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Perio 2 - SP19 > 2 - nonsurgical at home mechanical and chemical > Flashcards

2 - nonsurgical at home mechanical and chemical Flashcards

1
Q

plaque biofilm cannot be completely eliminated

plaque biofilm can be managed thru effective oral hygiene measures like

A

proper diet`- watch carbs/sugar frequency

toothbrushing 2X with ADA Fl toothpaste - 3x recommended

interdental cleaning

use of ada-accepted antimicrobial mouthrinse 2X

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2
Q

role of personal oral hygiene

~on the quantity and composition of _

~on longterm outcomes of _ tx

A

~on the quantity and composition of subgingival plaque

~on longterm outcomes of periodontal and surgical tx

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3
Q

ideal tooth brush features

handle size
head size
use of _ filaments
use of soft bristle configurations
bristle patterns which enhance interdental plaque removal
A

small size handle and head to reach posterior areas

use of end-rounded nylon or polyester filaments

we want soft brushes because somestimes too aggressive on the gingiva

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4
Q

6 brushing methods

A 
stillmann's method
roll and sweep method (modified stillmann's method)
Bass Method
Rotational Scrub
Charters Method
Horizontal Scrub
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5
Q

_ tooth brushing method

30 degree angle with bristles pointing toward the gingiva

movement in coronal direction with a vibrating and rolling stroke

half on gums half on tooth

A

Stillmann’s Method

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6
Q

_ brushing method

30 degree angle with bristles pointing toward the gingiva

movement in coronal direction with a rolling stroke

A

Roll or Sweet Method
Modified Stillman -

more coronal surface same angle to stillmans method

angle because trying to get bristles in sockets

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7
Q

_ brushing method

45 degree angle with the bristles pointing toward the gingiva

movement with a vibratory, circular motion

A

Bass Method

we have prob heard of this method

Modified Bass method
-additional sweeping motion following vibratory, circular motion - only one we can recommend

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8
Q

_ brushing Method

brush is positioned on the tooth surface

bristles are perpendicular to tooth and gingival surfaces

movement is in small circulatory motions

A

rotational scrub

no angle - perpendicular

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9
Q

_ brushing method

45 degree angle with bristles pointing toward the occlusal surface

movement back and forth in a circular motion

best method for patients with open interpoximal spaces

most difficult method to do correctly

A

Charters Method

angle is totally opposite of Bass

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10
Q

_ brushing Method

90 degree angle between brush and teeth

movement in horizontal motion

this method should be used occlusal surfaces

can cause both soft and hard tissue damage at cerical area

A

horizontal scrub

only good for occlusal surfaces

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11
Q

really no difference in tooth brushing methods as long as the patients are brushing

_ plaque removal with a toothbrush is ineffective

A

interproximal plaque

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12
Q

difference between waxed and unwaxed floss?

A

no difference

might use waxed in really tight contacts

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13
Q

when do we recommend using proxybrushes

A

where there are large interproximal spaces to clean

change every 2 weeks

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14
Q

explain in general toothbrushing frequency and duration study

A

for 6 weeks following a patient
12-48 hours of not brushing for 2 minutes didn’t really make a difference

we still recommend 3x a day because patients don’t brush for the full 2 minutes

2 minutes accepted to get big reduction in plqaue but after 2 minutes it slows

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15
Q

_ brush for distal of posterior molar - ortho brackets

A

end tufted brush

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16
Q

2 rows of bristles for gum line

A

sulcus brush

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17
Q

we use tongue brushers/scrapers especially for _

A

halitosis

bacteria on the tongue big cause of bad breath

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18
Q

3 things associated with trauma from brushing

A

gingival erosion
cervical abrasion
gingival recession

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19
Q

rounded or cut ended filaments for brush

A

rounded ends produce less trauma to gingival tissues

20
Q

toothbrushes can effectively remove plaque for at least _ months and that after _ weeks one should consider replacement

A

2 months
9 weeks

2 weeks for interproximal brushes

21
Q

big picture about powered toothbrushes

A

powered brushes with a rotation oscillation action provice slightly better plaque removal and may provide better protection against gingival inflammation than manual

Rotation and oscillation action are better

Not recommended for every patient because costly - we give to patients that have manual brushing problems - also for too aggressive brushing

22
Q

Dentifrice(toothpaste) effects on periodontal health

Supragingival plaque control is necessary to reduce _

A

gingival inflammation

appropriate brushing and flossing can reduce supragingival plaque

23
Q

toothpaste ingredients

for plaque and stain removal - can cause root sensitivity

make up 10-50%

A 
abrasives
~Ca-phosphates
~Ca-pyrophosphates
~Hydrated Silica
~Alumina
~Ca-Carbonate
~Na-Bicarbonate

abrasion depends on particle hardness, size, and shape

24
Q

toothpaste ingredients

therapeutic 0.2-1.5%

replace Ca in hydroxyappatite

A

fluorides

sodium fluoride
monofluoro-phosphate MFP
stabilized stannous fluoride

25
Q

toothpaste ingredients

therapeutic 0.2-1.5%

_ only thing in toothpaste to help control inflammation or bleeding

A

Triclosan

Triclosan - only thing in toothpaste to help control inflammation

Patient has bleeding gums - we might want to give them a toothpaste with Triclosan

26
Q

toothpaste ingredients

40-70%, act to retain moisture and prevent the toothpaste from hardening on exposure to air. Glycerol, sorbitol, Xylitol and propylene glycol are commonly used.

also sweeten the toothpaste, though this is not their main function.

A

humectants

27
Q

toothpaste ingredients

foaming agents
thickening agents 0-12%
flavoring agents 0.8-1.5%

_0.5-2% mainly a foaming agent, which enables uniform distribution of toothpaste, improving its cleansing power.

A

surfactants

Na-lauryl-sulfate - Irium - SLS

Na-N-lauroyl sarcosinate 0 - Gardol

28
Q

which is more statistically and clinically effective in reducing plaque

triclosan/copolymer dentifrice or fluoride dentifrice

A
  • flouride better - tricolsan for bledding gumms

more effective at reducing gingival inflammation too

29
Q

compare stannous fluoride to triclosan

A

stannous fluoride has anti-inflammatory effects but it causes staining

triclosan does not cause staining, only thing to activly reduce bleeding,

30
Q

why use mouth rinse?

A

teeth only make up 25% of the oral cavity

biofilms cover the entire mouth, not just teeth

liquid carries actives to all areas of the mouth

plaque biofilm cannot be managed by tooth brushing and flossing alone

31
Q

Phenols, quaternary ammonium compounds, bisbiguanides, herbal extracts are examples of _

A

supragingical anti plaque and gingivitis agents

32
Q

Mouth Rinses

EO - Essestial Oils

fixed combo of

  1. Eucalyptol 0.092%
  2. Menthol 0.042%
  3. Methyl salicylate 0.060%
  4. Thymol 0.064%
A

LESTERINE

need alcohol as solution

33
Q

mouth rinses

CPC cetylpridinium chloride - active ingredient

quaternanry ammonium compound

A

crest prohealth

34
Q

mouth rinses

0.12% CHX
chlorhexidine

a _

Peridex and PerioGard

A

it is a bisbiguanide antiseptic

only one that needs a prescription

35
Q

EO - Essential Oils - Listerine

26.9% alcohol
_compound
has ADA seal of acceptance for plaque and gingivitis

1st OTC mouthwash in 1914

A

phenolic compound

~might want to watch for history of alcoholism

36
Q

EO - Essential oils exhibits broad spectrum of activity against gram positive or negative bacteria?

how?

A

both gram positive nand negative bacteria

EO non-selectively and rapidly disrupts bacteria cell wall

reduces plaque endotoxin levels and pathogencity for gingivitis

plaque reductions of up 56.3% and gingivitis reductions of up to 35.9% when used as directed

37
Q

CPC - Cepacol

14% alcohol
_compound
has ADA seal

A

quaternary ammonium compound

plaque - 15-25%
gingivitis - 20%

ruptures bacteria cell membrane, leading to rapid leakage of cell contents and cell death

may alter bacterial metabolism inhibitiing cell growth

38
Q

what kind of mouthwash?

ruptures bacteria cell membrane, leading to rapid leakage of cell contents and cell death

may alter bacterial metabolism inhibitiing cell growth

A

cpc cepacol

39
Q

what kind of mouthwash?

non-selectively and rapidly disrupts bacteria cell wall

reduces plaque endotoxin levels and pathogencity for gingivitis

A

EO essential oils - listerine

40
Q

what kind of mouthwash?

kills bacteria by altering the permeability of the cell membrane of the bacteria. this alteration causes the bacteria cell to leak. which eventually kills the bacteria

used to treat gingivitis and bleeding gums

A

peridex - chlorhexidine

0.12% chlorhexidine gluconate

Used to treated gingivitis and bleeding gums

Can’t brush teeth very well so always give CHX after surgery for post-op care

41
Q

which mouthwash may cause tooth discoloration or increase in calculus formation?

A

peridex - CHX

42
Q

which mouthwash may cause local hypersensitivity and sometimes generalized allergic reactions have also been reported

bitter taste and can cause taste interference

A

peridex - CHX

43
Q

which mouthwash?

binds salivary mucins, reducing pellicle formation which in turn inhibits plaque bacteria colonization

plaque reduction up to 60.9% and gingivitis reduction up to 42.5% when used as directed

A

CHX

ruptures bacteria cell wall membrane leading to rapid leakage of cell contents and cell death

binds bacteria. inhibiting absorption onto the teeth

44
Q 
bacteria and bacterial by products like 
H2S
CH3SH
CH3SCH3
short chain fatty acids
polyamines (cadeverin. putrecine)
Nitrogen byproducts (urea)
Keton byproducts
Alkalines
Phenyl byproducts
A

halitosis

malodor - bad breath

we need to eliminate etiological factors

review oral hygiene habits

recommend dietary changes

45
Q

only herbal extract we use - may work. coat the sutures

may have antimicrobial properties

A

Chitosan

derived from Chitin

46
Q

how can products get the ADA seal of acceptance

A

across two 6 month studies an average minimum of 20% gingivitis reduction is demonstrated in order to award the seal

Perio 2 - SP19 (16 decks)

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