Day 4 Lecture 2

Question 1

Tooth centered

Answer 1

Tooth centered is surgical intervention to eliminate cavitated lesions.

Question 2

Patient Centered

Answer 2

To use a medical model to control the disease process.

Question 3

CAMBRA

Answer 3

Caries management by risk assessment

Caries risk assessment to establish risk level. Individual risk indicators, individual risk factors, protective factors, non surgical therapeutics and dental surgical intervention.

Question 4

Individual risk indicators

Answer 4

Things that you can see or have a history of that show that there has been active mouth disease. You’re sick.

Question 5

Individual risk factors

Answer 5

Things that encourage decay - Mtn. Dew, coffee. You might get sick.

Question 6

Protective Factors

Answer 6

Things that discourage decay. Often a balance between individual risk factors and protective factors. Fluoride, healthy diet.

Question 7

Non-surgical therapeutics

Answer 7

Non surgical = sealants, fluoride treatment, diet intervention

Question 8

Dental surgical interventions

Answer 8

What it sounds like.

Question 9

Caries risk assessment

Answer 9

Gather data on current/recent dental history. Interview patients for risk factors. Conduct tests to determine status of saliva, bioload, and other data. Establish risk level for new lesions. Establish treatment plan.

Question 10

Caries of mother/caregiver

Answer 10

1 indicator for kids less than 6 - mother tests food and gives bacteria to kids.

Question 11

Special health care needs

Answer 11

Something physical that prevents tooth care.

Question 12

Bolemia

Answer 12

Maxillary lingual sides.

Question 13

Gerd

Answer 13

Gastro-esophogeal reflux disease. Difference between Gerd and bolemia - only mandibular teeth usually.

Question 14

How long it takes for decay to reach dentin

Answer 14

16-24 months.

Question 15

Xylitol

Answer 15

Gum stimulates saliva, xylitol interferes with early colonization of plaque. Also hard to break down.

Question 16

Social, economic, education status

Answer 16

Social and economic are not involved directly in disease process. They are important because they affect the expression and management of the caries disease. This is about compliance and behavior. Predictive at population level, not too accurate at individual level.

Question 17

CRA

Answer 17

Updated 3 months for high risk, 6 months for med risk, year for low risk.

Question 18

Bacterial biofilm analysis

Answer 18

Shown to be high predictor of pH, but not a great indicator.

Question 19

Risk considerations for kids under 6

Answer 19

Primary caregiver, nursing bottle (kids go to bed with anything but water).

Question 20

Factors influencing caries risk

Answer 20

Immunization - if you eliminate a certain bacteria, it really doesn’t matter. Some bacteria are also beneficial, so trying to just eliminate certain bacteria from oral flora. Plus, opportunistic pathogens can move in which could be worse.

Question 21

Calcium and phosphate compounds

Answer 21

In toothpastes - doesn’t really work.

Question 22

Look these up - replace 9 with 10 (?)

Answer 22

Sample Preventive Protocol For a High Risk Patient With Cavitated Caries Lesions(Pages 8 – 9 H/O)
Table 2-7 Suggested Risk-Based Interventions for
Adults (Page 10 H/O)
Table 2-8 Health History Factors Associated with
Increased Caries Risk (Page 11 H/O)
Table 2-9 Clinical Examination Findings Associated
with Increased Caries Risk (Page 11 H/O)
Table 2-10 Methods of Caries Treatment by the
Medical Model (Page 12 H/O)
Table 2-11 Treatment Strategies (Page 13 H/O)

Question 23

Caries control restoration

Answer 23

Operative procedure in which multiple teeth with acute threatening caries are treated quickly by removing infected structure, medicating pulp if needed (calcium hydroxide with GI). This prevents spread.

Question 24

Root caries management

Answer 24

The first strategy is to try to improve salivary flow rates and increase the
buffering capacity.
 The second strategy is to try to reduce the numbers of cariogenic bacteria (S.
mutans) in the oral cavity.
 The third strategy is to reduce the quantity and numbers of exposures of
ingested refined carbohydrates.
 The fourth is to attempt to remineralize noncavitated lesions and prevent new
lesions from developing.