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Operative Dentistry > CAMBRA baby! > Flashcards

CAMBRA baby! Flashcards

1
Q

Dental caries is an ______ microbiological disease of the teeth that results in localized dissolution and destruction
of the calcified tissues.

A

infectious

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2
Q

What are the two categories of factors that have our caries balance?

A

1.Pathological 2.Protective

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3
Q

BOOM: WHAT ARE THE 4 indicators of HIGH caries risk in CAMBRA?

A

1.Visible Cavities Present 2.Caries restored in last 3 years 3.Interproximal Caries lesions/radiolucencies 4.White Spots on enamel surfaces

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4
Q

LETS GET IT!!!! What are the 9 indicators for MODERATE caries risk in CAMBRA?

A
  1. MS and LB medium/high by culture 2.visible heavy plaque 3.frequent snacks (>3x/day) 4.Deep P&F 5.Drugs 6. Bad Saliva Flow (meds, radiation, Sjogrens) 7.Exposed roots 8.Ortho Appliances
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5
Q

ASSIGN A RISK LEVEL!!! Disease Factors: None Risk Factors: None Protective Factors: one or more

A

low risk

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6
Q

ASSIGN A RISK LEVEL!!! Disease Factors: None Risk Factors: One or more Protective Factors: need to increase

A

medium risk

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7
Q

ASSIGN A RISK LEVEL!!! Disease Factors: one or more Risk Factors: blank Protective Factors: need to increase

A

high risk

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8
Q

ASSIGN A RISK LEVEL!!! Disease Factors: one or more Risk Factors:low saliva flow Protective Factors: need to increase

A

extreme risk

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9
Q

What are the 4 ways we can INCREASE PROTECTIVE FACTORS??

A

1.Topical Fluoride 2.Saliva Stimulation/Supplement 3.Antibacterial Tx 4.minimally invasive restorative dentistry

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10
Q

Hey heres a concept that works!!! ______ the tooth and _____ the bacterial infection!

A

restore…treat

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11
Q

CAMBRA DAWG!!! Antimicrobials: Low Risk

A

Not indicated

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12
Q

CAMBRA DAWG!!! Antimicrobials: Moderate Risk

A

Not indicated

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13
Q

CAMBRA DAWG!!! Antimicrobials: High Risk

A

CHX-10mL rinse for 1 min daily at bedtime for 1 wk/month

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14
Q

CAMBRA DAWG!!! Antimicrobials: Extreme Risk

A

CHX-10mL rinse for 1 min daily at bedtime for 1 wk/month

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15
Q

CAMBRA DAWG!!! Bacterial Test/Saliva Flow: Low Risk

A

basline reference

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16
Q

CAMBRA DAWG!!! Bacterial Test/Saliva Flow: Moderate Risk

A

baseline/suspision

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17
Q

CAMBRA DAWG!!! Bacterial Test/Saliva Flow: High Risk

A

tests at EVERY periodic oral exam

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18
Q

CAMBRA DAWG!!! Bacterial Test/Saliva Flow: Extreme Risk

A

tests at EVERY periodic oral exam

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19
Q

CAMBRA DAWG!!! Fluoride…Low Risk

A

otc fluoride toothpase 2x day

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20
Q

CAMBRA DAWG!!! Fluoride…Moderate Risk

A

otc fluoride- toothpaste, mouth wash

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21
Q

CAMBRA DAWG!!! Fluoride…High Risk

A

varnish at all visits, Rx toothpaste 2x day

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22
Q

CAMBRA DAWG!!! Fluoride…Extreme Risk

A

varnish, Rx toothpaste, AND gel in trays daily

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23
Q

CAMBRA DAWG!!! Freq of RGraphs—Low Risk

A

BW’s 18-24 mo

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24
Q

CAMBRA DAWG!!! Freq of RGraphs—Moderate Risk

A

BW 18-24 mo

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25
Q

CAMBRA DAWG!!! Freq of RGraphs—High Risk

A

BW 6-12 mo, until no caveated lesions

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26
Q

CAMBRA DAWG!!! Freq of RGraphs—Extreme Risk

A

BW every 6 mo until no caveated lesions

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27
Q

CAMBRA DAWG!!! Freq of POEs (Periodic Oral Exams) Low Risk

A

1/yr!

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28
Q

CAMBRA DAWG!!! Freq of POEs (Periodic Oral Exams) Moderate Risk

A

1/yr

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29
Q

CAMBRA DAWG!!! Freq of POEs (Periodic Oral Exams)

A

every 6-12 mo to re-eval and apply F- varnish

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30
Q

CAMBRA DAWG!!! Freq of POEs (Periodic Oral Exams)

A

every 3-6 mo to re-eval and apply F- varnish

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31
Q

CAMBRA DAWG!!! Xylitol/Baking Soda- Low Risk

A

none

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32
Q

CAMBRA DAWG!!! Xylitol/Baking Soda- Moderate Risk

A

2 sticks/mints 2x/daily

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33
Q

CAMBRA DAWG!!! Xylitol/Baking Soda- High Risk

A

2 sticks/mints 4x/daily

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34
Q

CAMBRA DAWG!!! Xylitol/Baking Soda- Extreme Risk

A

2 sticks/mints 4x/daily AND Baking Soda 4-6x/day

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35
Q

CAMBRA DAWG!!! Sealants–Low Risk

A

none

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36
Q

CAMBRA DAWG!!! Sealants–Moderate Risk

A

for deep P&F’s

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37
Q

CAMBRA DAWG!!! Sealants–High Risk

A

for deep P&F’s

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38
Q

CAMBRA DAWG!!! Sealants–Extreme Risk

A

for deep P&F’s

39
Q

When doing Caries Risk Assesment which factor had BY FAR the highest odds of having a cavity?

A

Interproximal Enamel Lesions! 13.6 (vs white spots 3.3 and visible plaque 2.7)

40
Q

_________ does not reduce the bacterial loading in the rest of the mouth!

A

Placing restorations

41
Q

Reducing caries risk status by ________ markedly reduced the level of new caries.

A

chemical therapy

42
Q

Enamel: Hexagonal crystals are closely packed, but with protein/_____/water channels between them

A

LIPID!

43
Q

Enamel rods are _______ to the surface of the tooth.

A

PERPENDICULAR

44
Q

What are the 4 Functions of Saliva? What is the MOST important one??

A

1.Antibacterial 2.Clearance 3.Lubrication 4.MINERAL EXCHANGE (most important)–buffering & re-mineralizatoin

45
Q

What is the “normal” stimulated saliva flow rate? Where do we draw the line and call it LOW saliva flow?

A

1.0 (haha or 1.4) mL/min….draw the line at 0.7mL/min

46
Q

What are the two most important inorganic compounds in saliva?

A

Calcium and Phosphate

47
Q

IMPORTANT! the LIPIDS in our saliva are high in ________.

A

Phosphate (a BUFFER)

48
Q

What are the pellicle forming proteins found in saliva? They inhibit spontaneous precipitation of ______ by binding to it. (making it available for Remineralization!!)

A

Proline-Rich-Proteins (PRP’s)…Calcium

49
Q

What is the salivary protein that helps with pellicle formation and inhibits PRIMARY precipitation of Ca AND PO4?

A

Stat-Her-Ins

50
Q

What is the AWESOME pellicle former, antibacterial, AND anti fungal protein in saliva?

A

His-tat-ins (histidine rich proteins)

51
Q

What Pellicle forming protein in saliva ALSO inhibits periodontal distruction!

A

Cys-tat-ins

52
Q

Antibacterial Salivary Proteins: ________ aggregation and lysis of oral micro-organisms; aggregation of bacteria

A

LysoZyme

53
Q

Antibacterial Salivary Proteins: _______: Binds iron needed for cell wall. Effective against S. mutans

A

Lacto-Ferrin

54
Q

Antibacterial Salivary Proteins: _________: Effective against S. mutans. WOO (hint, and cuts on skin)

A

Salivary Peroxidase

55
Q

Antibacterial Salivary Proteins: ________ Inhibits attachment of S. mutans to tooth surface.

A

sIgA

56
Q

Other salivary proteins: ______ DIGESTIVE

and antibacterial. Breaks down starch.

A

Amylase

57
Q

Other salivary proteins: _________: lubrication, bacterial aggregation, pellicle

A

Mucins

58
Q

THE SALIVARY PELLICLE: Thin film on the surface of the enamel, Comprised of strongly adsorbed specific _______ and _____ from the saliva, Begins immediately. Forms within _____. Matures in days. Multiple layers.

A

proteins….lipids….HOURS

59
Q

The Pellicle is also a protective layer for ________, protection from _______, and is a mineral store needed for ________..NOT ALL BAD!!

A

lubrication….demineralization….remineralization

60
Q

THE GOOD in SALIVA: Salivary proteins contribute to the _______ to protect the outer surface


A

pellicle

61
Q

THE GOOD in SALIVA: Salivary proteins maintain supersaturation of _________.

A

calcium phosphate

62
Q

THE GOOD in SALIVA: Salivary calcium and phosphate inhibit _______ and enhance ________.

A

demineralization…remineralization

63
Q

THE GOOD in SALIVA: Saliva carries ______ around the mouth

A

fluoride

64
Q

THE GOOD in SALIVA: Salivary components ______ plaque acids

A

buffer

65
Q

THE GOOD in SALIVA: Salivary proteins have _______ properties

A

antibacterial

66
Q

THE GOOD in SALIVA: With low saliva, caries activity grows

_________.

A

exponentially

67
Q

What is the FIRST bacterial to colonize the teeth? How? (oxygen preferences, pH)

A

S. Sanguinis..aerobic, pH of 7

68
Q

What is this term used to describe S.Mutans? Produce acids that can dissolve the tooth..

A

Acidogenic

69
Q

What is this term used to describe S.Mutans? Can survive in a low pH environment.

A

AcidUric

70
Q

S. Mutans can adhere to the tooth structure using the extracellular _______ they produce.

A

GLUCANS!

71
Q

What is the critical point pH?

A

5.5

72
Q

Levels of S. Mutans in a White Spot Lesion are __-___ times higher then on adjacent sound enamel.

A

10-100x

73
Q

What is the other main bacterial family associated with Caries? The presence of this bug may indicate a _____ lesion.

A

Lactobacilli…deeper!

74
Q

S. Mutans can survive without ______, Colonize in furrows of the ______.

A

teeth…tongue

75
Q

By what method does acid get to the enamel and how does Ca2 & P04 leave the enamel?

A

diffusion!

76
Q

About ___% of the hydroxyapatite crystal is CARBONATED and is therefor more easily dissolved by acids.

A

20%!!

77
Q

In the early stages of demineralization, some of the dissolved mineral gets ______ at the surface as it exits the tooth…SO we can have a NON-cavitated lesion (with a cover on top!)

A

re-deposited

78
Q

How can I tell the difference between demineralization and gastric acid exposure?

A

Gastric acid/Citric Acid exposure is MORE damaging and gets Mulitple surfaces of multiple teeth

79
Q

What form of F- must we have in order to gain access to bacteria? What bacterial enzyme does it block?

A

HF…Enolase

80
Q

If the Pt is ingesting LIQUID sugar, then multiply by…

A

1

81
Q

If the Pt is ingesting Solid & Sicky sugar, then multiply by…

A

2

82
Q

If the Pt is ingesting Slowly Dissolving sugar, then multiply by… What is a high DIETARY risk?

A

3..Total of 9 or more

83
Q

In a pH test you record the pH every ______ for ___ minutes total.

A

minute…20

84
Q

What # is low risk for AMOUNT of SMutans via a bacteria test?

A

< 1500

85
Q

What does a HIGH bacterial test indicate for OVERALL caries risk?

A

> 1500 on the bacteria test indicates Moderate caries risk in CAMBRA

86
Q

CHX: Use ____ml and swish in mouth for __ minute

A

10mL…1min

87
Q

CHX: Spit out without ______, Continue daily for a total of __ days and then discontinue use Using same routine, rinse with NaF rinse for ___ weeks. See your dentist for ______ testing and re-evaluation If necessary, continue Chlorhexidine and NaF rinse regime used earlier

A

rinsing…7 days…3 weeks…bacterial

88
Q

Drawbacks of CHX: _______ & alters ______ if used for prolonged period, the 1% gel is not available in the ___. It is _______ for cariogenic bacteria.

A

stains & alters taste…US…NOT specific

89
Q

Is Iodine more effective in Children or adults?

A

Children

90
Q

Rank Xylitol, F- Varnish, CHX in prego moms not to pass S. Mutans to kiddo.

A

Xylitol > CHX > F- Varnish

91
Q

What is the THERAPUTIC dose of Xylitol/Day??

A

5-10mg/day

92
Q

What is MI paste made of? What are the 3 methods of delivery?

A

Amorphous Calcium Phosphate…1 Rub on teeth 3-5x/day 2.Tray 3.prohpy paste

93
Q

OK this is just fun now…..What are the 6 systemic diseases we, as the ORAL PHYSICIAN, can test for in the saliva??

A

1.Myocardial Infarction (c-reactive proteins released) 2.Renal disease (elevated nitrate/urea) 3.Breast Cancer (antigen) 4.Type II Diabetes (proteins) 5.Sjogren’s Syndrome (proteins) 6. DNA analysis (forensics, who the daddy)

Operative Dentistry (25 decks)

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