Disease Prevention Flashcards

1
Q

what is a care plan

A

blueprint or guide that coordinates all treatment

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2
Q

what is the preliminary phase

A

emergency only review pg 1 still

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3
Q

Steps in Learning-Ladder or Decision-Making Continuum

A
  1. Unawareness or Ignorance
  2. Awareness
  3. Self-Interest
  4. Involvement
  5. Action
    6.Habit or commitment
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4
Q

Learning-Ladder or Decision-Making Continuum:
1. Unawareness or Ignorance

A

client lacks information or has incorrect information about the problem

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5
Q

Learning-Ladder or Decision-Making Continuum:
2. Awareness

A

Client knows a problem exists but does not act on this knowledge

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6
Q

Learning-Ladder or Decision-Making Continuum:
3. Self- Interest

A

the client recognizes the problem and has an inclination towards change

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7
Q

Learning-Ladder or Decision-Making Continuum:
4. Involvement

A

Client attitude and feelings are affected, desire for additional knowledge

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8
Q

Learning-Ladder or Decision-Making Continuum:
5. Action

A

new behaviours directed toward solving the problem are instituted

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9
Q

Learning-Ladder or Decision-Making Continuum:
6.Habit or Commitment

A

new behaviours are practiced over a period, become a lifestyle change

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10
Q

Trans-theoretical model steps

A
  1. precontemplation
  2. contemplation
  3. preparation
  4. action
  5. maintenance
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11
Q

Trans-theoretical model:
1. Precontemplation

A

client has no intention of making a change within the next 6 months

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12
Q

Trans-theoretical model
2. Contemplation

A

client intends to make a change within the next 6 months

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13
Q

Trans-theoretical model:
3.Preparation

A

client intends to make a change within the next 30 days and has taken some behavioural steps In this decision

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14
Q

Trans-theoretical model:
4.Action

A

the client has practiced changed behaviours for less than 6 months

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15
Q

Trans-theoretical model:
5. Maintenance

A

the client has practiced changed behaviours for more than 6 months

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16
Q

learning domain: cognitive

A

concerned with the knowledge outcomes and the client’s intellectual abilities and skills

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17
Q

learning domain: affectice

A

concerned with the clients attitudes, interests, appreciation and modes of interest

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18
Q

learning domain: psychomotor

A

concerned with the client’s technical skills or motor skills

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19
Q

Health belief model is based on

A

based on the concept that one’s beliefs direct behaviour. (what they believe happens)

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20
Q

Health belief model: susceptibility

A

clients must believe they are susceptible to a particular disease/condition

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21
Q

Health belief model: severity

A

clients must believe that if they get the particular disease/condition, consequences will be severe

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22
Q

Health belief model: asymptomatic nature of disease

A

clients must believe that a disease may be present without their being fully aware of it

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23
Q

Health belief model: benefit of behaviour change

A

clients must believe that the effective means of preventing or controlling problem exists

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24
Q

agent-host-environment theory

A

theory that disease is a result of an imbalance in one or all three factors:
- agent
-host
-environment

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25
Q

Primary prevention

A

targets risk factors
involves techniques and agents to forestall onset and reverse the progress of the disease or
arrest the disease process before treatment becomes necessary

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26
Q

primary prevention intention is

A

to reduce or eliminate risk factors

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27
Q

primary prevention examples

A

plaque removal, use of fluoride, sugar discipline, sealants

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28
Q

secondary prevention

A

routine tx methods to prevent injury/disease once exposure to risk factors occurs. but still in early “preclinical” stage.

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29
Q

secondary prevention intention is

A

early identification [through screening and treatment]]

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30
Q

secondary prevention examples

A

screening and deep scaling, restorations, periodontal debridement, endodontics

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31
Q

teritiary prevention

A

involves using measures to replace lost tissues and rehabilitate patients so physical capabilities and/or mental attitudes are as near to normal as possible after secondary prevention has failed

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32
Q

tertiary prevention intention is

A

to prevent sequelae (after effect of disease)

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33
Q

tertiary prevention examples

A

prosthodontics, implants

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34
Q

primordial prevention

A

targets social and economic policies and factors that impact health

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35
Q

Maslow’s hierarchy of needs theory

A

suggest that inner force drives a person to action. and only when a client’s lower needs are met will the client become concerned about the higher-level needs

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36
Q

Maslow’s hierarchy of needs classified

A
  1. self actualization
  2. esteem
  3. love and belonging
  4. safety needs
  5. physiological needs
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37
Q

**Bass or Sulcular Method recommended for
also what about modified bass

A

periodontal patients

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38
Q

**Bass or Sulcular Method angulation

A

45 degree angle to the gingival 1/3 (margin)

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39
Q

***what does Bass or Sulcular Method do

A

disrupts biofilm, good gingival stimulation, effective control technique

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40
Q

*Stillman’s method indicated for

A

gingival stimulation + recession

look at ur slides to add more tom

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41
Q

how to do stillman’s method*

A

position bristles on attached gingiva, direct apically at 45 degree angle to the long axis

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42
Q

*how to roll method

A

roll or sweep bristles, often used in combination with bass, charters, or stillman’s method

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43
Q

*how to charters method

A

position bristles toward occlusal surfaces, move in short strokes

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44
Q

*charters method is ideal for

A

orthodontics

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45
Q

leonard method*

A

throw off

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46
Q

fones methods*

A

circular brushing, children

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47
Q

power assisted toothbrushes are indicated for: (6)

A

-children
-physically and mentally challenged
-elderly
-arthritic patients
-poorly motivated individuals
-implant care

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48
Q

hard tissue variables are (4)

A

tooth position
root anatomy
status of restoration
prostheses

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49
Q

client variables

A

level manual dexterity
adherence
skill development
personal preference

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50
Q

TYPE 1 EMBRASURE

A

embrasures are occupied by interdental papillae

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51
Q

TYPE 2 EMBRASURE

A

embrasures have slight to moderate recession of interdental papillae

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52
Q

TYPE 3 EMBRASURE

A

embrasures have an extensive recession or complete loss of interdental papillae

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53
Q

dental floss effectivenesss

A

floss is the primary recommendation but patient compliance Is low

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54
Q

flossing may not be as effective for which patients ?

A

perio patients: recession, attachment loss, size of gingival embrasure space are limiting factors

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55
Q

floss indications for use

A

patient with type 1 embrasure space and excellent compliance

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56
Q

floss holder recommended for

A

physically challenged,
*caregivers providing oral hygiene care

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57
Q

floss holder indications

A

type 1 embrasure, pt is motivated but has dexterity challenges

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58
Q

tufted dental floss use

A

under pontics of bridges or ortho appliances

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59
Q

tufted dental floss indications

A

type 2 embrasure spaces, fixed bridges, distal surface of last tooth, proximal surface or widely spaced teeth
- under pontics of bridges or ortho apliances

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60
Q

interdental brush indications

A

-type 2 or 3 embrasure spaces
-distal surface of last tooth
- exposed class 4 furcations
- embrasure spaces with exposed root concavities
-ortho appliances, prostheses, dental implants

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61
Q

for interdental brushes be cautious because the

A

inner wire must be plastic coated to avoid scratching cementum or implant oxide layer

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62
Q

end tuft brush indicated for

A

type 3 embrasure spaces,
*hard to access areas: 3rd molars, crowded teeth
lingual of mandibular teeth
open proximal spaces
exposed furcation
fixed partial dentures, pontics, ortho

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63
Q

pipe cleaner indications for use

A

type 3 embrasure
exposed furcation areas that permit insertion

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64
Q

*what is the best choice for exposed class 4 furcations

A

wooden toothpick in holder

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65
Q

wooden toothpick in holder indications

A

exposed class 4 furcations*
interdental cleaning- concave proximal surfaces
biofilm removal at ginigival margins above ortho appliances
root concavities
type 2 or 3 embrasure

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66
Q

wooden wedge shape

A

triangular , made from birch

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67
Q

wooden wedge indication

A

interdental areas with exposed root surfaces (recession)
type 2 + 3 embrasure

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68
Q

rubber tip stimulator indications

A

after perio surgery

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69
Q

rubber tip simulator is used for

A

massaging the gingiva to improve blood circulation, increase keratinization and provide epithelial thickening
- can do plaque removal but not the primary use

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70
Q

things responsible for halitosis

A

voilate sulfur compounds- family of gasses
hydrogen sulfide
methyl mercaptan

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71
Q

tongue cleaning is indicated to remove

A

the bulk of voilate sulfur compounds forming bacteria and debris which accumulate mostly within filiform papillae and on the back of tongue

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72
Q

90% of oral malodor orginates from

A

mouth and oropharynx

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73
Q

10% of oral malodor originates from

A

systemic disorders

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74
Q

contributing factors to oral malodor

A

oral dryness from alcohol, medications, caffeine, smoking
post nasal drip, nasal odor
perio infections, overnight denture wearing

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75
Q

therapy for controlling oral malodor

A

tongue cleaning *
abstain from tobacco alcohol and caffeine
stimulate salivary flow by chewing gum, xylitol, antimicrobrial agents, sugar free sprays/breath fresheners/drops
nasal sprays or humidifiers

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76
Q

dentifrice for caries

A

fluoride

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77
Q

dentifrice for tartor control

A

pyrophosphates

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78
Q

leading cause of dentinal hypersensitivity

A

pyrophosphates

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79
Q

dentifrices for antihypersensitivity

A
  • potassium nitrate
  • strontium chloride
    -sodium citrate
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80
Q

dentifrices for antibacterial

A

triclosan

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81
Q

dentifrices for whitening

A

carbamide peroxide or hydrogen peroxide
(carbamide peroxide breaks down hydrogen peroxide and urea

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82
Q

in essential oils, you should assume there is _____ unless otherwise stated

A

alcohol

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83
Q

considerations for essential oils? what is the most common

A

most common is burning sensation associated with alcohol content
slight extrinsic staining

84
Q

essential oils are contraindicated for

A

current or recovering alcoholics

85
Q

quaternary ammonium compounds: considerations/side effects

A

staining
burning sensations
increased supragingival calculus

86
Q

fluoride for pre-eruptive*

A

systemic

87
Q

fluoride for post eruptive

A

topical

88
Q

water is both topical and systemic

A
89
Q

dietary fluoride supplements are recommended for

A

for children who live in areas with inadequate water fluoridation

90
Q

dietary fluoride supplements are NOT recommended for

A

NOT recommended for pregnant women

91
Q

optimal level of water fluoridation

A

0.7ppm

92
Q

extrinsic (exogenous) stains are

A

removable

93
Q

intrinsic (endogenous) are

A

not removable

94
Q

where can extrinsic staining become intrinsic

A

in demineralized areas

95
Q

extrinsic staining causes

A

certain bacteria
other sources such as food, beverages, tobacco

96
Q

intrinsic staining causes (4)

A

pulpal necrosis, internal resorption, excessive systemic fluoride, use of tetracycline during tooth development

97
Q

clinical uses for chlorhexidine (5)

A
  • preprocedural rinse prior to aerosol generation
  • decrease supragingival plaque formation, inhibit gingivitis
  • short term adjunctive therapy following surgery
    -implants
    -patients with high risk for caries. suppress S.mutans
98
Q

what is the #1 side effect of chlorhexidine

A

stains teeth, tongue, restorations

99
Q

side effects/considerations of chlorhexidine

A

1- stains teeth, tongue, restorations

  • alters taste sensation (dysgeusia) including bitter taste
  • can irritate and burn oral mucosa
  • increase in supragingival calculus formation related to decreased bacteria action
  • inactivated by sodium lauryl sulfate
100
Q

for patients with cancer with oral mucositis you should

A

rinse with baking soda or saline solution followed by plain water rinse

101
Q

for plaque-induced gingivitis, slight-to- moderate chronic perio, NUG/NUP and periodontal maintenance you should recommened

A

chlorhexidine BID

102
Q

for patients with an alcohol conditions you should recommend

A

non-alcohol rinses

103
Q

alcohol rinses are contraindicated with patients who are being treated with Antabuse because

A

may induce nausea and vomiting

104
Q

fluoride is an essential nutrient in the formation of

A

teeth and bones

105
Q

is fluoride acquistion topical or systemic

A

both topical and systemic

106
Q

where is fluoride absorbed

A

GI tract (small intestine)

107
Q

fluoride is excreted where

A

in urine (kidneys)

108
Q

fluoride uptake depends on

A

the amount of fluoride ingested (note delivered) and the length of time of exposure

109
Q

what is the halo effect

A

refers to the unintentional addition of fluoride to a concentrated beverage or food that is from a water supply containing fluoride

110
Q

fluoride interferes with

A

bacterial metabolism

111
Q

in high concentration (professionally applied) fluoride is

A

bactericidal (destructive to bacteria

112
Q

bactericidal means

A

destructive to bacteria

113
Q

in low concentrations (at home applications) fluoride is

A

bacteriostatic (restricts growth or multiplication of bacteria)

114
Q

bacteriostatic

A

restricts growth or multiplication of bacteria

115
Q

do you need to polish teeth prior to fluoride application? why or why not?

A

DO NOT need to polish teeth because fluoride penetrates through pellicle and plaque

116
Q

what is more effective: professional fluoride 2x per year or daily at-home rinse?

A

daily at home rinse

117
Q

fluoride has substantivity which is

A

the ability to bind to the pellicle, plaque, and tooth surface and be released over a period of time with retention of potency

118
Q

fluorides aid in accelerated maturation:

A

fluoride continues to accumulate in the outermost portion of enamel

119
Q

pre eruptive systemic examples

A

water, supplements, food

120
Q

systemic fluoride circulates in _____ and is incorporating into developing ______

A

systemic fluoride circulates in __bloodstream___ and is incorporating into developing __enamel____

121
Q

what foods contain large amounts of fluoride

A

tea and fish contain large amounts of fluoride

122
Q

what is the most cost-effective and efficient fluoridation method

A

water fluoridation

123
Q

a larger community has _____ costs vs a smaller community has ______ costs

A

a larger community has LOWER costs vs a smaller community has HIGHER costs

124
Q

what does environmental protection do (2)

A

monitors concentration levels in drinking water
sets limits on bottled water

125
Q

what are compounds used to fluoridate water (3)

A

sodium fluoride
sodium silcofluoride
hydrofluorosilicic acid

126
Q

what is school fluoridation for

A

decreasing dental caries in student population

127
Q

school fluoridation is adding how much fluoride?

A

5ppm to a school’s water supply

128
Q

why is there an increase in ppm in school fluoridation

A

due to the fact that children consume only part of their water consumption through school hours

129
Q

ppm means

A

parts per million

130
Q

self- applied fluoride is topical or systemic

A

topical

131
Q

self applied fluoride provides additional forms of

A

frequent low concentration fluoride to promote remineralization (bacteriostatic effect)

132
Q

dentifrice range between what ppm

A

400-1500ppm

133
Q

rinse contain what %/ppm

A

0.05% NaF daily = 225ppm

134
Q

children under what age should not use fluoride rinses because

A

children under 6 years of age should not used fluoride rinses due to the risk of ingestion (LOOK AT PT AGE ON CASES)

135
Q

example of professionally applied fluoride ?

A

acidulated phosphate fluoride,
sodium fluoride and varnish
stannous fluoride

136
Q

acidulated phosphate fluoride is not ideal for what patients

A

bulimic, xerostomia, chemo

137
Q

acidulated phosphate fluoride pH level

A

3.0-3.5pH

138
Q

acidulated phosphate fluoride is contraindicated when? and why

A

in the presence of tooth- coloured restorations and porcelain and acid can etch the glass components and cause roughening. due to its pH

139
Q

acidulated phosphate fluoride side effect

A

can convert extrinsic stain to intrinsic

140
Q

acidulated phosphate fluoride application

A

tray or painting with gel like (thixotropic) or foam for 4 min application

141
Q

sodium fluoride is safest used for

A

tooth coloured restorations and porcelain restorations, veneers, crowns , bridges , acid erosion patients

142
Q

sodium fluoride is used in patients suffering from what

A

bullimic, chemotherapy and xerostomia

143
Q

sodium fluoride application

A

4 min application for maximum efficiency

144
Q

sodium fluoride aftercare

A

instruct pt not to smoke/drink for 20 mins

145
Q

sodium fluoride 0.05% daily rinse is used on

A

children OVER 6 years of age and adults with CARIES susceptibility

146
Q

sodium fluoride 0.2% weekly rinse is used for what program

A

school based programs

147
Q

sodium fluoride 1.19-2% gel in a tray used for

A

used for rampant caries and pt undergoing radiation therapy

148
Q

5% sodium fluoride varnish is used for

A

desensitizing exposed roots and caries prevention, remineralization

149
Q

fluoride is least effective where?

A

in pits and fissures

150
Q

less fluoride is required where? and why? how much

A

in warmer environments because people drink less water.
0.6ppm

151
Q

5% sodium fluoride varnish is recommend how many times a year `

A

2-4 times a year

152
Q

5% sodium fluoride varnish is most effective in what than other fluoride

A

caries reduction

153
Q

5% sodium fluoride varnish is retained for how long? retained for what?

A

it is retained for 24-48 hours for high substantivity for fluoride release into underlying enamel

154
Q

5% fluoride varnish is effect for use on infants and small children because

A

decreased risk of ingestion

155
Q

5% sodium fluoride varnish, is it for home use or no?

A

NOT for home use

156
Q

excellent candidate for 5% sodium fluoride varnish is

A

hypersensitivity patient due to recession

157
Q

corresponding with eruption of primary and permanent molars, fluoride can be applied how often? after that how often can it be applied

A

4x at once a week intervals, after that 6-month intervals

158
Q

sodium NaF concentration and pH

A

2%
pH- 7.0

159
Q

varnish concentration and pH

A

5%
pH-7

160
Q

Acidulated Phosphate fluoride concentration and pH

A

1.23%
pH-3.0-3.5

161
Q

stannous (SNF2) concentration and pH

A

8%
pH-2.1-2.3

162
Q

stannous fluoride an ___ solution and must be mixed ____

A

stannous fluoride is an UNSTABLE solution and must be mixed FRESH

163
Q

stannous fluoride has an unpleasant taste because

A

tin ion provides metallic taste

164
Q

stannous fluoride adverse reactions

A

sloughing of gingiva
stains demineralized areas and porcelain veneers, crowns,bridges ,margins of restorations,
brown stain

165
Q

why does stannous fluoride stain

A

reaction of fluoride tin ion in the compound

166
Q

stannous fluoride daily rinse concentration and use

A

0.63%
use for high susceptibility to root surface caries and dentinal hypersensitivity

167
Q

stannous fluoride brush-on gel concentration and use

A

use for high caries rate and sensitivity

168
Q

sodium fluoride application frequency

A

4x/year for ages 3,7,10,13
(corresponds with the eruption of primary and permanent molars )

169
Q

sodium fluoride varnish application frequency

A

3-6 months

170
Q

APF fluoride application frequency

A

1-2x/year

171
Q

stannous fluoride application frequency

A

1-2x/year

172
Q

emergency tx for acute fluoride toxicity

A
  1. induce vomiting using stimulation or syrup of ipecac
  2. ingest milk/limewater
    - vomiting should not. be induced with APF)
173
Q

fluoride mouthrinses are indicated for

A

moderate to high-risk caries
ortho or prosthetic appliances
xerostomia, recession, demineralization

174
Q

fluoride mouth rinses are used weekly in_____ and contain

A

fluoride mouth rinses are used weekly in school rinse programs without water fluoridation and contain 2%NaF

175
Q

school rinse programs uses ___mL for younger children and __mL for older children and swished for ___ seconds

A

school rinse programs uses _5__mL for younger children and 10mL for older children and swished for _60__ seconds

176
Q

most common school-based program in US

A

weekly rinse

177
Q

certainly lethal dose (CLD)

A

the amount of drug likely to cause death if not intercepted by antidotal therapy

178
Q

safely tolerated dose (STD)

A

1/4 of CLD

179
Q

toxicity symptoms begin within when and last when

A

begin within 30 mins and can last up to 24 hours

180
Q

fluoride toxicity symptoms

A

fluoride in the stomach reacts with hydrochloric acid to form hydrofluoric acid causing irritation to the stomach lining
nausea, vomiting, diarrhea
abdominal pain
increased salivation and thirst

181
Q

systemic involvements of fluoride toxicity result in

A

symptoms of hypocalcemia (calcium too low)
hyperreflexia (overactive body reflexes)
convulsions, paraesthesia (burning/prickling sensation)
cardiac failure or respiratory paralysis

182
Q

tx for <5mg/kg fluoride ingested*

A

administer fluoride-binding agent (anything with calcium)

183
Q

tx for >5mg/kg fluoride ingested (toxic dose)*

A
  1. emesis (induce vomiting)
  2. adminster fluoride binding agent
  3. seek medical treatment
184
Q

tx for >15mg/kg (lethal dose)*

A
  1. seek medical treatment
  2. induce vomit
  3. cardiac monitoring
185
Q

dentinal hypersensitivity occurs

A

on root-exposure areas, where recession may has occcured

186
Q

characteristics of hypersensitive dentin

A

open, large, and numerous tubules
thin/poorly calcified smear layer

187
Q

what is a smear layer

A

deposit of salivary proteins, debris from dentifrices, and other calcified matter

188
Q

a-delta fibers

A

myelinated fibers that can conduct stimuli rapidly and line the pulp

189
Q

c-delta fibers

A

unmyelinated fibers that can conduct stimulus more slowly

190
Q

who accounts for 80-90% of oral cancer

A

smokers (cigs, cigars, pipes, smokeless tobacco) and heavy alcohol drinkers

191
Q

tobacco users had approx ten-fold increased chance of developing what compared to non-smokers

A

squamous cell carcinoma

192
Q

oral virus

A

HBV
HIV
HPV
helicobacter pylori

193
Q

recent studies suggest oral cancer is related to

A

HPV-16

194
Q

oral cancer found primarily where

A

tongue , oropharyngeal area (throat, back third of tongue, soft palate, side and back walls of throat and tonsils

195
Q

oral cancer traditional risk factors

A

-prior oral cancer lesion
-older age
-frequent sun exposure
- low consumption of fruits and veggies

196
Q

tobacco smoking is associated with what (8)

A

-atherosclerosis
-Cardiovascular disease
-hypertension
-spontaneous abortion
-fetal death
-neonatal death
-SIDS
-COPD

197
Q

tobacco causes an increased risk of

A

perio

198
Q

tobacco quit aids (3)*

A

Buproprion/wellbutrin
Zyban
Chantix

199
Q

nictoine replacements (5)

A

transdermal patch
gum
nasal spray
inhaler
lozenge

200
Q

Tobacco cessation counselling 5 A’s?

A
  1. Ask
    2.Advise
  2. Assess
    4.Assist
  3. Arrange
201
Q

tobacco prognosis?

A
202
Q

black line stain has what kind of bacteria and where is it located

A

-gram-positive bacteria
typically located on cervical 1/3 of facial/linguals

203
Q

brown stain is associated with

A

poor OH
drinking dark-colored beverages: tea ,coffee, fruit juices and red wine

204
Q

dark-brown/black stain associate with

A

tobacco use

205
Q

orange stain bacteria +location
is associated with?

A

chromogenic bacteria in plaque
typically located on anterior teeth at the cervical 1/3
associated with poor OH

206
Q

Yellow-brown to Brown stain associated with

A

chlorhexidine use or stannous fluoride

207
Q

green stain can be embedded where? and is associated with

A

poor OH
chromogenic bacteria, fundi, gingival hemorrage
can be embedded into decalcified surface enamel