CAMBRA Flashcards
Explain the dynamic chronic process of caries.
Caries results from release of acids formed in biofilms that cover susceptible tooth surfaces.
Bacteria ferment available carbs, generating acids that can diffuse into enamel/dentin and dissolve the carbonated HA tooth material.
Three primary mechanisms of fluoride in managing caries
1) inhibits demineralization
2) enhances remineralization
3) (at high concentrations) inhibits bacterial metabolism
What factors potentiate caries in the prosth patient?
1) acidogenic bacteria
2) reduced salivary function
3) existing restorations harboring plaque (overhanging or open margins)
4) frequent ingestion of fermentable carbs
5) decreased OH compliance or skills
6) root exposure
7) FPD or RPD wear
Toothpaste containing fluoride reduces incidence of caries by what %?
20-35% depending on dose and frequency. Standard level in toothpaste (1000-1100ppm) is effective.
chlorhexidine mechanism of action
CHX is strong base with cationic properties
cationic molecules bind to negatively-charged bacterial cell walls, disrupting the osmotic balance and weakening the bacteria over time
What is chlorhexidine most effective in conjunction with? What is the issue with the combination?
fluoride
Fluoride is (-) and chlorhexidine ion is (+), so should be used 1h apart to not compete.
recommended dosage of chlorhexidine
10 mL of .12% rinse for 1 min at night at least 1h after brushing with fluoridated toothpaste
xylitol mechanism of action
increases salivary flow
raises pH
decreases colony counts of S. mutans
decreases adherence of S. mutans to tooth structure
recommended use of xylitol gum
chew gum 2x/day for 15 min
dose: 10g/day
How does caries-indicating dye work?
What are two key ingredients? Which one was banned?
Stains areas of dentin with altered organic matrix
Ingredients:
- polypropylene glycol
- basic fuchsin or erythrosine (red dye no. 3)
- erythrosine (red dye no. 3) was banned Jan 2025 due to carcinogenic potential– eating high dose can cause thyroid cancer
