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Perio 2 > 3 - Non-surgical Therapy - Chemical Home Care > Flashcards

3 - Non-surgical Therapy - Chemical Home Care Flashcards

1
Q

What chemical cleaning options are available to patients for home use?

A

toothpaste and mouthwash

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2
Q

What ingredients are present in toothpaste (8)?

A

fluorides, triclosan, humectants (xylitol), surfactants, abrasives

foaming, thickening, and flavoring agents

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3
Q

What abrasives are present in toothpaste (6)?

A

Ca++ phosphates, Ca++ pyrophosphates, Ca++ carbonate, Na++ bicarbonate, hydrate silica, alumina

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4
Q

_______ _____ control is necessary to reduce gingival inflammation. This can be done through brushing and flossing. These ________ methods may not be enough.

A
  • supragingival plaque

- mechanical

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5
Q

Toothpaste as a drug:

  1. Target: ?
  2. Route: ?
    3: Carrier: ?
A
  1. calcified and soft tissue (teeth/gums)
  2. toothbrush - mouth
  3. inactive ingredients potentiate
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6
Q

(T/F) - Triclosan/copolymer toothpaste is equally or slightly more effective than regular fluoride for plaque reduction AND reducing gingival inflammation (Loe and Silness index).

A

T

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7
Q

The normal triclosan MIC for bacteria is 0.29 - 0.78 ug/mL, whereas it is _______ for dental plaque.

A

4.14 ug/mL

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8
Q

Triclosan inhibition of IL-1B and TNF-a inflammatory mediators leads to favorable inhibition of _______.

A

PGE2 (Prostaglandin E2)

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9
Q

Though SnF (stannous fluoride) and triclosan both have anti-inflammatory effects, triclosan is favorable because ________.

A

SnF causes staining (looks fluorotic)

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10
Q

Fluroide usage in higher concentrations for children under age 6 should balance ________ and _______.

A
  • risk of fluorosis

- caries

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11
Q

Mouth washing is good because: ________________.

A

Teeth are only 25% of the mouth, liquid caries can travel

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12
Q

What is the only mouthwash that must be prescribed? What ingredient is the reason?

A
  • 0.12% CHX (cetylpridinium chloride)

- chlorhexidine

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13
Q

Supragingival Mouthwashes: __________

  • 26% acohol (phenolic)
  • indication: plaque, bad breath, gingivitis
  • action: essential oils inhibit gingivitis symptoms
  • 56% gingivitis reduction, 36% plaque reduction
A

Listerine

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14
Q

Mouthwash Mechanism of action: __________
- broad spectrum G+ and G-
- disrupts CW
reduce plaque endotoxin levels

A

Listerine

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15
Q

Supragingival Mouthwashes: _________

  • 0.05% cetylpyridinium chloride
  • reduce plaque and gingivitis
A

CPC (cetypyridinium chloride) - Viadent

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16
Q

Supragingival Mouthwashes: _________

  • 0.05% cetylpyridinium chloride
  • antiseptic mouthwash
  • quaternary ammonium compound

Apparently also works on plague and gingivitis…

A

CPC (cetylpyridinium choride) - Cepacol

17
Q

Mouthwash Mechanism of action: __________

  • Ruptures bacterial cell wall
  • alters bacterial metabolism to inhibit cell growth
A

CPC

18
Q

Supragingival Mouthwashes: ___________

  • 0.12% chlorhexidine gluconate
  • treat gingivitis and bleeding gums
  • action: alters PM permeability of bacteria
A

CHX / Chlorhexidine / Peridex

19
Q

Chlorhexidine has what negative side effects if used in too high a concentration (3)?

A
  • tooth discoloration/increase calculus
  • hypersensitivity/allergic reaction (local)
  • bitter taste/taste disruption
20
Q

Mouthwash Mechanism of Action: ________

  • rupture PM
  • binds salivary mucins, reducing pellicle, inhibits plaque colonization
  • 60% plaque reduction, 42% gingivitis reduction
A

CHX/Peridex

21
Q

_______: bad breath caused by chemical by byproducts of bacteria. What 3 chemicals? General others?

A
  • Halitosis
  • H2S, CH3SH, CH3SCH
  • Short chain FA’s, polyamines (cadaverine, putricine), N byproducts (urea), ketone byproducts, alkalines, phenyl byproducts
22
Q

If bad breath is not removed by periodontal treatment, what else could be a cause (that we discussed), and to whom would you refer your patient?

A
  • Sinus infections

- ENT

23
Q

What 3 steps should a dentist use in treating halitosis?

A
  1. eliminate etiological factors
  2. review oral hygiene habits
  3. recommend dietary changes
24
Q

Is mouthwash recommended for patients with halitosis?

A

Yes

25
Q

What should a dentist do preoperatively to help with an antiseptic oral environment?

A

Mouthwash is NOT effective preoperatively. Professional cleaning is recommended.

26
Q

(T/F) - Herbal medicines are an uncommonly used health remedy for people, as many seeking treatment can be properly treated by their dentist or physician.

A

F

27
Q

(T/F) - Most people that use herbal medicines in the USA are middle-aged, college-educated individuals.

A

T

ex of herbal meds: Chitosan (derived from chitin)

28
Q

(T/F) Based on the FDA’s 3 categories of safety, the mouthwashes EO, CPC, and CHX are classified as category I.

A

F

EO and CPC are category I, but CHX must be prescribed

29
Q

When HEALTHY patients used CHX and EO long term, what 3 effects did these mouthwashes have on oral bacteria?

A
  • no microbial overgrowth
  • no opportunistic infection
  • no development of microbial resistance
30
Q

Alcohol mouthwashes are contraindicated in what 2 groups (since mouthwashes are meant to be expectorated)?

A
  • alcoholics

- children at or under 12 years old

31
Q

(T/F) - Alcohol mouthwashes should be used only as needed, because there is a link between them and oral cancers.

A

F

- there are no carcinogens in it, use as directed by dentist

32
Q

In patients with xerostomia, _______ ______ on tissues that aren’t thoroughly irrigated is (low/high). In addition, salivary flow rates are (lower/higher) after use of EO mouthwash.

A
  • irritation potential / low

- higher

33
Q

(T/F) - Fluorine is a safe element that we’re exposed to on a regular basis though things we consume such as tea, fish, meat, fruit, as well as non-edibles (toothpaste, razor blades, Teflon, etc.).

A

F
- fluorine is a toxic element that can be harmful to the CNS in high concentration, but we are indeed regularly exposed to it

34
Q

(T/F) - Triclosan is generally considered safe, even though we have high exposure rates to it in soaps, toothpastes, deodorants, etc.

A

T

35
Q

Aside from offering a true/accurate portrayal of the intended use and _______ of a product, the ADA Seal of Acceptance for antiplaque/antigingivitis agents requires what time requirement (in studies) and what minimum amount of gingivitis reduction?

A
  • efficacy
  • two 6-month studies
  • 20% gingivitis reduction
36
Q

ADA Clinical Trial Guidelines:

How must studies be “designed?”

A
  • randomized, crossover, or parallel group, well-controlled
  • normal VS placebo
  • 2+ studies from independent investigators
37
Q

ADA Clinical Trial Guidelines:

Population info?

A

must represent typical product users

38
Q

ADA Clinical Trial Guidelines:

What methodology must be employed?

A
  • 6+ months
  • scoring performed at baseline
  • qualitative plaque sampling
  • quantitative plaque sampling
  • must be safe

Perio 2 (15 decks)

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