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operative dentistry > Cariology pp3 > Flashcards

Cariology pp3 Flashcards

1
Q

Having any one of the 4 disease indicators place patient automatically in what risk category?

A

High risk category

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2
Q

Having any one of the 9 risk factors for caries automatically places patient in what risk category?

A

Moderate risk category

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3
Q

Having any of the protective factors and the absence of disease or risk factors automatically places the patient in what category?

A

Low risk category

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4
Q

What are the 4 risk assessment procedures?

A
  1. Diet analysis
  2. Plaque pH measurements
  3. Saliva flow test
  4. Bacterial test
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5
Q

What 4 things are you looking for when you ask a patient to record a week long diet log or fill out a dietary risk survey?

A
  1. Analyze fermentable sugars/carbs
  2. Find “hidden sugars”
  3. Frequency of snack time exposures
  4. Duration of each sugar exposure
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6
Q

Is dietary risk the same as caries risk?

A

No - high dietary risk put you at moderate caries risk

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7
Q

What are some examples of “hidden sugars”?

A
  1. Cereals
  2. Fructose
  3. Lactose and baby bottle syndrome
  4. Sucrose
  5. Sticky foods (contact time)
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8
Q

When is the bacterial test mandatory in an exam?

A

Extreme or high risk levels (optional in moderate)

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9
Q

How is plaque pH measured?

A

Use toothpick to collect plaque from teeth then place on litmus paper, record the pH every minute for at least 20 minutes, and then create a graph

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10
Q

Frequent snacking throughout the day =______ _____ _____ = multiple demineralization periods. _______ occurs between demineralization times.

A

Multiple acid challenges

Remineralization

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11
Q

How is the saliva flow test done?

A

Get a small piece of paraffin wax or 2 sticks of sugarless gum and have patient chew at least 3 minutes. Then patients spits into measuring cup and calculate ml/minute

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12
Q

What is the saliva flow that indicates xerostomia?

A

< or equal to 0.7 ml/min with sugarless gum**

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13
Q

What is the normal saliva flow rate for adults?

A

> or equal to 1.4 ml/min with sugarless gum***

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14
Q

What are 4 affects of xerostomia?

A
  1. Slow clearance of food particles
  2. Decrease buffering of acids
  3. Encourage growth of bacteria
  4. Inhibit remineralization bc Ca and P ions are reduced
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15
Q

5 possible causes of xerostomia

A
  1. Many medications
  2. Radiation therapy to head/neck
  3. Salivary gland disease
  4. Diabetes
  5. Aging
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16
Q

What does a bacterial test like CariScreen test for?

A

ATP Bioluminescence Activity - high correlation with S. mutans bacteria levels - the reaction is swift and reading must occur with in 1 minute

17
Q

During a bacterial test where and how do you swab the mouth?

A

Swab the incisal 2/3rds of the tooth
Do not touch the gingivae or soft tissue
Only go in one direction
Do not re-swab

18
Q

Why must the CariSceen bacteria test be done before the Saliva Flow Test?

A

Saliva will wash away some of the bacteria

19
Q

What are the CHX guidelines?

A

Use CHX after tooth brushing in the evening
Do not combine CHX and F rinse - at least an hour apart
Use 10ml and swish in mouth for 1 min
Spit out without rinsing
Continue daily use for 7 days and then discontinue

20
Q

Generally how does CHX work?

A

CHX attaches to the biofilm and reduces the growth of additional plaque - effective against S. mutans but lactobacilli are resistant in mouth

21
Q

Drawbacks of CHX?

A
  1. Limited efficacy
  2. Stains teeth with prolonged use (1 week ok)
  3. Unpleasant taste
  4. Non-specific for cariogenic bacteria
  5. 1% gel not available in USA
22
Q

What should you use twice daily after brushing and flossing. Shake bottle before use, using the measuring cup, combine 5ml of component A and 5ml of component B. Vigorously swish for 1 min and spit out. Do not swallow

A

Sodium Fluoride 0.05% RInse

23
Q

Fluoride in saliva at concentrations of ___ -___ ppm can markedly enhance remineralization

A

0.04-0.1 ppm

24
Q

Initial high F concentrations from Dentifrice or mouth rinse is produced in whole saliva and plaque which takes __-__ hours to fall to baseline. Baseline concentrations in whole saliva are ____ and maintained at 0.04- 0.1 ppm

A

1-6 hours

Elevated

25
Q

3 Steps for placing 5% Na fluoride varnish - time release for months, safe for infants and children, should be considered after cleanings.

A
  1. Dry tooth
  2. Apply varnish
  3. Do not rinse
26
Q

What 3 things do calcium fluoride crystals on enamel surfaces do?

A
  1. Act as fluoride reservoir
  2. Makes surface harder to demineralize
  3. Release free F in acidic environments
27
Q

Why would someone at the extreme risk level use a baking soda rinse?

A

Neutralizes the acids and raises the plaque pH - use it before applying Fluoride

28
Q

What is the therapeutic dosage for xylitol gum or mints?

A

5-10 mg/day

29
Q

What are the 3 key ingredients in oral neutralizer gels like CariFree which you use in place of toothpaste 2x daily

A
  1. Glycerin (highest concentration - does nothing)
  2. Sodium Bicarbonate
  3. Xylitol (lowest concentration)
    (Not recommended)
30
Q

Name 5 non-cariogenic sweeteners

A
  1. Sorbitol
  2. Aspartame
  3. Saccharin
  4. Sodium Cyclamate
  5. Xylitol
31
Q

Xylitol is a _ carbon “sugar alcohol” and penetrates the _____ easily. It looks like _____ and has about the same sweetness by weight. It is used in some foods, chewing gum, candies, lozenges, and dental products as a ______. _____ bacteria can not feed on it. Humans can feed on it and use it as an ____ source. It inhibits the transfer of bacteria from person to person by altering the way the bacteria ____ to surfaces. No ____ effects but deadly to dogs. Xylitol chewing gum use enhances ________ and inhibits future ___________.

A 
5
Biofilm
Sucrose
Sweetener
Cariogenic
Energy
Stick
Diabetic
Remineralization
Re-colonization
32
Q

Order CHX, Xylitol, and F varnish, best to worst of acquisition of S. mutans in infants when given to the moms

A
  1. Xylitol
  2. CHX
  3. Fluoride varnish
33
Q

What 3 things do chewing on sugar free gum with xylitol and baking soda do?

A
  1. Simulate saliva
  2. Enhance remineralization
  3. Antibacterial effect
34
Q

What 4 things can Amorphous Calcium Phosphate (MI Paste) help provide?

A
  1. Matrix for remineralization
  2. Cover root sensitivity
  3. White spot lesions
  4. With xerostomia - hyposalivary gland function
35
Q

How is MI Paste used?

A
  1. Rubbed on teeth several times daily
  2. 3-5 minutes
  3. Use F rinses after for a better re-mineralization or overnight in a tray
36
Q

What are some health complications that can be evident in salivary diagnostic testing?

A
  1. MI - specific c-reactive proteins
  2. Renal disease - elevated nitrate/urea
  3. Breast Cancer - elevated CA15-3 cancer antigen
  4. Type II diabetes
  5. Sjogrens Syndrome
  6. DNA analysis - forensics
    (7. Bacteria, fungal, and viral, testing for future)

operative dentistry (3 decks)

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