Cariology Part II Flashcards
Guiding Principle #1 Assess Caries Risk: Oral Hygiene–THIS WILL ROCK YOUR F—ING WORLD: There is no evidence that removal of plaque by ______ (with a non-F toothpaste) or _______ decreases the incidence of caries.
brushing…flossing
Guiding Principle #1 Assess Caries Risk: Oral Hygiene–Daily oral hygiene does help to control _____ disease and is necessary for the application of ______ toothpaste.
gingival…fluoride
Guiding Principle #1 Assess Caries Risk: Oral Hygeine–WHAT IS THE #1 Factor with Caries????
SALIVARY [S. Mutans]!!!!!!
Guiding Principle #1 Assess Caries Risk: Oral Hygeine–BUT WHY is there no evidence that brushing doesn’t do shit against caries?????? Plaque indices designed for studies of ________ disease not caries… Plaque indices don’t measure _______…don’t worry, plaque removal is still important though
periodontal….microbes
Guiding Principle #1 Assess Caries Risk: Oral Hygeine–_____ is the best way to remove plaque BY A LANDSLIDE!
Brushing
Guiding Principle #1 Assess Caries Risk: Oral Hygeine–Which is better a motorized or old school tooth brush?
No significant difference
Guiding Principle #1 Assess Caries Risk: Oral Hygeine–ONLY introduce ______ when brushing has been mastered.
Flossing
Guiding Principle #1 Assess Caries Risk: Oral Hygeine–How often should I floss?
we don’t know :) every few days, once a week
Guiding Principle #2 Diagnose the Disease EARLY: A Caries diagnosis is “a mental ______ on the way to intervention!”
resting place
Guiding Principle #2 Diagnose the Disease EARLY: Avoid lawsuits and ALWAYS WRITE DOWN YOUR _______
DIAGNOSIS
Guiding Principle #2 Diagnose the Disease EARLY: What are the 4 prereqs for detection?
1.Clean the teeth 2.Dry the Teeth 3.Magnification 4.Light
Guiding Principle #2 Diagnose the Disease EARLY: When dried, ____ replaces _____ in enamel! The refractive index is farther away, making lesions easier to see!
air…water
Guiding Principle #2 Diagnose the Disease EARLY: White-spot lesions visible when DIRED have penetrated about ____ of the enamel!!!
1/2
Guiding Principle #2 Diagnose the Disease EARLY: White/brown lesions visible when wet have penetrated ______ the enamel.
THROUGH!!!
Guiding Principle #2 Diagnose the Disease EARLY: At what age should you be using magnification? (dentist above this age frequently fail vision tests)
over 45 years of age
Guiding Principle #2 Diagnose the Disease EARLY: Detection of _______ lesions is no longer an appropriate diagnosis of dental caries…BECAUSE If detected before this point, caries is _______!!!!
cavitated….REVERSIBLE
Guiding Principle #2 Diagnose the Disease EARLY: The problem with the explorer- Instruments currently available for the diagnosis of carious lesions do not detect lesions _____ and _______…
early and quantitatively
Guiding Principle #2 Diagnose the Disease EARLY: We can’t detect caries until its ____ to ____ through the enamel.
1/3…1/2
Guiding Principle #2 Diagnose the Disease EARLY: Teaching the use of the explorer to diagnose carious lesions may be potentially ______.
DAMAGING (sorry GV Black)
Guiding Principle #2 Diagnose the Disease EARLY: What are the 3 possible problems with diagnosing with an explorer can cause?
1.Damage to Newly Erupted Teeth 2.Create a Cavity 3.Transmit Bacteria!
Guiding Principle #2 Diagnose the Disease EARLY: Probing Newly Erupted 3rd molars with an explorer in the pits and fissures ___% had tissue loss!
60% (compared to 7% w/o probing)
Guiding Principle #2 Diagnose the Disease EARLY: Explorers transmit bacteria– ____% of probed fissures had S. Mutans compared to 0% that were not probed.
70%
Guiding Principle #2 Diagnose the Disease EARLY: IF you are going to use an explorer to check a lesion, how hard do you push?
enough pressure to blanch your finger nail
Guiding Principle #2 Diagnose the Disease EARLY: radiographs are an _______ procedure that should be used with caution
invasive
Guiding Principle #2 Diagnose the Disease EARLY: “accuracy of radiographs”–the study where 86 dentists looked at the same x rays: % of teeth decayed ranged from __-__%
15-75% WOW!
Guiding Principle #2 Diagnose the Disease EARLY: NEW School Tech- What am I? Decay scatters and absorbs more light than healthy tissue, Decay near the imaged surface appears as a darker area, images can indicate the presence of early decay before either film or digital radiography. _______ can detect incipient or recurring caries before they are visible on x-rays!!!
DIFOTI (digital imaging fiber optic trans-illumination)
Guiding Principle #2 Diagnose the Disease EARLY: NEW School Tech- A laser diode provides pulsed light that is directed onto the tooth. When the light meets a change in tooth substance, it stimulates fluorescent light of a different wavelength. This is translated through the handpiece into an acoustic signal, and the wavelength is then evaluated by an appropriate electronic system in the control unit.
DIAGNOdent
Guiding Principle #2 Diagnose the Disease EARLY: NEW School Tech- _______ (laser diode) should not be relied on as a clinician’s primary diagnostic method
DIAGNOdent
Guiding Principle #2 Diagnose the Disease EARLY: NEW School Tech- Tooth is illuminated with blue-green light, Fluorescence of enamel is observed, Demineralized areas appear dark
QLF (quantitative light-induced fluorescence)
Guiding Principle #2 Diagnose the Disease EARLY: NEW School Tech- What was the NEAR-infrared detector out of UCSF??
CariVu
Guiding principle #3-Treat the disease, Remineralize, Control Infection–WHAT IS THE BEST WAY TO REMINERALIZE?
FLUORIDE IS THE BEST WAY TO REMINERALIZE
Guiding principle #3-Treat the disease, Remineralize, Control Infection– F concentrates in dental _____…F is released from plaque when _____ is lowered…F is taken up more readily by _______ enamel than by sound enamel
plaque…pH is lowered…demineralized
Guiding principle #3-Treat the disease, Remineralize, Control Infection–Interesting!!! Plaque fluoride inhibits bacterial _______!
glycolysis
Guiding principle #3-Treat the disease, Remineralize, Control Infection–What are the two forms of F- that make it back into enamel?
Fluor-Apatite & CaF2
Guiding principle #3-Treat the disease, Remineralize, Control Infection– the PRIMARY Cariostatic effect of F- is _______.
TOPICAL
Guiding principle #3-Treat the disease, Remineralize, Control Infection– Best effect of F- is _______ exposure to LOW concentrations, Exposure about every ___ hours
frequent…4 hours
Guiding principle #3-Treat the disease, Remineralize, Control Infection–Fluoride prevents ________ caries. Fluoride arrests _____ & _______ caries.
smooth surface….enamel & dentine
Guiding principle #3-Treat the disease, Remineralize, Control Infection–What is the MOST EFFECTIVE Fluoride Delivery Vehicle? What is usually put in the Pedo Trays?
Varnish…APH-AcidulatedPhosphoFluoride (the low pH destroys
Guiding principle #3-Treat the disease, Remineralize, Control Infection–Community Water Fluoridation reduces caries by ___-___%!!!!
15-20%
Guiding principle #3-Treat the disease, Remineralize, Control Infection–What is the main Disadvantage of water fluoridation?
Really young Children don’t drink water
Guiding principle #3-Treat the disease, Remineralize, Control Infection–Self-Applied Fluorides like tooth paste prevents ___% of caries.
24%
Guiding principle #3-Treat the disease, Remineralize, Control Infection–Self-Applied Fluorides are not appropriate for _______.
low-risk patients
Guiding principle #3-Treat the disease, Remineralize, Control Infection–DO NOT USE gels/foams in children ___ years and younger.
5
Guiding principle #3-Treat the disease, Remineralize, Control Infection–Which has more F-? Gels/Foams or Varnish?
GELS/FOAMS 35mg…varnish-5mg
Guiding principle #3-Treat the disease, Remineralize, Control Infection–FLUORIDE 1. Patients at ____ risk of caries on smooth surfaces 2. Patients at high risk of caries on _____ surfaces 3. Special patient groups such as:
_______ patients, Patients undergoing head and neck ______, Patients with decreased ______ flow
4. NOT recommended for patients at ____ caries risk
high…root…Orthodontic…raditation…salivary…low
Guiding principle #3-Treat the disease, Remineralize, Control Infection–So F- VARNISH is the best huh? Then what % of teeth had disease prevented? WAIT! What is CHX’s %???
46%! ok, not bad :) SAME AS CHX!!!
Guiding principle #3-Treat the disease, Remineralize, Control Infection–Again, F- is very effective against _____ caries (surface)
ROOT
Guiding principle #3-Treat the disease, Remineralize, Control Infection–THIS IS BIG- What are the 4 ChemoTheraputic Treatments?
1.Fluoride-remineralize 2.Baking Soda-buffer 3.Chlorhexidine-anti-microbial 4.Xy-lit-ol—non-fermentable sugar
Guiding principle #3-Treat the disease, Remineralize, Control Infection–YOUR VERY OWN Baking Soda Prescription Cheat Sheet! Dissolve 1 _______ in tumbler of water Rinse vigorously & spit, swallowing will cause _____ discomfort, _______ unused water at end of day, make new batch each day
teaspoon…gastric…discard
Guiding principle #3-Treat the disease, Remineralize, Control Infection–How long is the CHX treatment? What is the only form available in the US?
14 days…mouthwash
Guiding principle #3-Treat the disease, Remineralize, Control Infection–How long do I wait when doing CHX & F- in between the 2?
1 hour!
Guiding principle #3-Treat the disease, Remineralize, Control Infection–What is a great Chemo-Theraputic for mothers during the child’s window of infectivity?
CHX
Guiding principle #3-Treat the disease, Remineralize, Control Infection–What was the best chemo-theraputic treatment on patients undergoing head and neck radiation?
The F- and CHX combo!
Guiding principle #3-Treat the disease, Remineralize, Control Infection–What is the most important aspect of Xy-lit-ol gum?
it inhibits bacterial ADHESION!
Guiding principle #3-Treat the disease, Remineralize, Control Infection–Doctor, what age do you recommend my kid starts chewing Xylitol gum?
at about 5 (1 year before permanent teeth erupt)
Guiding principle #3-Treat the disease, Remineralize, Control Infection–How many grams of Xylitol do you need in adults for effectiveness?
100g!! thats a shit ton!
Guiding principle #3-Treat the disease, Remineralize, Control Infection–Sealants should be used with _____.
Fluoride
GUIDING principle #4-Delay or Avoid Operative Intervention: The surgical management of noncavitated carious lesions should be the treatment of _______.
last resort
GUIDING principle #4-Delay or Avoid Operative Intervention: ____% of fillings are replacements of existing fillings.
70%!!
GUIDING principle #4-Delay or Avoid Operative Intervention: What % of lesions are caveated when there is radiolucency in the outer half of enamel?
0%
GUIDING principle #4-Delay or Avoid Operative Intervention: What % of lesions are caveated when there is radiolucency in the inner half of enamel?
10.5%
GUIDING principle #4-Delay or Avoid Operative Intervention: What % of lesions are caveated when there is radiolucency in the outer half of dentin?
40%
GUIDING principle #4-Delay or Avoid Operative Intervention: What % of lesions are caveated when there is radiolucency in the inner half of dentin?
100%!!!
GUIDING PRINCIPLE NUMERO 5: Restore active caries only!–What are the three stages of caries for monitoring?
1.Progressing 2.Arrested 3.Shifting to Remineralization
GUIDING PRINCIPLE NUMERO 5:Filling teeth does not _____ the disease of dental caries….Filling teeth simply restores the ______ of the disease.
treat….effects!
