Clinical Aspects of Prevention

Question 1

Name 7 Professional Preventative Methods you may use for a patient.

Answer 1

• diet sheet
• behaviour modification
• engage the patient
• guidance and support
• practise efficient methods
• fissure sealants
• interventions - fluoride toothpaste, topical application

Question 2

How can you make the patient aware of their oral health?

Answer 2

plaque free scores and disclosing tablets

Question 3

What parts of patient history can you identify risk factors?

Answer 3

medical history
social history
dental history
diet history

Question 4

how can social history identify risk factors?

Answer 4

smoking
alcohol
occupation
recreational drug users

Question 5

is poor saliva flow a risk factor for poor oral health? why?

Answer 5

yes

• doesn’t neutralise acids
• chance of dental caries, demineralisation, sensitivity

Question 6

what risk factors can there be in dental history?

Answer 6

concentration of fluoride in toothpaste
what type of brush
brushing technique
use of inderdental brushes/mouthwash
dental attendance
previous caries experience

Question 7

what is the recommended brushing technique?

Answer 7

modified bass technique

Question 8

how can a plaque free score motivate a patient?

Answer 8

• can physically see where changes need to be made
• can set small goals and targets to reach

Question 9

how can a diet sheet motivate a patient?

Answer 9

can discuss chair side the diet and where changes/alternatives can be made

Question 10

what can you discuss with a diet sheet?

Answer 10

• frequency of sugar/acid attacks
• time between snacking
• if it is a balanced diet
• medications with sugar

Question 11

why would you need intervention for a patient?

Answer 11

if they are at high caries risk/early lesions

Question 12

what interventions are there?

Answer 12

duraphat toothpaste or varnish
fissure sealants

Question 13

what is the fluoride concentration of prescribed duraphat?

Answer 13

below 16 = 2800ppm
above 16 = 5000ppm

Question 14

what is the purpose of a fissure sealant?

Answer 14

to seal the pits and fissures
stop caries developing further

Question 15

for toddlers/babies, how can a bottle be harmful to the primary dentition?

Answer 15

leads to high caries risk
soaking the teeth with substances containing sugar over long periods of time

Question 16

give examples of risk factors from medical history.

Answer 16

medications which reduce salivary flow
radiation from treatment
pathology of parotid, submandibular, sublingual glands

Question 17

Give a method which identifies levels of dry mouth

Answer 17

Challacombe Scale
- better if the score is low as possible

Question 18

What word is used to describe dry mouth?

Answer 18

xerostomia

Question 19

Describe the Challacombe Scale.

Answer 19

score of 1-3 = mild dryness, do not need treatment, chewing gum and hydration

score of 4-6 = moderate dryness, chewing gum, hydration, saliva substitutes and topical fluoride

score of 7-10 = severe dryness, saliva sub, topical fluoride, refer patient for investigation and diagnosis to exclude hypo salivation and sjrogens syndrome

Question 20

describe each score of the Challacombe Scale

Answer 20

1 = mirror sticks to buccal mucosa
2 = mirror sticks to tongue
3 = frothy saliva
4 = no saliva pooling
5 = tongue has short papillae
6 = smooth gingiva
7 = glossy oral mucosa
8 = tongue is lobulated
9 = cervical caries
10 = debris sticking to palate/teeth

Question 21

what 6 medications can cause reduced salivary flow?

Answer 21

antihistamines
anti-depressants
high blood pressure meds
diuretics
anti-inflam
steroids

Question 22

can liquid medication be a risk factor?

Answer 22

yes

Question 23

which groups of people may be on liquid medication?

Answer 23

children
elderly
adults with special needs

Question 24

What are the 5 steps of Dietary Counselling.

Answer 24

1. identify high risk patient
2. take detailed diet history
3. set goals
4. develop action plan
5. monitor and review the patient

Question 25

what even if fluoride?

Answer 25

fluoride is a naturally occurring mineral that can be found in water, fish, tea and beer which strengthens teeth and prevents decay

Question 26

what is the recommended fluoride values for the age categories?

Answer 26

0-3 yrs = 1,000 ppm
3-6 = over 1,000 ppms
7+ = 1,350-1,500ppm

duraphat
under 16 - 2800
over 16 - 5000

Question 27

what is the concentration of a fluoride varnish?

Answer 27

22,600ppm

Question 28

how many times should you use fluoride varnish on a patient?

Answer 28

3-young adult = twice a year

those showing concern = twice a year

Question 29

fluoride varnish can contain which ingredient, which can be an allergy?

Answer 29

colophony