CS 1 - introduction Flashcards

1
Q

what factors are needed for caries to develop?

A
  • tooth
  • substrate
  • flora
  • time
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2
Q

what affects the tooth susceptibility to caries

A
○ Age 
○ Fluorides
○ Nutrition
○ Morphology 
○ Trace elements
○ Carbonate level
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3
Q

what affects the substrates ability to act on a tooth?

A
○ Oral clearance 
○ Oral hygiene
○ Salivary stimulants
○ Frequency of eating
○Carbohydrate (type, concentration)
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4
Q

what is caries risk assessment?

A

The risk of the patient developing new / progressive disease in the future
an assessment must take place on an individual level for each patient and not at a population level

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5
Q

what 2 categories can caries risk factors be divided into

A

general

local

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6
Q

what is included within general caries risk factors?

A
○ Social 
	§ Where they live
	§ What means do they have
	§ What are their thoughts about OH
○General health
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7
Q

what is included within local caries risk factors?

A
○ OH
○ Diet 
○ Fluoride experience 
○ Past caries Experience
	§ Restorations present
○ Orthodontic treatment
	§ Braces can create poor oral hygiene
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8
Q

what are the 7 elements of caries risk?

really common exam Q

A

i) Clinical evidence
ii) Dietary habits
iii) Social history
iv) Fluoride use
v) Plaque control
vi) Saliva
vii) Medical history

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9
Q

what does dmft / DMFT stand for

A

diseased missing filled teeth in primary dentition for lower case and in permanent dentition for upper case

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10
Q

what role does clinical evidence play?

A

• Caries experience
○ dmft greater than / equal to 5 (primary dentition)
DMFT greater than / equal to 5 (permanent
dentition)
○ Caries in 6’s at 6 years
○ 3 years caries increment greater than / equal to
• Orthodontics
○ Fixed appliance therapy
• Prosthetics
○Fixed or removable

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11
Q

what role does the diet play in caries risk?

A
  • sugar intake
    ○ frequency more of a problem than amount
    ○ processed sugars more cariogenic than natural
    sugars ie sucrose worse than glucose
    ○ natural sugars still cause harm
    ○ diet diary beneficial
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12
Q

how does social history affect caries risk?

A
  • SIMD category
  • Education
  • Unemployment
  • Work stressors
  • Single parent families
  • Violence
  • Inequalities and access to healthcare
  • Dependents
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13
Q

how does patient’s fluoride intake affect caries risk?

A
  • infrequent use of fluoride toothpaste

- no water fluoridation

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14
Q

what does fluoride / F- do?

A
  • Incorporation into enamel crystals to form fluorapatite which is more caries resistant (resistant to demineralisation) than HA
  • Bactericidal? Resistant to streptococcal strains
  • Interferes with the adhesion force of bacteria reducing their ability to stick to the surface of the teeth
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15
Q

what role does oral hygiene play in caries risk?

A
  • poor brushing technique
  • irregular brushing
  • young / old / unable left unassisted
  • access to tooth paste / toothbrush
  • difficulty due to changes ie mixed dentition, orthodontics, gaps
  • lack of other cleaning aids like floss
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16
Q

how does saliva play a role in caries risk?

A
  • Amount
  • Flow
  • Buffering capacity
  • pH
  • Viscosity
17
Q

what is the ideal viscosity of saliva?

A

don’t want it too thick, should be washing

18
Q

how does medication affect caries risk?

A
  • some medications cause xerostomia (dry mouth) so lack of saliva for clearance
  • medications often have free sugars added to them to make them easier to take
  • social convention = when someone is ill we bring them sweets
  • lactoulose for children
19
Q

what are the 8 elements of caries prevention?

A

i) Radiographs
ii) Toothbrushing instruction
iii) Strength of F in toothpaste
iv) F varnish
v) F supplementation
vi) Diet advice
vii) Fissure sealants
viii) Sugar free medicine

20
Q

what is typical of a child who is a high caries risk?

A
• Social 
	○ Mother's education secondary only
	○ Poor dental attender
	○ Family unit
		§ Single parent
		§ Social class
		§ Unemployment
• Health 
	○ Poor health / chronic sick
	○ Sugar-based medications
• Caries experience
	○ Dmft > 5, DMFT >5 
	○ >/= 10 initial lesions in primary dentition at first attendance 
	○ Caries in 6's at 6 years
	○ 3 years caries increment >/= 3

• Orthodontics
○ Fixed appliance therapy

• Behavioural
○ Mother’s caries rate
○ Prolonged nursing habits
§ Giving milk overnight - try and stop this as soon as possible (14 weeks old)
§ On demand breastfeeding overnight = terrible tooth decay
○ Bottle / pacifier at bedtime
§ Put to bed with sippy cup of juice / milk = overnight caries
○ Cariogenic snacking
○ No tooth cleaning
§ tiny bit of tooth visible = start cleaning
○ Little fluoride exposure

21
Q

what is typical of an adult who is high caries risk?

A
• Level of education
• Attends only when they have a problem
• Social difficulties 
• Sweet tooth with poor OH
	○ Good OH solves this problem
• Sugar containing meds or meds affecting saliva
• Root caries
• Secondary caries