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Pharm301 Topics > Dental care > Flashcards

Dental care Flashcards

1
Q

What is the current status of oral health in NZ?

A
  • prevalence of total tooth loss has decreased since 1976
  • among children, the percentage of 12-13 year olds who are caries-free has doubled since 1988
  • dental decay still a problem
  • in 2009, 1 in 3 adults had untreated coronal decay, and 1 in 10 had root decay
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2
Q

What are the three main layers of the tooth?

A

crown, neck, root

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3
Q

What is the enamel?

A

outer most shell

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4
Q

What is the dentine?

A

layer behind the enamel

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5
Q

What is the pulp?

A

layer under the dentine.

this contains the blood vessels and nerves

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6
Q

What is the gum (gingiva)?

A

structure which holds the tooth in place.

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7
Q

What is the bone?

A

structure below the gum

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8
Q

What is the peridontal membrane?

A

membrane between bone and the cementum, in the root part of the tooth

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9
Q

What is the cementum?

A

layer which holds the tooth in place in the gum

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10
Q

What is the root canal?

A

leads up to the pulp

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11
Q

What does appropriate dental care consist of?

A
  • appropriate brushing
  • flossing
  • fluoride intake
  • regular check ups
  • reduce sugar intake
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12
Q

What are dental caries?

A
  • caused by bacteria in plaque metabolising sugars
  • acid produced from metabolism causes demineralisation of enamel and dentine
  • sucrose and glucose implicated
  • individual predisposition varies
  • genetic, saliva flow, tooth composition plays a larger factor than nutrition
  • fluoride can increase resistance to caries process
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13
Q

What is the role of fluoride in dental care?

A
  • some areas fluoridate water, usually around 1ppm.
  • strongly supported by ministry of health
  • said to prevent and reduce tooth decay across the whole population.
  • most tooth decay is preventable and fluoridation is a good way to prevent it
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14
Q

How else is fluoride available?

A
  • tooth paste
  • fluoride varnishes
  • fluoride mouth rinse
  • topical fluoride gels and foams
  • fluoride supplements only used when recommended by dentist or dental therapise
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15
Q

What are the requirements of fluoride in toothpaste?

A
  • should be labelled in ppm fluoride
  • toothpaste of at least 1000ppm is recommended for all ages and should be used bd.
  • smear of fluoride toothpaste is recommended until 5 years old
  • from 6 years pea-sized amount should be used
  • under 6 years living in fluoridated areas, at low risk of dental caries, can consider fluroide toothpaste less than 1000ppm to reduce total fluoride intake
  • children supervised when using toothpaste (should not be eaten)
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16
Q

what can fluoride enriched teeth withstand?

A

acid attacks from metabolised sugar

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17
Q

What increases risk of dental caries/

A
  • eating sugars between meals

- natural sugars like fructose, honey, fruit juice can also cause caries

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18
Q

What can help with dental caries?

A
  • snacking on sugar free things, savoury items

- sugar free cewing gum may help to remineralise damaged enamel by encouraging saliva flow (rich in Ca and P)

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19
Q

What is toothache?

A

pain due to tooth - may not necessarily be in the mouth

  • commonly presented in pharmacies
  • generally caused by caries
  • may be accompanied by swelling of gum or face, bad breath or bad taste in mouth
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20
Q

What questions should be asked regarding toothache?

A
  • where is the pain
  • how long have you had the pain?
  • describe the pain?
  • is there any swelling?
  • is there an unpleasant taste in the mouth?
  • when did you last see the dentist
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21
Q

How can toothache be managed?

A

-will require treatment from dentist, but symptomatic relief can include analgesic or clove oil.

(clove oil might cause irritation)

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22
Q

What can gum disease cause?

A
  • bleeding gums
  • unsightly appearance of gums
  • bad breath
  • premature tooth loss - can affect appearance, eating, speaking
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23
Q

What is the mildest form of gum disease?

A

gingivitis

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24
Q

What is gum disease?

A
  • caused by bacteria in plaque
  • bacterial metabolism irritates the gums
  • gums are red, swollen and bleed easily
  • there is little/no discomfort at this stage
  • reversible with professional treatment and good at home oral care
25
Q

What happens if gingivitis is left untreated?

A

peridontitis can occur

26
Q

What is peridontitis?

A
  • pockets of bacteria form where gums fall away from teeth
  • begins to destroy bone and tissue that support the teeth
  • changes the way teeth fit together
27
Q

What dental care advice can pharmacists give?

A
  • brush teeth regularly to remove plaque
  • dont use hart brush
  • floss daily
  • regular dentist and teeth cleaning
28
Q

What treatment is available for gingivitis?

A

chlorhexidine mouth wash- kills bacteria but is not a suitable substitute for brushing
-may stain teeth temporarily

29
Q

What is the prevalence of ulcers?

A

~25% people have an ulcer at some time

-often no cause and not infectious

30
Q

What are the most common causes of ulcers?

A
  • trauma to mucosa.

- see health professional if it does not resolve within 7-10 days

31
Q

What can ulcers be treated with?

A
  • chlorhexidine mouthwash and local anesthetic gel or Orabase
  • corticosteroid paste
  • pain killers
32
Q

When should ulcers be referrred?

A
  • ulcers that don’t heal after 2 weeks

- recurrent ulcers where no cause has been identified

33
Q

Can ulcers be recurrent?

A
  • yes, often occurring in crops although sometimes singly,
  • not always in the same place
  • may be related to dentures which may require re-adjusting
34
Q

What pharmacist only preparations can be used to treat ulcers?

A

Triamcinolone 0.1% in an emollient dental paste (Oracort)

35
Q

What general sale preparation can be used to treat ulcers?

A

Choline salicylate 87g/g (Bonjela)

36
Q

What is hypersensitivity?

A
  • occurs when dentine is exposed due to receding gums/nerves

- teeth may be sensitive to hot, cold and touch

37
Q

How can hypersensitivity be treated?

A

-desensitising toothpaste can help
-strontium can be used to seal the surface
-potassium containing products can reduce transmission on nerve impulse
fluoride toothpastes can offer protection

38
Q

What may bleeding gums indicate?

A
  • trauma
  • gingivitis
  • vitamin C deficiency
  • may be more evident during pregnancy due to hormonal changes
  • refer if unresolved
39
Q

What is halitosis?

A
  • extensive tooth decay
  • peridontal disease occurs in pockets where the gum is loose
  • may be due to oral infections, cancers
  • bacteria produce sulfides
  • some medical conditions can precipitate this
40
Q

What can help with halitosis?

A
  • advise improved dental hygiene

- visit dentist if it continues to rule out infection

41
Q

What is trenchmouth?

A

a painful form of gingivitis which is rare

  • seen in younger adults
  • may be assoc with stress, smoking, poor dental hygiene
42
Q

What are the symptoms of trenchmouth?

A
  • painful gums
  • profuse gum bleeding in response to any pressure or irritation
  • gums appear reddened and swollen
  • greyish film on gums
  • crater-like ulcers in between the teeth on the gum papillae
  • foul taste in the mouth
  • bad breath
43
Q

What can trenchmouth be treated with?

A
  • mouthwash
  • dental hygiene
  • scaling
  • antibiotics
44
Q

What is xerostomia?

A
  • dry mouth
  • can be caused by drugs (anticholinergics, antidepressants, opiods)
  • do not suck on sugary foods to stimulate saliva
45
Q

What can be used to help with xerostomia?

A
  • oral lubricants

- sugar free gum

46
Q

When is oral candida infection common?

A

in young children and elderly

-often assoc with denture use

47
Q

What helps with oral candida infection?

A

-careful cleaning of dentures
-antifungal treatments like Daktrin gel (Miconazole) which is a restricted medicine,
Nystatin suspension (restricted medicine)

48
Q

What is the prevalence of cold sores?

A

between 20-40% of people have had a cold sore at some time

49
Q

What events might precipitate a cold sore?

A 
physical trauma
strong sunlight
mensturation
emotional stress
illness (e.g. cold)
50
Q

What are the characteristics of cold sores?

A
  • tend to recur at the same sites
  • mostly involve lips,
  • the nostrils may be involved but this is less common
51
Q

What are the different stage of the cold sore?

A

Prodrome stage:
Day 1-2: tingle
Day 2-3: blister

Ulcer stage:
Day 4: weeping stage- this is most painful and contagious
Day 5-8: crusting
Day 9-12: final healing stage

52
Q

What are the complications of cold sores?

A

herpes simplex virus can cause:

  1. herpetic whitlow which is a painful infestation of the fingers
  2. eye infection which can result in corneal blindness

-always wash your hands after handling or applying medicine to cold sores

53
Q

What are the treatments for cold sores?

A

Aciclovir- best used at tingling stage
numbig agents for cold sores e.g. benzocaine, lidocaine, benzyl alcohol, camphor and phenol

Products which limit cod sore formation/promote their healing: zinc, lysine, phenol, tannic acid.

antibacterial agents to prevent secondary bacterial infection

medications which moisturise and soften cold sores e.g. petrolatum and allantoin

medications which provide sunscreen protection (SPF lip balm?)

54
Q

Who does acute herpetic gingivostomatitis (AHGS) mostly affect?

A
  • most likely in kids, but can be in in adults too
  • often confused with teething
  • very painful
  • vesicles in the mouth burst and become ulcers
  • can result in secondary infection
  • referral is needed
55
Q

What happens in teething?

A
  • localised inflammation of the gum
  • will want to bite on things to relieve the pain
  • commonly assoc with red hot cheeks, crying, diarrhoea,
56
Q

How is teething treated?

A

by treating symptoms - bonjela teething gel

-if diarrhoea or fever is severe, refer

57
Q

Which dental conditions need referral?

A
  • intractable toothache
  • swelling
  • gingival overgrowth
  • gingivitis plus foul breath
  • bleeding gums- for several days
  • severe ulceration
  • ulcers that don’t heal after 2 weeks
  • burning mouth
  • abscesses
  • AHGS
58
Q

What are the teeth cleaning techniques that should ideally be implented?

A
  • hold brush at 45 degrees to gum and brush side to side along gum line
  • brush 2x day for 2 mins each time
  • new tooth brush every 3 months
  • use soft/medium brush
  • use correct size brush
  • clean tongue gently
59
Q

What teeth cleaning techniques should be avoided?

A
  • brushing too vigourously, too often
  • brushing after eating acidic food or drink (should wait half an hour)
  • using hard toothbrush
  • using abrasive toothpastes
  • smoking

Pharm301 Topics (8 decks)

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