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Patient Care III > Antimicrobials and Caries Risk Assesment > Flashcards

Antimicrobials and Caries Risk Assesment Flashcards

1
Q

: harmful to patient

A

Adverse effect

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2
Q

: patient’s ability, desire, and motivation to use a product

A

Compliance

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3
Q

ability of an agent to absorb to teeth and surfaces and be released at therapeutic levels

A

Substantivity:

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4
Q

: may be harmful, useful, or beneficial

A

Side effect

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5
Q

pleasant taste and sensation, decrease in microorganisms, halitosis control

A

Cosmetic:

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6
Q

reduction in plaque, gingivitis and/or dental caries

A

Therapeutic:

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7
Q

Protects consumers from useless or harmful products
Therapeutic claims must be backed with proof
Evaluates Rx and OTC

A

Food and Drug Administration (FDA)

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8
Q

Advertising OTC and Rx

A

Federal Trade Commission (FTC)

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9
Q

Program is voluntary
Started in 1930 to “help consumers make wise choices”
Products submitted for seal must have independent, controlled studies to demonstrate effectiveness and safety
Seal is found on consumer products (professional product seal has been phased out)

A

ADA Seal of acceptance

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10
Q

Is it enough for an antimicrobial to reduce plaque only?

A

No; must be therapeutic

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11
Q

Used as solvent for active ingredients
High content can cause hyper-keratotic lesions
Possible link to oral cancer? (inconclusive and still heavily debated)

A

Alcohol

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12
Q

Cytoplasmic poison; causes rupture of cell membrane allowing leakage
Binds to mucins, reducing pellicle formation and inhibiting colonization
Binds to bacteria, inhibiting their adhesion onto teeth
Substantivity: 12-24 hours
12% alcohol
35-40% decrease in plaque and gingivitis
.12%
-Peridex, perio-gard

A

Cholorohexidine

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13
Q

0.12% CHXAlcohol free (water-based)
Therapeutically equivalent (?)
Evidence suggests it is as effective as AOH-based CHX
Consider as option for those pts who are intolerant of AOH or who might have other risk factors

A

ALCOHOL-FREE CHLORHEXIDINE

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14
Q 
Side effects of \_\_\_\_\_\_:
Staining
Altered taste
Supragingival calculus
mucositis
A

Chlorhexidine

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15
Q

What is the dosage and how many time a day for how long should it be used?

A

15 ml; Twice daily 30 secs

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16
Q

Most effective anti-plaque agent currently available
Available with prescription only
FDA approved (no longer carries the ADA seal of approval due to a change in the program)

A

CHX

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17
Q

_____ on established biofilm will have only superficial effects.
 is more effective when plaque is removed prior to rinsing.
The biofilm will adapt and protect itself from the effects.

A

CHX

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18
Q

Inactivated by toothpaste—important to rinse well with water prior to rinsing with it (or wait 30 min before rinsing with it)
DO NOT rinse with water immediately after rinsing with it
Recommend for patients who cannot or will not maintain adequate plaque control
Post (periodontal) surgical cases

A

CHX

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19
Q

Active ingredients: Essential oils: thymol, eucalyptol, methyl salicylate, menthol
Original formula: 26.9% alcohol (Cool Mint: 21.6% alcohol)
Alters cell membrane, causing leakage and cell death
18-25% decrease in plaque and gingivitis
Low substantivity

A

Phenolic Compounds (Listerine)

20
Q

Side effects of _______:
Bad taste
Burning sensation
Tooth staining

A

Phenolic compounds

21
Q

How often per day, how much, and for how long do you use phenolic compounds?

A

20 ml twice a day for 30 secs

22
Q

Introduced in 2010
“…powered by our 4 essential oils formula”
“…for patients who prefer an alcohol-free rinse”
This product is NOT Listerine Antiseptic without alcohol
COSMETIC
Contains essential oils for flavoring—they are NOT a therapeutic concentration

A

LISTERINE ZERO

23
Q

Ingredient in many OTC ‘cosmetic’ mouthwashes (.05%)
Quaternary ammonium compound
Marginally effective in reduction of plaque and gingivitis
Little to no substantivity

A 
Cetylpyridinium chloride (CPC)
0.5%
24
Q

ie: Crest Pro-Health Rinse Multi-Protection Rinse* // Colgate Advanced Pro-Shield
no alcohol
Studies indicate plaque and gingivitis reduction comparable to Listerine Antiseptic.
Mechanism of action: ruptures cell wall; also may alter bacterial metabolism and inhibit cell growth

A 
CETYLPYRIDINIUM CHLORIDE (CPC)
(.07% THERAPEUTIC CONCENTRATION)
25
Q

Alcohol free
Cleanses oral wounds, irritations
Preliminary information reported H2O2 to be effective against COVID
*More investigation: Data does not currently support

A

Hydrogen peroxide based rinses

26
Q

“…Plaque Loosening Rinse”
Marketed as pre-brushing rinse
Ingredients: surfactants (detergents), sodium bicarbonate, glycerin, alcohol (7.5%)
Non-toxic, non-irritating, no enamel damage
- No active ingredients
- Not therapeutic

A

PLAX

27
Q

The following are reasons to recommend a _______
Determine need (caries and/or periodontal)
Caries risk (OTC fluoride, Rx fluoride)
Patients who are unable to adequately remove plaque
Patients who, despite their best attempts, need adjunctive measures
Patients with ANUG (Acute Necrotizing Ulcerative Gingivitis)
Pre/post periodontal surgeryPatients undergoing disease control therapy

A

Mouthrinse

28
Q

Are the following products therapeutic or cosmetic?
Peridex(CHX)
Listerine Antiseptic (and generic equivalents)
Crest Pro-Health Multi-Protection Rinse/Colgate Total Advanced Pro-Shield (0.07% CPC)

A

THERAPEUTIC

29
Q

Are the following products therapeutic or cosmetic?
Scope, Cepecol, Lavoris, etc. (.05% CPC)
Whitening rinses
Plax and other pre-brushing rinses
Listerine Zero

A

COSMETIC

30
Q

Practice of holding a tablespoon of edible oil (coconut, sunflower, sesame, olive) inside the mouth and ‘pulling’ the oil through the teeth, anywhere from 1-5 minutes, up to 20 minutes or longer
Ancient, traditional folk remedy, practices in India and Southern Asia.

A

Oil Pulling

31
Q 
Multifactorial disease
Can be altered by secondary factors: fluoride, saliva flow, etc.
Bacterial infection, followed by acid attack
Remin/demin
Controlled by multiple risk factors
Trends
Decline: fluoride
Increase: fermentable carbohydrate
A

Caries

32
Q

 stabilize high concentrations of calcium and phosphate ions, together with fluoride ions, at the tooth surface by binding to pellicle and plaque
The ions are supposedly freely bio-available and can diffuse into enamel subsurface lesions, thus promoting re-mineralization
Evidence suggests that, under highly favorable conditions, these agents may re-mineralize lesions to a low/modest extent. There is need for independent, randomized, controlled studies, under clinically relevant conditions

A

CPP-ACP (Recaldent)

33
Q

□Active caries
□Restorations within 3 years
□Areas of demineralization, including interproximal

A

Caries disease indicators

34
Q 
□Multiple multi-surface restorations
□Frequent snacking/sugared drinks  
□Reduced saliva
□Exposed roots
□Visible, heavy plaque
□Deep pits and fissures
□Ortho
□Recreational drug use
□Physical or mental limitations
A

Caries risk factors

35
Q 
□Regular dental care
□Regular professional fluoride treatments/varnish
□Sealants
□Fluoridated water
□Fluoridated toothpaste
□OTC fluoride mouthrinse(daily)
□Rx fluoride daily (5000 ppm)
□Xylitol gum
□Xylitol products
□Adequate saliva flow
A

Caries protective factors

36
Q

_____ caries risk:

no disease indicators, <2 risk factors, has protective factors

A

□Low

37
Q

_____ caries risk

no disease indicators, >2 risk factors (but no caries

A

□Moderate

38
Q

_____ caries risk:

(cavitated lesion(s)/disease indicators OR > 3 risk factors)

A

□High

39
Q

Cleansing action
Re-mineralization and repair of enamel
Antimicrobial Properties
Diltuion of Plaque acids

A

Saliva

40
Q

Many compounds (antibodies, enzymes, hormones) found in blood are also found in it
_____ can be source to monitor oral and systemic health
Contains biomarkers that serve as indicator of normal processes, pathologic processes, and pharmacologic response to therapy
Biomarkers can be used to predict disease
Contribute to prevention and treatment
Aid in assessment of potential health risks

A

Saliva

41
Q

Detect levels of Strep mutans and lactobacilli (Most) require 48-hour incubation period and follow-up appointment to discuss results
Chairside tests available (15 minute result)

A

Salivary bacterial count

42
Q

_______ can lead to demineralization and dental caries
Influenced by time of day, diet, age, disease, and medications
Testing flow rate can aid in caries susceptibility and in diagnosing salivary gland dysfunction
Buffer capacity measures response to acid challenge

A

Insufficient salivary flow

43
Q

Provide opportunity for patient to objectively observe their dietary habits.
Gain overall picture of types of food in patient’s diet
To study food habits: ie. frequency and regularity of foods eaten. (record frequency of cariogenic foods)
Determine consistency of diet (fibrous vs sticky)
Overall objectives:
identify specific dietary behaviors that affect caries risk (identify the high-risk behaviors)
Enable clinician to open conversation regarding dietary habits

A

Diet assessment

44
Q

Record 24 hr period –week-long
Explain purpose
Review form/app that you will send home with patient
Encourage to fill out soon after eating
Record everything eaten, including beverages and in-between meal snacks.
Encourage patient to be detailed
Encourage patient to be truthful
Consider having patient include when he/she brushes/flosses

A

Diet diary

45
Q

During what appointment should caries assessment and prevention/management?

A

Diagnosis appt

Patient Care III (12 decks)

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