caries prevention Flashcards
why prevention? 3 things
- to decrease prevalence of disease
- to decrease rate of progression
- decrease spending/resources
in UK how much money is spend on dental treatment per year?
£2 billion
- trained personnel
- materials
define sequelae.
a consequence of previous disease/injury
what is the sequelae of caries?
loss of deciduous dentition =
- malocclusion - no space for permenant dentition
- difficulty maintaining normal diet - cant eat hard food
- psychological problems - bullying & not wanting to smile
the need for fixed or removable appliances
- regular dental treatment
- quite difficult to clean
what is the most destructive sugar according to the stefan curve and why?
sucrose as it causes the most RAPID DROP in pH
what is the time scale for the saliva to put the oral pH back to a normal?
15-40 mins dependant upon the saliva flow rate (increased with sugar free gum)
an increased saliva flow does what 3 things to microorganisms?
- inhibits adhesion
- inhibits growth
- inhibits metabolism
what bacteria does xylitol specifically supress?
strep mutans
caries and pre-eruption diet
high vit D and calcium good for bone development but no evidence for teeth
what has occured in developing countries where there is malnutrition?
- delayed tooth eruption
- increased caries due to different comp of saliva and flow
- hypoplastic enamel defects
what is the effect of fluoride and other trace elements pre eruption?
large number so studies show that fluoride has substantial effect on preventing caries pre-eruption
naturally found in soil, sea water, plants etc
ingested from fish
what is the ranking of how cariogenic sugar is from highest to lowest?
sucrose > glucose > fructose > maltose > lactose
3 ways that fluoride alters the tooth structure?
- increases re-mineralision of enamel
- prevents demineralisation of enamel
- decreases acid production in plaque
pre eruptive effects of fluoride on anatomy?
1- wider fissures
2- more rounded cusps
3- thinner enamel and dentine
how does fluoride make the enamel less susceptible to demineralisation?
it integrates itself into hydroxyapatite crystals in enamel giving fluorapatitie.
hydroxiapatitie critical pH = 5.5
fluorapatitie critial pH = 4.5 (less soluble)
what % of uk population live in water fluoridated area?
15%
lifelong residency in a water fluoridated has shown what % reduction in caries?
20-40%
what are the advantages of water fluoridation?
- safe (as verified by strathclyde case) - no cancer risk
- cost effective
- consistent
- little compliance required (passive)
- reaches masses
disadvantages of water fluoridation?
- cost! (still cheaper than caries tx)
- unethical (no freedom of choice)
other than water fluoridation what are the 5 methods of fluoride delivery?
- tablets/drops
- fluoridated salt
- fluoridated milk
- topical fluoride
- fluoride toothpaste
what is the minimum age to take a fluoride drop/tablet?
6 months
what is the daily dose of fluoride for a 6month - 3 year old
0.25mg / day
what is the daily dose of fluoride for a 3 year - 6 year old?
0.5mg / day
what is the daily fluoride dose for a 6 year old - adult?
1mg / day
what are the advantages of fluoride drops/tablets?
- effective at reducing caries
- freedom of choice
what are the disadvantages of fluoride drops/tablets?
- compliance required
- need consistency
- risk of overdose
what is the compound of choice in fluoride drops/tablets?
sodium fluoride NaF
what is the % reduction in caries of adults and children who are taking fluoride tabs/drops?
40-50%
what are the advantages of fluoridated salt?
- effective
- freedom of choice
- consistent and regular
what are the disadvantages of fluoridated salt?
- conflicts health messages
“reduce salt intake to prevent coronary heart disease” - not everyone has added salt in diet
what effect does fluoridated milk have? and why does it not have both effects?
- has a systemic effect
- no topical affect as calcium in milk diminishes it
give the advantages of fluoridated milk?
- safe
- effective
- regular
- freedom of choice
- small risk of overdose
what are the disadvantages of fluoridated milk?
- untested in a community setting
what are the 2 most common choices of topical fluoride?
- sodium fluoride
2. stannous fluoride
what is the the % reduction when topical fluoride is used?
20-30%
what are the advantages of topical fluoride?
- easy
- effective
- cheap now
- freedom of choice
disadvantages of topical fluoride
need a professional
time
access to services
oral health promotion definition?
advocating indivitals to takw control over their own health and having life long maintenance of a dentition that is comfortable, functional, socially acceptable and promotes good general health
