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Caries! > Caries risk assessment > Flashcards

Caries risk assessment Flashcards

1
Q

clinical clues about caries risk?

A
  1. heavily restored
  2. active white spot lesions
  3. arrested lesions
  4. sound, entact dentition
  5. cavities
  6. ortho appliances
  7. partial denture
  8. several previously extracted teeth
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2
Q

what are NME sugars?

A

non-milk extrinsic sugars

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3
Q

the 3 NME sugars are?

A
  • sucrose
  • glucose
  • fructose
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4
Q

what is the milk sugar?

A

lactose

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5
Q

what type of sugar is found in fruit and veg?

A
  • intrinstic sugars
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6
Q

the 2 main sources of NME sugars are?

A
  • confectionary

- soft drinks (esp if given frequently)

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7
Q

name the two subgroups of sweeteners?

A
  • intense sweeteners

- bulk sweeteners

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8
Q

what are examples of intense sweeteners?

A
  • aspartame
  • acesulfame
  • saccharin
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9
Q

what are examples of bulk sweeteners?

A
  • sorbitol
  • xylitol
  • mannitol
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10
Q

which type of sweeteners are non-cariogenic and which type are metabolised so slowly by plaque bacteria that they pose no threat to the teeth?

A

intense sweeteners are non cariogenic and bulk sweeteners are slowly metabolised by plaque bacteria

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11
Q

what group of sweeteners are in chewing gum?

A

non cariogenic - intense sweeteners

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12
Q

relationship between low socio-economic background and caries?

A 
in children 
- higher caries rate 
- fewer caries free teeth 
- fewer sealants 
- more untreated caries 
different beliefs
- place less importance on dental health 
- except that edentulousness is inevitable(dont see as preventable)
- attend when in pain and thats it
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13
Q

what is the DEPCAT score?

A

a score that helps understand the level of deprivation based on postcode

(deprivation category)

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14
Q

do plaque levels have a direct impact upon caries?

A

no but an indirect one

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15
Q

how does having heavy plaque deposits influence caries?

A

it reduces the exposure of fluoride

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16
Q

the effect of the saliva on caries?

A

huge impact

low saliva flow = reduced buffering capacity and reduced antimicrobials = increased caries risk

17
Q

what are the 2 main functions of saliva?

A
  1. protection and digestion
    - antimicrobials
    - buffers (increases with flow rate)
    - bolus formation
  2. enamel stabilisation
    - balances remineralisation and demineralisation
18
Q

how many L of saliva is produced throughout the day at a constant low level?

A

0.5 - 0.6L

19
Q

what is the main composition of saliva?

A
  1. 5 % water

0. 5% electrolytes and proteins

20
Q

what are the 3 main salivary glands?

A
  1. parotid (mainly when stimulated)
  2. submandibular (mainly at rest)
  3. sublingual
21
Q

3 main groups of medications causing xerostomia?

A

1 - diuretics (given to pts who retain fluid so makes sense)
2 - antihistamines
3 - tricyclic antidepressants

22
Q

2 other causes for xerostomia other than medications?

A
  1. radio/chemo therapy

2. sjogrens syndrome

23
Q

what is the treatment for xerostomia?

A
  • changes in medication
  • salivary substitute
  • salivary stimulant
  • fluoride supplement or CHx gels
  • excellent OH
24
Q

how can xerostomia present clinically?

A
  • dry, glossy, atrophic look about oral mucosa
  • frequent fungal/bacteria mucosal infections common
  • angular chelitis
  • difficulty with speech/mastication/swallowing
  • increased caries
  • possible dry eyes if sjogrens syndrome
25
Q

learning diffuculties and caries?

A

not directly linked

association with

  • poorer OH
  • increased sugar snack consumption

high untreated caries and extraction rate

carers are often relied upon to provide oral care and it is often not a priority

26
Q

learning difficulties and tx planning

A
  • take into account the ability of the patient or carer to maintain treatment provided
  • be realistic
  • best intrest of patient
  • consider their ability to give consent (adults with incapacity to consent certificate)
  • consider using sponges soaked in CHx
  • consider modifiying toothbrush
  • consider a super brush (3 bristles = only round each Q 1x)
  • GA is often the only option for patients with disabilities
27
Q

factors indicating low caries risk?

A
  1. regular attender
  2. good OH
  3. DMFT = 0
  4. few active WSL
  5. fit and healthy
  6. fluoridated area
  7. low sugar diet
  8. socially advantaged background
28
Q

factors indicating a moderate caries risk?

A
  1. non-fluoridated area
  2. OH fair
  3. diet contains NMEs
  4. small and few restorations
  5. active WSLs
29
Q

factors for a high caries risk patient?

A
  1. poor attender
  2. poor OH
  3. DMFT high
  4. high sugar diet
  5. socially disadvantaged background
  6. non-fluoridated area
  7. cavitated lesion
  8. medically compromised (eg special needs)

Caries! (9 decks)

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