Exam 3 Flashcards
Foods and beverages that are commercially processed in optimally fluoridated cities can be distributed and consumed in nonfluoridated communities.
This effect can result in increased fluoride intake by individuals living in nonfluoridated communities providing them some protection against dental caries
Halo/Diffusion effect
Provides the most effective method for dental caries prevention and control
Fluoride
By way of the circulation to developing teeth
Systemically
Directly to the exposed surfaces of erupted teeth
Topically
A nutrient taken into the body by way of fluoridated water, dietary supplements, and found in small amounts in foods.
Tea, fish, and brocolli
F12
Absorbed by diffusion from the stomach as hydrogen fluoride. Most is absorbed within 60 minutes of ingestion.
F12
What percentage of the F12 in the body is located in the mineralized tissues(teeth and bones)?
99%
What part of the body is fluoride excreted through?
kidneys
The fluoride ion replaces some of the hydroxyl ions of the hydroxyapatite; fluorapatite is the nformed, which is less soluble and more resistant to acid formation.
Also results in the development of shallower occlusal grooves, reducing the risk of pit and fissure caries.
Excessive f12 during enamel formation and tooth development results in dental fluorosis. (The enamel is hypomineralized.)
Pre-Eruptive: Mineralization Stage
After mineralization is complete and before eruption, f12 deposition continues in the surface of the enamel.
Children who are exposed to fluoride for the first time within the 2 years prior to eruption have the greatest amount of f12 acquired during this pre-eruptive stage.
Pre-Eruptive: Maturation Stage
Hypomineralized (or decalcified) enamel absorbs f12 ingreater quantites than some enamel
Posteruptive
Topical fluoride works to:
Inhibit demineralization
Enhance remineralizaton of incipient lesions
Inhibit bacterial activity by inhibiting enolase, an enzyme needed by bacteria to metabolize carbohydrates
Desensitizer
Inhibits erosion
Continuous use of fluoridated water from birth can result in..
40-65% fewer carious lesions (40% in the primary teeth)
Led to the conclusion that the level of fluoride in the water optimum for dental caries prevention averages 1ppm in moderate climates
Trendley Dean
Began his studies to find the cause of “brown stain” which later was called mottled enamel and now is known as dental fluorosis
Fredrick McKay
A chemist, pinpointed fluorine as the specific element related to the tooth changes that Dr. McKay had been observing clinically
H.V. Churchill
What is the optimal fluoride concentration used for municipal water supplies to prevent dental caries?
0.7-1.2 ppm (parts per million)
For temperature climates, 1ppmThis
Absorbs the most fluoride before the other parts of the tooth
Decalcified enamel
If a patient has a significant concern, such as pain, this need is addressed prior to intiating dental hygiene treatment
Chief complaint
What is fluoride found in?
pesticides
Most common for patient on regular hygiene recall intervals
Neutral Sodium Fluoride due to its neutral pH of 7.0
2.0% Sodium Fluoride (NaF) Gel/Foam
Recommended for high risk carie
Etches porcelain, composite restorative material, and sealants so it should NOT be used on patients with such restorations.
1.3% Acidulated Phosphate Fluoride (APF) Gel/Foam
Has tricalcium phosphate
Great for use in children due to caries inhibiting effect and great diffusibility
Reduces demineralization in white areas around ortho brackets
Application of choice for dentin hypersensitivity!!!!
Cavity liner
5% Neutral Sodium (NaF) Varnish
Acute fluoride poisoning is rare
True or False
True
Certain lethal dose of of fluoride toxicity
Adult 5-10g of NaF taken at one time
Child 0.5-1.0 g, variable with size and weight
What do you do when a patient has ingested too much fluoride?
Induce vomiting (manually or with Ipecac syrup) Administer fluoride-binding liquid when patient is not vomiting: milk, milk of magnesium, or lime water
What are the parts of a dental hygiene care plan?
Periodontal/Gingival Health
-Primary objective is to restore and maintain health of the periodontal tissues
Dental Caries Control
-Includes fluorides, sealants, and dietary control of fermentable carbs
Prevention
-Preventive care starts with the patient’s personal daily biofilm control and includes interventions such as: tobacco cessation, risk factor reduction, desensitizing exposed dentin, helping with halitosis, etc.
Properties of unwaxed floss
Thinner floss helpful for tight contacts
More likely to fray and shred
Flossing removes biofilm from proximal surfaces
Prevents soft tissue trauma due to wax coating
Resists breaking/shredding
Wax gives strength and durability
Waxed Floss
Types of interdental brushes
Small insert brushes with reusable handle
Brush with wire handle
Uses for interdental brushes:
Proximal tooth surfaces with open embrassures
Ortho
Fixed prostheses
Dental implants
Space maintainers
Any hard to reach area
For application of chemotherapeutic agents
End-Tuft brushes
Open interproximal areas
Fixed dental prostheses
Difficult to reach area
Broad spectrum antibacterial and antigingivitis
Chlorhexadine (CHX)
What does chlorhexadine do?
Action: Binds to oral hard and soft tissue Causes cell lysis Prevents biofilm accumulation Substantivity 8-12 hours
Availability and Uses:
0.12% solution
Preprocedural rinse before/during/after perio debridement
Efficacy:
Antimicrobial & antigingivitis
Considerations:
Brown staining
Causes heavier calculus formation
Altered taste sensation (metallic)
What are local self care methods for delivering chemical agents?
What are the benefits?
Toothbrushing
Rinsing
Irrigating
Preventive
Therapeutic
Cosmetic
Why do we do preprocedural rinses?
To reduce bacterial load before instrumentation producing aerosols
Benefits of oral irrigation:
Reduction of gingivitis & bleeding
Reduction of subgingival dental biofilm
Reduction of inflammatory mediators
Subgingival delivery
*The standard jet tip can penetrate below the gingival margin 44% to 71% of the pocket depth
Functions of Chemotherapeutic Agents/:
Remineralization: restore mineral elements
Antimicrobial: bactericidal or bacteriostatic
Gingival health: reduction and prevention of gingivitis
Astringent: shrink tissues
Anodyne: Alleviate pain
Buffering: reduce oral acidity
Deodorizing: neutralize odor
Oxygenating: cleansing
Segment connecting the submerged implant body to the prosthetic component
Provides a platform for attaching crowns or bridges
Abutment
Capable of existing in harmony with the surrounding biologic environment
Biocompatible
What is fibrous encapsulation?
Layer of fibrous connective tissue between the implant and surrounding bone. Also called fibrous integration; indicative of failed osseointegration
What is osseointegration?
The direct attachment or connection of osseous tissue to an inert alloplastic material without intervening connective tissue
Reversible inflammation of the periodontal tissues around an implant with no subsequent bone loss; similar to gingivitis in a natural tooth
Peri-implant mucositis
Destructive inflammatory process of the periodontal tissues around an implant charcterized by progressive bone loss in addition to soft tissue inflammation with hemmorrhage and/or exudate; similar to periodontitis in a natural tooth
Peri-implantitis
Risk factors for caries:
behavioral factors dietary factors low fluoride tooth morphology and position xerostomia genetics developmental factors
Risk factors for perio disease:
behavioral factors tobacco use systemic condition hormonal considerations nutritional status iatrogenic factors genetic factors
Risk factors for systemic infections:
infective endocarditis cardiovascular disease and atherosclerosis diabetes mellitus respiratory disease adverse pregnancy outcomes
Risk factors for oral cancer:
tobacco use
alcohol use
sun exposure
Material: titanium or vitallium
Rests over the bone of the mandible or maxilla; complete arch or unilateral
Subperiosteal Implant
Most commonly used for denture patients
Material: stainless steel, ceramic-coated materials, and titanium alloy
Pt has atrophic endentulous or a congenital or traumatic deformity of the mandible
Transosseous Implant
An implant within the bone to replace a single tooth or provide support for the replacement of complete or partial loss of teeth
Most common type to use
Material: primarily plasma-sprayed titanium
Endosseous Implant
Indicates failure of osseointegration. Mobility is evident.
Fibrous encapsulation
Implant/Soft Tissue Interface
Soft tissue connection: sulcular epithelium is in contact with the implant surface
The long junctional epithelium of an implant is arranged parallel to the fixture, surrounding it, but with no attachment
No connective tissue (Sharpey’s fibers) exist to hold the attachment as with a natural tooth
Hypersensitivity
Exposed cementum/gingival recession
Gingival bleeding
Biofilm accumulation causing inflammation
Increased caries risk
Previous history of dental caries and consumption of sugar-sweetened beverages frequently throughout each day
Biofilm control record score= fair to poor score
Limited ability to perform oral self-care tasks
Reversible bacterial infection in the soft tissue similar to gingivitis. Mild color change with bleeding may be present
Initial Stage- Mucositis
Inflammation has reached the level of the bone. Edema or hemmorage is present in the surrounding tissues. Probing depths are increased.
Secondary Stage Periimplantitis
Inflammation present but no mobility. Consult surgeon if no response to tx in 2 weeks.
Ailing Implant
Inflammation present. Bone loss has occured and continues. Mobility faintly noticeable.
Failing Implant
Evident mobility. Radiographic changes are evident, often showing a vertical bony defect. Refer pt. immediately back to surgeon.
Failed Implant
What type of instruments are used on dental impants?
Plastic instruments
No ultrasonic
Only non-abrasive prophy paste is used if any at all
Wedge or v-shaped cervical lesion created by the stresses of lateral or eccentric tooth movements during occlusal function, bruxing, or parafunctional activity resulting in enamel microfractures
Abfraction
Transient pain arising from exposed dentin, typically in response to stimulus
Dental Hypersensitivity
Theory there is fluid movement within the dentinal tubules
Hydrodynamic Theory
What type of fluoride is used with dental implants?
Neutral Sodium Fl is recommended
Avoid acidic fl
APF
Acidulated Phosphate Fluoride
Breakdown of the tooth structure with loss of mineral content, primarily calcium and phosphorus
Demineralization
Decayed, missing, and filled teeth
DMFT
Apatite formed when low concentrations of fluoride react with tooth mineral; at higher concentrations, calcium fluoride is formed.
Fluorhydroxyapatite
Form of enamel hypomineralization due to excessive ingestion of fluoride during the development and mineralization of the teeth
Fluorosis
Occurs when foods and beverages processed in a fluoridated community are imported and consumed in a nonfluoridated community
Halo or diffusion effect
NaF
Neutral Sodium Fluoride
PPM
parts per million
Restoration of mineral elements in a tooth surface
Remineralization
SnF2
Stannous fluoride
Indentification of an existing or a potential oral health problem that a dental hygienist is qualified and licensed to treat
Dental Hygiene Diagnosis
