Caries symposium 1 Flashcards
what are the factors that are required for caries to be present?
3
tooth
substrate
flora - strep mutans
what is a caried risk assessment used as?
a prognastic indicator to help determine what care that individual needs
what are the four categories of caried risk factors?
biological
environmental
behavioural
protective
what are the biological risk factors of caries?
4
previous caries history
diet
salivary function
bacterial load
what are the environmental risk factors of caries?
2
fluoride exposure
socioeconomic status
what are the behavioural risk factors of caries?
2
oral hygiene
dental visits
what are the protective risk factors of caries?
4
sealants
diet
salivary function
bacterial load
what are the 7 elements of caries risk?
clinical evidence
dietary habits
social history
fluoride use
plaque control
saliva
medical history
what is the role of clincal evidence in caries risk?
3(3,1,1)
caries experience
* dmft>=5, DMFT>=5
* caries in 6 before 6yrs
* 3 year caries increment >=3 teeth
orthodontics
* fixed appliance therapy
prosthetics
* fixed or removable
what is the role of diet in caries risk?
4
> =3 sugar intakes per day
high frequency worse than volume of sugar
highly processed carbs more cariogenic than natural sugars
natural sugars still cause harm
what are some social history factors to consider?
8
SIMD category
education
unemployment
work stressors
single parent families
violence
inequalitites and access to healthcare
dependents
what is the role of fluoride in caries development?
2
infrequent use of F- toothpaste
no F- in water supply
what are the actions of fluoride on bacteria
2
inhibits bacterial growth by interrupting bacteria metabolism so less acids produced
interferes with the adhesion of bacteria so less able to stick to teeth, disrupting the formation of the biofilm
what are the actions of fluoride on enamel?
2
remineralisation is promoted
fluorapatite is created which is stronger and more acid resistant
what is the role of plaque control and oral hygiene in caries development?
5
poor technique
irregular brushing
unassisted brushing
access to toothbrush/toothpaste
difficulty due to changes (mixed dentition/orthodontics/gaps/recession)
what is the role of saliva in caries development?
5
amount
flow
buffering capacity
pH
viscosity
what is the role of medication in caries development?
7
- xerostomia
- other side effects making OH hard e.g. mucositis
- free sugars added to make more palatable
- lactulose - very sugary
- frequency of taking sugar containing medicine
- recreational drug use/rehabilitation (methadone)
- social convention - giving sick people sweets
describe the typical high caries risk child
4(2,2,4,1)
social
* poor dental attender
* family unit situation (single mother)
health
* poor health
* sugar-based medications
caries experience
* dmft>=5, DMFT>=5
* >=10 initial lesions in primary dentition at first attendence
* caries in 6s at 6yrs
* 3 year caries increment >=3 teeth
orthodontics
* fixed appliance therapy
what are social/behavioural considerations of caries risk for toddles/infants?
6
mother’s caries risk
prolonged nursing habits
bottle/pacifier at bedtime
cariogenic snacking
no tooth cleaning
little fluoride exposure
what are some factors to consider with typical high risk adults?
7
level of education
attends only when they identify a problem
social difficulties
“sweet tooth” with poor OH
sugar containing meds/that affect saliva
root caries
secondary caries
what are the 8 elements of the preventative programme?
radiographs
toothbrushing
strength of F- in toothpaste
F- varnish
F- supplementation
diet advice
fissure sealants
sugar free medicine
