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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
stannous fluoride
deposits fluoride ions on enamel tin ion from the stannous fluoride interferes with cell metabolism has an antimicrobial effect
26
sodium fluoride
deposits fluoride ions on enamel inhibits demineralization and enhances remineralization
27
fluoride availability and use
prevention of demineralization reduction of hypersensitivity and of gingivitis
28
fluoride efficacy
reduction in biofilm and dental caries when used topically by patient
29
fluoride considerations
instruct patient not to swallow it tooth staining
30
chlorhexidine mechanism of action
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
31
depending on the concentration chlorhexidine can be either
bactericidal or bacteriostatic
32
chlorhexidine is an _______ and an ________ agents
antimicrobial anti-gingivitis agents
33
chlorhexidine substantivity
8-12 hours
34
CHX availability and use
most effective antimicrobial and antigingivitis agent available
35
CHX recommended uses
preprocedural before, during, after debridement patients at high risk of dental caries immunocompromised patients post surgery
36
CHX efficacy
safe and effective in: preventing formation and reducing viability of biofilm preventing gingivitis reducing mutans streptococci
37
CHX varnish reduces caries in these groups
children xerostomia patients patients undergoing ortho root caries
38
triclosan mechanism of action
effective against both gram-negative and gram-positive bacteria bisphenol and non-ionic antimicrobial agent acts on microbial cytoplasmic membrane
39
CHX considerations
low level toxicity staining of teeth increase in supragingival calculus formation altered taste perception minor irritation
40
triclosan is an ______ and an _______ agent
antimicrobial and an antigingivitic agent
41
triclosan has low
toxicity
42
triclosan availability and uses
reduction of biofilm and gingivitis reduced accumulation of biofilm reduced formation of supragingival calculus
43
triclosan efficacy
reduces biofilm and bleeding on probing
44
triclosan considerations
easily released from the oral tissue-binding sites when combined with PVM/MA there is an increase in substantivity and efficacy
45
phenolic-related essential oils mechanism of action
disrupts the cell walls and inhibits bacterial enzymes decreases pathogenicity of biofilm is an antimicrobial and antigingivitis agent
46
phenolic-related essential oils availability
a combination that includes thymol, eucalyptol, menthol, and methyl salicylate for clinical use
47
phenolic-related essential oils recommended use
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
phenolic-related essential oils efficacy
significant reduction in biofilm and gingivitis
49
phenolic-related essential oils considerations
burning sensation bitter taste poor substantivity efficacy is based on patient following the manufacturer's instructions contraindicated for alcoholics
50
quaternary ammonium compounds mechanism of action
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
quarternary ammonium compounds most common agent
CPC (0.05-0.07%)
52
quarternary ammonium compounds recommended use
reduction in accumulation of biofilm use adjunct to mechanical self-oral care routine
53
quarternary ammonium compounds efficacy
weak evidence for reduction in biofilm and gingivitis possible inhibition of formation of calculus
54
quarternary ammonium compounds considerations
staining of teeth and tongue burning sensation and desquamation
55
oxygenating agents mechanism of action
alters bacterial cell membrane poor substantivity
56
oxygenating agents most common agents
10% carbamide peroxide and 1.5% hydrogen peroxide
57
oxygenating agents recommended use
short-term use to reduce symptoms of periocoronitis and NUG
58
oxygenating agents efficacy
very small antimicrobial effect debriding agent
59
oxygenating agents considerations
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
oxidizing agents mechanism of action
neutralization of volatile sulfur components
61
oxidizing agents common agents
chlorine dioxide and chlorine dioxide/zinc combination
62
oxidizing agents efficacy
management of halitosis
63
oxidizing agents consideration
diluted sodium hypochlorite used as a mouthrinse 2x/week showed reductions in BOP, biofilm, and inflammation
64
commercial mouthrinses active ingredients
usually contain more than one active ingredient, therefore may advertise multiple claims for use
65
factors that may influence how effective an agent is
dilution by the saliva length of time the agent is in contact with the tissue or bacteria evidence supporting the product
66
commercial mouthrinses inactive ingredients
water: largest % alcohol: enchances flavour, increases solubility of active ingredients, 18-27% flavouring: essential oils and derivatives, aromatic waters, artificial sweeteners
67
contraindications of mouthrinse
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
oil pulling
swish with 10 mL of sesame oil reduces biofilm reduces bacteria
69
purpose of the FDA
regulate drugs, equipment and devices some devices are exempt, including dental water syringe, power and manual toothbrushes and floss
70
dental products regulated include
infection control products ultrasonic instruments diagnostic test kits prosthetic and restorative materials surgical and periodontal materials prescription drugs, controlled sustained release devices, chemotherapeutics
71
for dentifrices and mouthrinses, the FDA has
reviewed individual active ingredients and outlines permissible levels of those ingredients and statements that product labels must have
72
purposes of the ADA/CDA program
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
information required from the ADA company
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
acceptance and use of the ADA Seal
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
documentation of dentifrice and mouthrinse
recommended dentifrice and mouthrinse patient instructions: amount, frequency, usage summary of current findings
76
factors to teach the patient
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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