Clinical aspects of prevention Flashcards

1
Q

Give examples of professional preventative methods we can use

A
  1. Diet diary
  2. Nutritional sport
  3. Behaviour modification
  4. Engaging patients
  5. Plaque scores
  6. Oral health guidance and support
  7. Fissure sealants
  8. Fluoride varnish
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2
Q

how can we identify a patients risk factors

A
  1. Medical hits
  2. Social history
  3. Saliva flow
  4. Dietary habits
  5. Exposure to fluoride
  6. Clinical evidence of previous caries
  7. Siblings
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3
Q

For behavioural cadges to be successful what must you tell the patient?

A

The severity of the outcome if they do not change their habits
How susceptible they are to negative consequences

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4
Q

What can we use to emphasise the patients the importance of effective plaque removal?

A

Plaque disclosing tablets

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5
Q

What do you need for dental caries to form and progress?

A
  1. Bacterial plaque
  2. Tooth surface
  3. Refined carbohydrates
  4. Time
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6
Q

What can we do if we have identified a patient as high risk fro dental caries?

A
  1. We can use duraphat varnish or clinic

2. Can prescribe durphat toothpaste

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7
Q

What is special about duraphat toothpaste?

A

It has 2800ppm fluoride for under 16s

Has 5000+ppm for over 16s

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8
Q

Alongside OHI how else can we support Unger patients and protect them from developing caries?

A

By sealing tier pits and fissures b doing fissure sealants

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9
Q

What do we do once we have received a completed diet sheet?

A

We need to identify the frequency of cariogenic food ad see if the patient is taking any hidden sugars they may not be aware of

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10
Q

What is the main advice we give in regards to diet?

A

Reduce the FREQUENCY of sugary snacks

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11
Q

Give examples of patients who may be at higher risk of developing caries

A
  1. Infants, toddlers and the elderly
  2. Patients with reduced salivary flow
  3. Increased carbohydrate intake due to medical problem
  4. Recreational drug users who have a craving for sugar
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12
Q

Give examples of professions hat may be at a higher caries risk

A
  1. Athletes taking sports drinks
  2. Food or drinks samplers
  3. Night shift workers (may snack more or take energy drinks to stay up)
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13
Q

How can we identify levels of dry mouth?

A

By using the Challacombe scale

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14
Q

What is the purpose of the Challacombe scale?

A

It is a way to identify and quantify if your patient has xerostomia

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15
Q

What does a score of 1 on the Challacombe mean?

A

Mirror sticks to buccal mucosa

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16
Q

What does a score of 2 on the Challacombe mean?

A

Mirror sticks to tongue

17
Q

What does a score of 3 on the Challacombe mean?

A

Saliva is frothy

18
Q

If patient scored 1-3 on the challacombe scale what does this indicate and what should you do?

A

Indicates mik dryness
May not need treatment of management but recommend:
1. Sugar free gum for 15 mins twice a day
2. Increase water intake

19
Q

What does a score of 4 on the Challacombe mean?

A

No saliva pooling in floor of mouth

20
Q

What does a score of 5 on the Challacombe mean?

A

Tongue shows generalised shortened papillae (mild depapiliation)

21
Q

What does a score of 6 on the Challacombe mean?

A

Altered gingival architecture (smoother)

22
Q

If patient scored 4-6 on the challacombe scale what does this indicate and what should you do?

A

Indicated moderate dryness

  1. Chewing sugar free gum may be required
  2. Saliva substitutes and topical fluoride may be helpful
  3. Monitor and identify cause of dryness
23
Q

What does a score of 7 on the Challacombe mean?

A

Glassy appearance of oral mucosa especially palate

24
Q

What does a score of 8 on the Challacombe mean?

A

Tongue lobulated/ fissured

25
Q

What does a score of 9 on the Challacombe mean?

A

Cervical caries on more than 2 teeth

26
Q

What does a score of 10 on the Challacombe mean?

A

Debris on palate or sticking to teeth

27
Q

If patient scored 7-10 on the challacombe scale what does this indicate and what should you do?

A

Indicated severe drynes

  1. Saliva substitutes and topical fluoride
  2. NEED to identify cause of hypo-salivation
  3. Possible specialist input may be needed condition worsens
28
Q

Give examples of mediations that can cause xerostomia

A
  1. Antihistamines
  2. High blood pressure meds
  3. Antidepressants
    4 Diuretics
  4. Inflammatories
  5. Steroids
29
Q

Whatmight put the elderly in a high risk caries group

A

Patients on liquid medications

30
Q

Name some the most prescribed liquid medications

A
Lactulose,
Ensure,
Amoxicillin,
Fortisip,
morph sulphate,
amoxicillin,
gaviscon,
oramorph,
paracet
31
Q

Give the 5 steps we take when giving dietary counselling

A
  1. Identify high risk patients
  2. Take a detailed dietary history
  3. Set goals
  4. Develop an action plan
  5. Monitor and review
32
Q

Other than dietary advice how can we minimise plaque deposits in patients

A
  1. Mechanical plaque removal
  2. Recommend electric toothbrushes
  3. Interdental cleaning
  4. Fluoride toothpaste