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Clinical Theory > Dentifrices and Mouthrinses > Flashcards

Dentifrices and Mouthrinses Flashcards

1
Q

dentifrices (toothpaste) is used for

A

removal of biofilm, stain, and other soft deposits
application of therapeutic agents
superficial cosmetic effects

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2
Q

preventive and therapeutic benefits of dentifrices

A

prevent of dental caries
reduction in biofilm formation
reduction in dentin hypersensitivity
remineralization of early non-cavitated dental caries
reduction in gingivitis/inflammation
reduction in formation of supragingival calculus

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3
Q

first caries-preventive toothpaste contained

A

stannous fluoride

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4
Q

fluoride enhances

A

remineralization

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5
Q

agents used to reduce biofilm formation

A

triclosan
zinc citrate
stannous fluoride

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6
Q

what is the primary agent in reducing gingival inflammation

A

triclosan

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7
Q

reduction of dentin hypersensitivity

A

chemical occlusion of dentinal tubules and desensitization of the nerve
potassium nitrate and sodium fluoride

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8
Q

reduction in supragingival calculus formation tarter-control agents include

A

pyrophosphate salts
zinc salts (chloride and citrate)
sodium hexametaphosphate

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9
Q

cosmetic effects of dentifrices

A

removal of extrinsic stain
reduction of oral malodor (halitosis)

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10
Q

removal of extrinsic stain

A

mechanical removal of stained biofilm
delivery of bleaching agent

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11
Q

reduction of oral malodor

A

ingredients can temporarily reduce malodor by inhibiting production of volatile sulfur compounds
CHX
triclosan/copolymer
stannous fluoride and sodium hexametaphosphate

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12
Q

basic components of dentifrices: inactives

A

detergents
cleaning and polishing agents
binders
humectants
preservatives
flavouring agents

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13
Q

detergents

A

foaming agents or surfactants
lower surface tension
penetrate and loosen surface deposits
suspend debris for easy removal by toothbrush
emulsify/disperse the flavor oils
contribute to foaming action

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14
Q

cleaning and polishing agents

A

abrasives
cleans without damaging tooth surface
produces a smooth tooth surface

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15
Q

binders

A

thickeners
stabilizes the formulation
prevents the solid and liquid ingredients from separating during storage

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16
Q

humectants

A

retain moisture
prevent hardening on exposure to air

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17
Q

preservatives

A

prevent bacterial growth
prolong shelf life

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18
Q

flavouring agents

A

sweeteners
impart a pleasant flavor for patient acceptance
mask other ingredients that may have a less pleasant flavor

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19
Q

active components of dentifrices and what benefits in what areas

A

fluoride

provide benefits in areas of:
anticaries
antibiofilm/antigingivitis
anticalculus
malodor
antisensitivity

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20
Q

considerations for the pediatric patient

A

from birth to eruption of first tooth:
clean gingiva with soft infant toothbrush or with a wet cloth

eruption of first tooth:
brush 2x daily using fluoridated toothpaste and soft, age-appropriate toothbrush, use rice-sized amount until 3 years old

2-5 years old:
use a pea-size amount of toothpaste, perform or assist child, avoid swallowing excess toothpaste

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21
Q

patient-specific dentifrice recommendations

A

patient’s current oral condition
any patient complaint/concern
sensitivities or allergies to a specific ingredient
propensity of staining
patient’s nontherapeutic/cosmetic choices
expectation of compliance

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22
Q

purpose and use of mouth rinses

A

supplement mechanical aids
may have preventive, cosmetic, or therapeutic benefits
chemotherapeutic rinses may reduce inflammation
therapeutic rinses have healing properties
deliver an agent less than 2mm into the sulcus or pocket

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23
Q

functions of chemotherapeutic agents

A

remineralization
antimicrobial: biofilm control, gingivitis reduction
astringent: shrink tissues
anodyne: alleviate pain
buffering: reduce oral acidity
deodorizing: neutralize odor
oxygenating: cleansing

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24
Q

preventive and therapeutic agents of mouthrinses

A

fluoride
CHX
triclosan
phenolic related essential oils
quaternary ammonium compounds
oxygenating agents
oxidizing agents

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25
Q

stannous fluoride

A

deposits fluoride ions on enamel
tin ion from the stannous fluoride interferes with cell metabolism
has an antimicrobial effect

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26
Q

sodium fluoride

A

deposits fluoride ions on enamel
inhibits demineralization and enhances remineralization

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27
Q

fluoride availability and use

A

prevention of demineralization
reduction of hypersensitivity and of gingivitis

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28
Q

fluoride efficacy

A

reduction in biofilm and dental caries when used topically by patient

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29
Q

fluoride considerations

A

instruct patient not to swallow it
tooth staining

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30
Q

chlorhexidine mechanism of action

A

binds to oral hard and soft tissues
attaches to bacterial cell membrane and damages the cytoplasm
binds to pellicle and salivary mucins to stop biofilm from accumulating

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31
Q

depending on the concentration chlorhexidine can be either

A

bactericidal or bacteriostatic

32
Q

chlorhexidine is an _______ and an ________ agents

A

antimicrobial
anti-gingivitis agents

33
Q

chlorhexidine substantivity

A

8-12 hours

34
Q

CHX availability and use

A

most effective antimicrobial and antigingivitis agent available

35
Q

CHX recommended uses

A

preprocedural
before, during, after debridement
patients at high risk of dental caries
immunocompromised patients
post surgery

36
Q

CHX efficacy

A

safe and effective in:
preventing formation and reducing viability of biofilm
preventing gingivitis
reducing mutans streptococci

37
Q

CHX varnish reduces caries in these groups

A

children
xerostomia patients
patients undergoing ortho
root caries

38
Q

triclosan mechanism of action

A

effective against both gram-negative and gram-positive bacteria
bisphenol and non-ionic antimicrobial agent
acts on microbial cytoplasmic membrane

39
Q

CHX considerations

A

low level toxicity
staining of teeth
increase in supragingival calculus formation
altered taste perception
minor irritation

40
Q

triclosan is an ______ and an _______ agent

A

antimicrobial and an antigingivitic agent

41
Q

triclosan has low

A

toxicity

42
Q

triclosan availability and uses

A

reduction of biofilm and gingivitis
reduced accumulation of biofilm
reduced formation of supragingival calculus

43
Q

triclosan efficacy

A

reduces biofilm and bleeding on probing

44
Q

triclosan considerations

A

easily released from the oral tissue-binding sites
when combined with PVM/MA there is an increase in substantivity and efficacy

45
Q

phenolic-related essential oils mechanism of action

A

disrupts the cell walls and inhibits bacterial enzymes
decreases pathogenicity of biofilm
is an antimicrobial and antigingivitis agent

46
Q

phenolic-related essential oils availability

A

a combination that includes thymol, eucalyptol, menthol, and methyl salicylate for clinical use

47
Q

phenolic-related essential oils recommended use

A

patients who are unable to perform adequate brushing and flossing
use to help improve oral hygiene
can be used in adjunct for mechanical self-care routines
as a preprocedural rinse to reduce bacteria available to aerosols

48
Q

phenolic-related essential oils efficacy

A

significant reduction in biofilm and gingivitis

49
Q

phenolic-related essential oils considerations

A

burning sensation
bitter taste
poor substantivity
efficacy is based on patient following the manufacturer’s instructions
contraindicated for alcoholics

50
Q

quaternary ammonium compounds mechanism of action

A

cationic agent that binds to oral tissues
ruptures cell wall –> alters cytoplasm
strong initial attachment then quickly releases
decrease ability of bacteria to attach to pellicle
low substantivity

51
Q

quarternary ammonium compounds most common agent

A

CPC (0.05-0.07%)

52
Q

quarternary ammonium compounds recommended use

A

reduction in accumulation of biofilm
use adjunct to mechanical self-oral care routine

53
Q

quarternary ammonium compounds efficacy

A

weak evidence for reduction in biofilm and gingivitis
possible inhibition of formation of calculus

54
Q

quarternary ammonium compounds considerations

A

staining of teeth and tongue
burning sensation and desquamation

55
Q

oxygenating agents mechanism of action

A

alters bacterial cell membrane
poor substantivity

56
Q

oxygenating agents most common agents

A

10% carbamide peroxide and 1.5% hydrogen peroxide

57
Q

oxygenating agents recommended use

A

short-term use to reduce symptoms of periocoronitis and NUG

58
Q

oxygenating agents efficacy

A

very small antimicrobial effect
debriding agent

59
Q

oxygenating agents considerations

A

do not consistently prevent the accumulation of plaque biofilm short term
when used long term, some reduction in gingival redness has been recorded
some reports of erosive changes on oral mucosa

60
Q

oxidizing agents mechanism of action

A

neutralization of volatile sulfur components

61
Q

oxidizing agents common agents

A

chlorine dioxide and chlorine dioxide/zinc combination

62
Q

oxidizing agents efficacy

A

management of halitosis

63
Q

oxidizing agents consideration

A

diluted sodium hypochlorite used as a mouthrinse 2x/week showed reductions in BOP, biofilm, and inflammation

64
Q

commercial mouthrinses active ingredients

A

usually contain more than one active ingredient, therefore may advertise multiple claims for use

65
Q

factors that may influence how effective an agent is

A

dilution by the saliva
length of time the agent is in contact with the tissue or bacteria
evidence supporting the product

66
Q

commercial mouthrinses inactive ingredients

A

water: largest %
alcohol: enchances flavour, increases solubility of active ingredients, 18-27%
flavouring: essential oils and derivatives, aromatic waters, artificial sweeteners

67
Q

contraindications of mouthrinse

A

can enhance a patient’s oral self-care regime but is not intended to replace mechanical brushing or flossing
some cannot be given to children under 6 years old
patients with physical or cognitive challenges
check manufacturer’s instructions

68
Q

oil pulling

A

swish with 10 mL of sesame oil
reduces biofilm
reduces bacteria

69
Q

purpose of the FDA

A

regulate drugs, equipment and devices
some devices are exempt, including dental water syringe, power and manual toothbrushes and floss

70
Q

dental products regulated include

A

infection control products
ultrasonic instruments
diagnostic test kits
prosthetic and restorative materials
surgical and periodontal materials
prescription drugs, controlled sustained release devices, chemotherapeutics

71
Q

for dentifrices and mouthrinses, the FDA has

A

reviewed individual active ingredients and outlines permissible levels of those ingredients and statements that product labels must have

72
Q

purposes of the ADA/CDA program

A

helps public and dental professionals make informed decisions regarding dental products
evaluate products for safety and efficacy when used as directed
inform dental teams and the public about the safety and efficacy of accepted products
maintain connections with regulatory agencies and professional research organizations

73
Q

information required from the ADA company

A

a complete list of ingredients
data from clinical trials that support the product is safe and effective when used correctly
compliance with the specific product category

74
Q

acceptance and use of the ADA Seal

A

any claims of product effectiveness on labeling in advertising must first be approved by the ADA Council
must be accompanied by an ADA-approved seal statement
statement tells consumer what claims have been reviewed and approved

75
Q

documentation of dentifrice and mouthrinse

A

recommended dentifrice and mouthrinse
patient instructions: amount, frequency, usage
summary of current findings

76
Q

factors to teach the patient

A

significance of ADA product acceptance seal
how to avoid impulse buying dental products
why chemotherapeutics are not a substitutes for daily biofilm removal
to ask about new dentifrices and mouthrinses
to understand the relationship between compliance and expected outcomes
to check ingredients of mouthrinses to prevent the purchase of high-alcohol content

Clinical Theory (18 decks)

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