Chapter 19 Caries Risk Assessment Flashcards
Risk assessment
Estimation of the likelihood that an event will occur in the future. (e.g. caries risk)
CAMBRA
Caries Management By Risk Assessment
What pH does demineralization occur?
5.5 and below
What pH level is plaque biofilm at rest?
Neutral pH of 7
When fermentable carbohydrates are ingested, what pH level does oral biofilm drop to?
Below 5.5
Demineralization
Acids diffuse into the tooth and dissolve the calcium and phosphate minerals (e.g. carbonated hydroxyapatite) .
How long does it take after the ingestion of fermentable carbohydrates stops, for the pH level to return to neutral?
30-60 min
Remineralization
Depositing of minerals via saliva onto existing crystal remnants inside the noncavitated, partially demineralized, carious lesion.
White spot lesion
Enamel surface remains intact, but area of demineralization turns white, caused by the net loss of mineral in the subsurface zone of the enamel.
Acidogenic bacteria
Acid producing
Caries balance
Balance between pathogenic and protective factors
Caries disease indicators
- Teeth with frank cavitations that radiographically show penetration to dentin
- Aprox. radiographic lesions that are confined to the enamel only
- Visual white spots on smooth surfaces
- Any restorations placed in last 3 years for a new patient, or 12 months for existing patient
ECC
Early childhood caries
Primary mechanisms of fluoride action
Most effective topically via water, food, products, etc.
Most toothpastes in the US contain how much fluoride?
1000-1100ppm
Most OTC dentifrices (toothpaste) in the US contain one of the following:
- Sodium fluoride NaF
- Sodium monofluorophosphate NaMFP
- Stannous fluoride SnF2
Studies reports a what percentage reduction in caries with use of fluoride dentifrices containing 1000-2800 ppm?
30%
There is a 56% reduction in caries with supervised brushing vs unsupervised, true or false?
True
CHX gluconate
Broad-spectrum antibacterial agent that works by opening up cell membranes in bacteria and has immediate bactericidal action and prolonged bacteriostatic action.
Casein Phosphopeptide - Amorphous Calcium Phosphate
Enhances remineralization, has same amount of calcium and phosphate as tooth mineral. Binds to fluoride but is difficult to use alone, CPP stabilizes ACP.
Tricalcium Phosphate
Ingredient in fluoride products to enhance calcium availability and remineralization. Once exposed to saliva on the tooth surface and in the plaque, calcium, phosphate, and fluoride ions are released.
Xylitol
Naural-occuring 5-carbon sugar alcohol, inhibits attachment and transmission of bacteria. It is not a source of energy so it isn’t fermented by cariogenic bacteria.
Sodium bicarbonate
Neutralizes acids produced by bacteria and has antibacterial properties. Good for extreme caries risk patients/low salivary flow.
Arginine
Not available in US, processed by oral bacteria to neutralize acids produced by cariogenic bacteria. Found in toothpastes
Probiotics
Used to replace and displace cariogenic bacteria with noncariogenic bacteria. Creates a balance
