Dietary advice for caries prevention

Question 1

what are the factors that cause caries

Answer 1

bacterial plaque
susceptible tooth surface
refined carbohydrates- non milk extrinsic sugars
time

Question 2

what happens if there is repeated pH dropping

Answer 2

can lead to demineralisation of the tooth surface

Question 3

how does plaque biofilm form

Answer 3

by the formation of the salivary pellicle

Question 4

what is found in the plaque biofilm

Answer 4

large amounts of microorganisms
eg strep mutans
strep oralis
strep sanguins

Question 5

what happens after 1-14 days of plaque formation

Answer 5

we have the dominated strep plaque which is then converted to dominated actinomycetes plaque

Question 6

where can cariogenic bacteria be sitting

Answer 6

pits and fissures 
interproximal 
around margin restorations 
buccal surface 
orthodontic brackets 
partial denture clasps

Question 7

what does the characteristic demineralised surface of a tooth look like

Answer 7

chalky white appearance when dried with the 3-in-1

Question 8

how do we seal teeth to protect them from caries

Answer 8

fissure sealants

Question 9

what days do we take a diet diary
Why?

Answer 9

2 weekdays and one weekend

indetifies sugar intake and hidden sugars

Question 10

what studies were taken which link carbohydrates to dental caries

Answer 10

tristan de cuna 
vipeholm 
hope wood house 
turku 
2nd world war

Question 11

what dow e have to consider which might alter caries formation

Answer 11

fluoride intake and saliva flow

Question 12

what can frequency of sugar intake relate to

Answer 12

intrinsic and extrinsic sugars 
medication that has sugar 
food and drinks which can be cariogenic 
reducing snacks 
and reducing frequency of acid attacks

Question 13

what do we need to consider in regards to the elderly and caries

Answer 13

medications

xerostomia

Question 14

which patients are at greater risk of caries

Answer 14

infants and toddlers- nursing caries etc
patients with reduced salivary flow or on medication, radiation or conditions such as Sjrogrens syndrome
increased carbohydrates due to medical issue
recreational drug users

Question 15

who is involved in the high risk caries group

Answer 15

nursing bottle caries age
language barriers
socially deprived- low economic groups
medically physically impaired

Question 16

what preventative measures do we use for high risk groups

Answer 16

plaque control and regular brushing
fluoride application or tissue sealants
regular oral checks with radiographs

Question 17

what diet advice do we give

Answer 17

keep sugar to meal time only
only milk and water should be given in a feeder cup
reduce soft drinks and use a straw
only water at bedtime
eg sweden saturday sweets-sugar only once a week

Question 18

what does GULP stand for

Answer 18

give up loving pop

Question 19

how many sugar intakes should we have per day

Answer 19

around 4 times

only at meal times

Question 20

extrinsic sugars that aren’t milk

Answer 20

honey 
dried fruits 
smoothies
cakes 
biscuits etc
all found in the toolkit

Question 21

what do we use to prevent plaque control

Answer 21

minimise sugars 
toothbrushing x2 a day 
interdental cleaning
manual and power toothbrushes 
fluoride toothpaste 1350ppm 
chemical plaque control using chlorhexidine

Question 22

what are the key messages of the toolkit

Answer 22

tooth brushing fluoride 
dietary advice
sugar free medicines
improving perio health
smoking cessation 
alcohol misuse 
prevention of erosion
behaviour change

Question 23

steps to dietary counselling

Answer 23

1. identify higher risk patients
2. take detailed history
3. set goals
4. develop action plan
5. monitor and review