Chapter 7, 8, and 19 Flashcards
Whitening
Cosmetic process that uses chemicals to remove discolorations from teeth or to lighten them
Power whitening
In office whitening procedure that uses strong whitening agents and a high-intensity light source to accelerate the whitening process
Walking bleach technique
Whitening technique for non-vital teeth in which whitening materials are sealed inside the tooth crown for a few days and the patient “walks” around with the whitening material in place
Enamel microabrasion
A process that uses hydrochloric acid and an abrasive such as pumice to remove shallow discolorations of the enamel
Mouth guard
An appliance made of hard or pilable material that protects teeth from trauma during sports activities or from grinding the teeth
Custom-fit
Made specifically to fit one individual
Obstructive sleep apnea
A sleep disorder caused when the muscles that support the soft palate, uvula, and tongue relax and the airway narrows or closes
Purpose of sealants
Prevent dental caries in pits and fissures
What are sealants
Lightly filled resins
Surfaces that sealants protect
Occlusal surfaces
Surfaces that fluoride protect
Smooth (buccal, lingual, facial) surfaces
Indications for sealants
Big pits and fissures
Molars and premolars most common to have sealants
Composition of sealants
bis-GMA
UDMA
Self cure for sealants
2 minutes (cat/base)
Light cure for sealants
20 sec (most common)
Color and wear (sealants)
Variety (amber, light gray, white)
We use clean-pro its pink in color and changes white when dried
Steps in placement of sealants
Isolate the tooth Pumice tooth with non-fluoridated paste Rinse tooth Apply etchant, 60 secs; chalky appearance Rinse Apply sealant material Light cure for 30-60 secs Floss interproximal space Check occlusion
Effectiveness of sealants
Very effective
If not sealed properly can cause caries
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Bleaching trays
Why do patients like bleaching their teeth
Cosmetics
How bleaching works
Depends on status of teeth
Hydrogen peroxide passes through the spaces in the enamel and reaches the dentin where it release oxygen free radicals that oxidize the stains
Whitening material in bleaching trays
Hydrogen peroxide, carbomide
Extrinsic stains
Outside
Yellow, green, black; from coffee, smoking. or poor hygiene
Intrinsic stains
Occur during tooth development
Medicine, root canals, or trauma
Yellow-brown, or white stains
You always take what before bleaching
Tooth shade
Home bleaching
10-16% carbomide peroxide
Over the counter products (bleaching)
5.3% hydrogen peroxide
Side effects of bleaching
Sensitivity
Contraindications with bleaching
Allergies to bleaching material
People with large restorations have increased sensitivity
Not recommended for tooth colored restorations
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Mouth protectors
Purpose of a mouth protector
Protect teeth and supporting structures and help prevent sports injuries
Types of mouth protectors
Stock guards
Boil and bite
Custom fit
Materials used to fabricate mouth protectors
Soft; thermoplastice sheets of poly(vinyl-acetate) polyethylene
Maintance of mouth protectors
Cleaned daily (liquid soap)
Stored in rigid container
Do not use sodium hydrochloride
Leave the container open
What is fluoride
It is naturally occurring mineral found in many forms in the modern world
Where is fluoride found
Water, food, and is an additive in many dental products over the counter or prescribed
Optimal levels of fluoride
0.7-1.2 ppm (parts per million)
0.7 ppm
is for warmer climates where more water is consumed
1.2 ppm
Increased in cooler climates where less water is consumes
Bottled water
Most bottled water does not contain fluoride unless the label indicates otherwise. Advise patients to fill water bottles from a fluoridated water supply
What is fluorosis
consumption of excess fluoride during tooth formation
Severe fluorosis
Leads to brown staining and pitting of the enamel surface
Mild to moderate fluorosis
Cosmetic concerns, such as opaque white spots or bands on the teeth
Demineralization
Actions that removes minerals from the tooth
Remineralization
Replacing minerals that are lost from a tooth
Bacterial inhibition
inhibit bacterial activity by inhibiting enolase, an enzyme needed by bacteria to metabolize carbohydrates
pH at which tooth minerals dissolves
5.5
Chlorexidine gluconate (CHX)
Board spectrum prescription mouth rinse
Concentraction of fluoride in CHX
0.12%
Uses of CHX
Management of bacteria associated with periodontal disease and dental caries
Side effects of CHX
Brown staining and bitter taste
2.0% Sodium Fluoride (NaF) Gel/Foam
Also called neutral sodium fluoride due to its neutral ph of 7
Most common for patients on regular hygiene calls
1.23% Acidulated Phosphate Fluoride (APF) Gel/Foam
Low ph of 3.5 (acidulated) enhances fluoride uptake
APF etches porcelain, composite resorations, and sealants so it should not be used on patients with such restorations
5% Neutral Sodium (NaF) Varnish
- Safe, effective, fast and easy to apply
- Higher concentration of fluoride than gel or foam, but an overall less amount of fluoride is used per application because it is painted in a thin layer on the enamel
- Sets quickly and remains on the teeth for up to (1-3) days releasing fluoride in pits and fissures and cervical areas of the teeth
- Great for children
- Reduces demineralization
- Application of choice for dentin hypersensitivity
Signs and symptoms of acute toxic dose
Nausea, vomiting, diarrhea, abdominal pain, increased salivation, and thirst. Symptons usually begin within 30 mins of ingestion
Emergency treatment of fluoride toxicity
- Induce vomiting
- Administer fluoride-binding liquid when patient is not vomiting
- milk
- milk of magnesium
- lime water
Patient instructions following application of fluoride
- Instruct to not rinse, eat, drink, brush, or floss for at least 30 min after gel or foam application
- After applying varnish, instruct patient to avoid hot drinks, alcoholic beverages, hard foods, and brushing or flossing for 4-6 hours or until next day
- Inform pt. that varnish will leave a yellow film on teeth until brushing and teeth may feel fuzzy
- Self applied fluorides (RX and OTC) are available as toothpastes, mouthrinses, and gels
