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DH200 Int Clinic > Ch 28 Dentifrices and Mouthrinses > Flashcards

Ch 28 Dentifrices and Mouthrinses Flashcards

1
Q

Chemotherapeutics

What can inflammation cause

Who can administer chemotherapy

A

=reduction of inflammation in oral cavity

-Increased inflammation associated with diabetes can make patient more susceptible to periodontal disease, also linked to heart diseases and several others

-Oral pathogens can travel to lungs can cause healthcare associated pneumonia

-Chemotherapeutics can be administered by clinician or patient

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2
Q

Dentifrices

A

Benefits may be preventative, therapeutic or cosmetic (superficial for cosmetics)

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3
Q

Preventive and Therapeutic Benefits of Dentifrices (6)

A
  1. Prevention of dental Carie’s
  2. Remineralization of Early Noncaviated Dental Caries
  3. Reduction of Biofilm Formation
  4. Reduction of Gingivitis/Inflammation
  5. Reduction of Hypersensitivity
  6. Reduction of Supra gingival Calc Formation
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4
Q

Prevention of Dental Carie’s

A

Stannous fluoride was problematic bc of lack of compatibility with abrasive agents (1st 1995)

Xylitol anticaries benefits

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5
Q

Remineralization of Early Noncaviated Lesions

A

Fluoride enhances Remineralization

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6
Q

Reduction of Biofilm Formation

A

**Agents used
-Triclosan
-Zinc Citrate
-Stannous Fluoride

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7
Q

Reduction of Dental Hypersensitivity

A

Chemical occlusion (**potassium nitrate and sodium fluoride) of the dentinal tubules and nerve desensitization are most effective

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8
Q

Reduction of Supra-gingival Calc Formation

A

“Tartar control”

Contain:
Pyrophosphate Salt
Zinc Salts (chloride and citrate)
Sodium Hexametaphosphate

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9
Q

Cosmetic Effects of Dentifrices

A
  1. Removal of Extrinsic Stain
    -food, tobacco, chemicals imbed in acquired pellicle and biofilm
    Based on mechanical removal and bleaching agent
  2. Reduction of Oral Malodor (Halitosis)
    -reduce on temp basis by inhibiting production of Volatile Sulfate Compounds (VSC)
    -Chlorhexidine (CHX), cetlypyridinium chloride (CPC) and zinc formulations beneficial via reduction of VSCs
    -Stannous fluoride + sodium Hexametaphosphate reduce VSCs
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10
Q

Basic Components: Detergents (Foaming Agents)

A

Lower surface tension (make surface slick)

Substances used: sodium lauryl sulfate USP, sodium N-lauryl sarcosinate

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11
Q

Basic Component: Cleaning and Polishing Agents (Abrasives)

A

Abrasives Used
Silica, silicates, hydrated silica gels
Calcium carbonate
Dicalcium phosphate
Sodium Bicarbonate

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12
Q

Basic Components: Binders (Thickeners)

A

Stabilize formation and prevent separation

Used:
Mineral colloids
Natural gums
Seaweed colloids
Synthetic cellulose

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13
Q

Basic. Components: Humectants (Moisture Stabilizers)

A

Prevent hardening

Used
Xylitol
Glycerol
Sorbitol

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14
Q

Basic Components: Preservatives

A

Prevent bacterial growth and prolong shelf life

Used
Alcohol
Benzoates
Dichlorinated Phenols

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15
Q

Basic Components: Flavoring Agents

A

Pt acceptance, mask other ingredients

Used
Essential oils
Artificial noncariogenic sweeteners (xylitol glycerol and sorbitol)

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16
Q

Active Components of Dentifrice

A

First active ingredient was fluoride

Anitbiolfilm=Stannous fluoride and zinc citrate

Anti calc=tetrapotassium pyrophosphate, tertasodium pyrophosphate, sodium Hexametaphosphate and zinc compounds

Desensitizer=potassium nitrate, potassium citrate, potassium chloride, Stannous fluoride and strontium chloride

Oral malodor=essential oils, chlorine dioxide, Stannous fluoride/Hexametaphosphate

17
Q

Selection of Dentifrices
-To prevent
-Considerations for pediatric patient?
What type of Recommendations?

A

Prevention or Reduction of oral disease

Ped Pt -
eruption of first tooth, “smear sized” or rice
2-5 years: pea sized

Patient Specific Recommendations
-current oral condition
-complaint or concern
Sensitivies
Compliance
Etc

18
Q

Mouthrinses

How far into the pocket?
Used as what?
Chemotherapeutics reduce what?

A

**deliver the agent less than 2mm into the pocket/sulcus

Should only be a supplement

Chemotherapeutics reduce inflammation

19
Q

Functions of Chemotherapeutic Agents (7)

A

Remineralization
Antimicrobial (biofilm control, gingival health)
Astringent (shrinks tissues)
Anodyne (alleviate pain)
Buffer (reduce acidity)
Deodorize
Oxygenate (cleanse)

20
Q

Purposed and Uses of Mouthrinse (2)

A

Before Professional Tx
-lower bacterial load and reduce aerosols

Self Care
-biofilm control
-prevent cavities
-contribute to malodor control
-post tx therapy

21
Q

Fluoride

Mechanisms of action ?

A

Stannous-tin oxide which interfere with cell metabolism
Sodium-cariostatic inhibits demineralization/enhances Remineralization

22
Q

Chlorhexidine

  1. Mechanism of action
  2. Availability and recd uses
  3. Reduces ______ ______
  4. Considerations (side affects)
  5. Some research suggests it interacts and inactivated by ___. Rinse should be performed immediately ____ brushing.
A
  1. Broad antibacterial activity, binds to oral hard & soft tissue, cell lysis or interferences, substantivity=8-12hrs
  2. Available by prescription in 0.12% or higher in US. For typical uses plus immunocompromised and susceptible to infection
  3. Mutants streptococci
  4. Stains teeth, increase in Supra Calc formation, altered taste
  5. Sodium lauryl sulfate (in toothpaste). After brushing
23
Q

Triclosan

A

No substantivity-easily released from tissue
Reduced Supra gingival calc

24
Q

Phenolic Related Essential Oils

Specific example
Disrupt what
Considerations

A

Listerine

Disrupt cell wall

Burning sensation, not for current or recovering alcoholics due to alcohol content

25
Q

Quaternary Ammonium Compounds

Action

Uses

Considerations

A

Low substantivity
Rupture cell walls and alter cytoplasm

Agent in CPC , reduce biofilm, adjunct for self care

Weak evidence of gingival, biolfim reduction

Stains , burns, sloughing (desquam)

26
Q

Oxygenating Agents

Actions

Common agents in commercial rinses

Short or long term to reduce periocoronitis and NUG

Considerations ( issues with product )

A

Alters bacterial cell membrane INCREASES permeability
Poor substantivity

10% carbamide peroxide and 1.5% hydrogen peroxide

Only short term use

Doesn’t consistently prevent biofilm and can be erosive mucosa

27
Q

Oxidizing Agents

Action

Agents are

A

Neutralizes VSCs that contribute to oral malodor

Chlorine dioxide and chlorine dioxide and zinc combo

Dilute 0.25 to 0.5 sodium hypochlorite used as mouth rinse reduces BOP, biofilm and gingival inflammation

28
Q

Commercial Mouth rinse Ingredients :

Active-influence how affective an agent can be

Inactive

Pt Specific Recs

A

Diluting saliva, length of time in contact with tissue/ bacteria

Water makes up largest volume
Alcohol-increase solubility of actives, preserve, ENHACE FLAVOR
Flavoring-oils, aromatic water, sweetener

Uses as substitute? Contraindications, xerostomia could be worsened

29
Q

FDA:
Rinses and dentifrices are classified as

Dental product regulation

A

Cosmetic, therapeutic or combo

Infection control, ultrasonic instruments, diagnostic kits, prosthetic and restoratives, surgical/periodontal, prescriptions, chemo

30
Q

Clinical trial
Larger sample who have disease condition
Large with disease do test efficacy, side effects

A

20-80
100-200
1k to 3k

31
Q

ADA is for ___ products
Its _^___
Acceptance for __ years

A

OTC
Voluntary
5

DH200 Int Clinic (15 decks)

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