Caries Prevention and Fluoridation

Question 1

Disease indicators

Answer 1

Recent evidence of caries experience (lesions and restorations)

Question 2

Risk factors

Answer 2

Cariogenic bacteria, diminished saliva, and undesirable habits (poor oral hygiene and frequent consumption of refined carbohydrates)
- Chair tests to quantify strep mutant levels in saliva, measure salivary flow, test strips to test pH (biofilm pH indicator)

Question 3

Protective factors

Answer 3

Biologic or therapeutic and measures taken to intervene in caries process. Any methods that intervene or disrupt the caries process

Question 4

When do you use ADA assessment forms

Answer 4

There’s one for child 1-6 yr olds and there’s another one for 6+ yrs old

Question 5

What is important to evaluate with each pt

Answer 5

Risk level - will inform your clinical decision making, treatment plan, and tailored recommendations for at home care

Question 6

Therapeutic intervention like sealants, intervene where?

Answer 6

at the host by creating physical barrier in pits & fissures so plaque biofilm cannot stagnant in difficult to clean areas in natural tooth structure

Question 7

What has shown to reduce Strep mutans?

Answer 7

Antibacterial agrees like chlorohexidine

Question 8

Xylitol does what?

Answer 8

By increasing salivary flow and physically disrupting the plaque biofilm, buffering pH, and delivering minerals to aid in remineralization

Question 9

Non-fermentable carbohydrate to consume ->

Answer 9

destruction and decrease in acid production

Question 10

Brushing and flossing does what?

Answer 10

physically disrupt cariogenic biofilm and remove it from tooth surface

Question 11

Diet modification, reducing frequency of fermented carbs causes what

Answer 11

oral bacteria to have less fuel to proliferate and produce less acid

Question 12

Minerals (Cl-, Ca+2, and phosphate) are incorporated into

Answer 12

demineralized enamel crystal to remineralize tooth structure

Question 13

Caries control concept - where should we intervene?

Answer 13

Host, cariogenic biofilm, fermentable carbohydrates, and time

Question 14

CaMBRA Recommendations - Low risk

Answer 14

OTC toothpaste w/ fluoride (1,000 to 1,100 ppm fluoride). 2X daily

Question 15

CaMBRA Recommendations - Moderate risk

Answer 15

• OTC toothpaste w/ fluoride (1,000 to 1,100 ppm fluoride). 2X daily.
• OTC fluoride rinse (005% NaF), daily
• Xylitol candies or gums, 4X daily
• Alternatice regimen: Presciption 5,000 ppm Fl toothpaste, 2X daily

Question 16

CaMBRA Recommendations - High risk

Answer 16

• Xylitol candies or gums, 4X daily
• Presciption 5,000 ppm Fl toothpaste, 2X daily
• Chlorhexidine gluconate (0.12%) rinse 1X daily for 1 week, every month until next POE, then reassess
• Fl varnish applied at first visit and at each POE/CaMBRA recall

Question 17

Fluoride plays a pivotal role in all risk levels bc

Answer 17

strong body safety and ethically

Question 18

Resin infiltration

Answer 18

caries arresting technique for non-cavitated lesions where very low viscosity resin is sucked up by lesion to reinforce and seal it up, stopping the caries process. No drilling or removal of anatomic structure of the tooth, it does involve acid etch to remove outer most layer of hypo-mineralized enamel to gain access to progressing lesion

Question 19

Intent of Varnish Training

Answer 19

Prevention of oral disease in children - community wide involvement

Question 20

PSP components

Answer 20

Surveillance, education, prevention, and referral

Question 21

Surveillance

Answer 21

Annual screening by a licensed dentist or dental hygienist

Question 22

Education

Answer 22

Curriculum materials available (toothbrushes, toothpaste, floss)

Question 23

Prevention

Answer 23

Fluortide varnish applied 2X yr by volunteers, prevent dental decay

Question 24

Referral

Answer 24

Children needing early or urgent dental care

Question 25

Varnishes are for

Answer 25

children of all ages (infant to HS)

Question 26

Fluoride is

Answer 26

a sticky substance applied with a small applicator brush to surfaces of teeth

Question 27

What does the fluoride do?

Answer 27

• Will firm up on teeth & remain until brushed away (don’t brush until next day)
• Fluoride on teeth will aid in strengthening the enamel of the child’s teeth
• Adds minerals to structure of enamel - more resistant to acids & rebuild soft tissue
• Buccal -> lingual -> Occlusal surfaces (top & bottom, front & back)

Question 28

As soon as the varnish is on the teeth it is ok for the pt to swallow?

Answer 28

Yes, it has adhered to the teeth

Question 29

Is it mandatory that the teeth be dried before fluoride varnish is applied?

Answer 29

No, it will set up in a moist environment

They may use a dry toothbrush to remove plaque

Question 30

Doe the child have to wait 30mins after varnish application before eating or drinking?

Answer 30

No, can eat or drink normally, however, it is good to avoid crunchy food and very hot liquids.
Ask pt to swallow in front of u immediately after application

Question 31

Can child have mouth mirror for home use?

Answer 31

No, one time use and must be disposed of after procedure, can sprees germs from one child to another