
- Access to toothbrush/toothpaste
- Difficulty due to changes (mixed dentition/orthodontics/gaps/recession)
What is the role of saliva in caries risk?
Amount Flow Buffering Capacity pH Viscosity
What is the role of medication in caries risk?
- Xerostomia (desired effect/side effect e.g. scopolamine patches/asthma inhalers)
- Other drug side effects making OH difficult e.g.Mucositits
- Free sugars to make medicine more palatable
- Lactulose
- Frequency of sugar containing medicine
- Recreational drug use/rehabilitation from drug addiction
- Social convention of how we act towards people who are ill- bring them sweets!
Describe a typical high caries risk child
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 at 6
- 3 year caries increment >3
Orthodontics
- fixed appliance therapy
