Exam 3 Review Flashcards
Purpose of flouride. What does it do?
Inhibits demineralization, enhances remineralization, and inhibits plaque
formation
Optimum range of fluoride in drinking water (ppm)
the optimum range of fluoride
concentration of 0.7-1.2 ppm
- Professionally applied prescription products
- Self-applied non prescription products
- Self applied prescription products
Put these in order from lowest concentration to highest
- 1.
Dentifrices
Mouth Rinses are what type of fluoride products
Rx Dentifrices & Gel
Rx Mouth Rinses
Self-applied nonprescription products
INDICATIONS FOR PRESCRIPTION
FLUORIDE USE
• Moderate/high caries risk determined by risk
assessment • Caries or white spot lesions/ demineralization • Dental hypersensitivity • Exposed root surfaces
PROFESSIONALLY APPLIED PRESCRIPTION PRODUCTS are?
- Sodium Fluoride (NaF)
- Sodium Neutral Fluoride (NaF) Foam
- Acidulated Phosphate Fluoride foam
Acute ingestion of fluoroide
Rapid ingested over short period of time - RARE
Chronic ingestion of fluoride
long term ingestion that exceed the approved therapetuic levels - Dental fluorosis-tooth development
- Skeletal Fluorosis
What are the percentages of the professionally applied prescription fluorides below?
- NaF varnish/Sodium Fluoride
- NaF gel or foam/Sodium Neutral Fluoride
- APF gel or foam /Acidulated Phosphate Fluoride
- 5% NaF varnish
- 2% NaF gel or foam
- 1.23% APF gel or foam
Sodoium Fluoride varnish is FDA approved for and off label use is for
FDA approved for dentinal
hypersensitivity…off label use is for
caries prevention
CONTRAINDICATIONS for VOCO fluoride varnish is
colophony rosin - solid form of resin obtained from pines
APF/ Acidulated phosphate fluoride gel or foam contraindication!
Contraindication: potential for etching; not to be used for patients w/ porcelain & composite restorations, sealants, titanium implants, sensitivity
How can people take fluoride systemically
take fluoride drops or tablets
• Emergency protocol for fluoride ingestion
• Induce vomiting
• Second person assist as needed- Call 911
• Administer binding liquid- milk, milk of magnesium,
limewater (if pt isn’t vomiting) • Additional therapy indicated at ER
Contraindications for Sealing
Wide fossa – self cleaning Low caries risk Good dietary habits Restorations present Decayed teeth (evaluate radiographically for interproximal decay)
Indications for Sealant Application
Deep pits and narrow fissures on occlusal surfaces Xerostomia Orthodontics Recently erupted teeth Incipient caries Snacking >3X/day Teeth free of interproximal caries Elevated risk for dental caries Total prevention program Heavy plaque Infrequent preventive care Head and neck radiation
Factor Affecting Penetration & Bonding
Dry field- Saliva occludes porosities and inhibits bonding. Re-etch with acid 10-20 seconds following saliva contamination.
Free from oils and flavoring-pumice.
proper sequence for sealant application (general)- don’t worry about how long to etch or cure.
Clean/ toothbrush or polish Isolate Dry Etch-period of time Rinse-period of time Isolate/Dry Sealant material Cure or not depending
Sequence of proper polishing technique can look notability
F/L UR ,Max Anteriors,UL
then
F/L LR, man Anteriors, LL
Contraindications to essential selective polishing
Medications? Inflammation primary teeth cementum restorations
Angle rubber polish cup to __at gingival margin. Use __ pressure
flare
moderate
Polishing: Modified pen grasp- rest HP in ___
between thumb and index finger
- V
- between index nuckle 1
V
Contraindications to essential selective polishing
Medications? Inflammation primary teeth cementum restorations -Decalcification, hypocalcification, demineralization, rampant caries Immediately following nonsurgical periodontal therapy- gingival treatment and or scaling and root planing Inflamed gingiva:enlarged, spongy, or bleeds easy
Polishing: Employ “___ and ___” motion working from
gingival 1/3 to incisal/occlusal 1/3
pat and sweep
2 types of powered instrumentation and cycles per second for each
Sonic: Low frequency 3,000-8,000 cycles/second
Ultrasonic: frequency of 18,000-
45,000 cycles/second
2 Subtypes of ultrasonics and how they differ
- Piezoelectric Electrical energy activates ceramic crystals within the handpiece to make the tip vibrate
- Magnetostrictive Electronic energy is transferred to metal stacks or to a ferrous rod.
Cavitation, fluid lavage, amplitude, frequency
Cavitation- Tiny bubbles formed by water stream. Bubbles collapse, which produces
shock waves that may alter or destroy bacterial
cell walls.
Levage: flush
out bacteria from beneath the gingival
margin
Amplitude- How far the instrument tip moves back and forth during one cycle. (length of stroke)
Frequency- How many times the tip vibrates per second (kHz)
Limitations for powered instrumentation
Disadvantages less tactile senstiitivty water control production of aerosals medical contraindications potential occupational hazard(noise and vibrations)
Slim vs standard working ends- when and where they are used- appropriate power settings for each
Slim : Light to moderate calculus
Improved for subgingival access due to 30% thinner
Standard: Moderate to heavy calculus
Thicker inserts with larger tips, specifically designed for efficient removal of heavier deposits
Contraindications to ultrasonics
- Communicable diseases- Aerosol production allows for dissemination of bacterial and viral infections; Hepatitis, TB, respiratory infections.
- High susceptibility to infection- Immunosuppressed patient due to disease or chemotherapy, uncontrolled diabetics, patients with organ transplants or chronic, debilitating medical conditions.
- Respiratory risk- Emphysema, cystic fibrosis, asthma, cardiac disease with secondary pulmonary disease, pneumonia, breathing problems.
- Unshielded cardiac pacemaker- Piezoelectric ok- only concern with magnetostrictive; may need physician consult to verify type of pacemaker present.
- Dysphagia (difficulty swallowing) or prone to gagging- MS; ALS; Muscular dystrophy, paralysis
- Age- Primary teeth and newly erupted teeth have large pulp chambers- more susceptible to damage from vibrations and heat.
Oral conditions- hypersensitive teeth; demineralized enamel surfaces, exposed dentin
-Restorations- Veneers, cast crowns, composite restorations- avoid these localized areas; place ultrasonic tip adjacent or apical to restoration- use dental chart and radiographs for guidance.
Patterns of vibration with piezo and magnetostrictive tips
Piezo: linear
Magnetostrictive: orbital
Piezo and magneto- What sides are active and which sides should be adapted during instrumentation?
Piezo: just lateral
Mangneto: lateral and back
2 types of bonding and which is the strongest and why??
Mechanical Bonding – entrapment of material within pores and cavities
Secondary Bond or physical bond – attraction between unlike molecules
What is the difference between cleaning and polishing a surface?
Polishing: Removing stain and plaque
Cleaning: Removing/debrieding surface of all debris..??
- Universal, sickle, and area specific design characteristics. When and where are they used?
- Selecting the correct working end of universal, sickles, and area specific curets
- Define adaptation, angulation, insertion, and activation
- Degrees of angulation for effective calculus removal
- Degrees of angulation for insertion
- Technique for activating calculus removal stroke
- Incorrect instrumentation that leads to burnished calculus and tissue trauma
Adaptation • Correct working end • Side of toe 1/3- pivot on fulcrum and roll handle
the rest i know
Intrinsic and extrinsic stain and examples of each
Intrinsic- incorporated within the tooth structure and
cannot be removed by mechanical means.
– Endogenous or exogenous
-EXAMPLE: Fluorosis
Extrinsic- On tooth surface and can usually be
removed by mechanical means.
EXAMPLE: Tobacco
BONUS
Brandys husband Alex had fluorosis on incisal edge of #
8 and 9
Results from alterations during the development of the tooth. Associated with: • Antibiotic use • Fever • Trauma • Infection • Ingestion of high amounts of systemic fluoride May appear mottled, opaque, brown, yellow, orange, or gray.
a. Intrinsic
b. Extrinsic
c. Endogenous intrinsic stain
Endogenous Intrinsic stain
2 examples of Endogenous intrinsic stain
Tetracyling stain
Dental flurosis
Develops due to: • Presence of Results from chromogenic bacteria • Use of staining substances – Tobacco – Red wine – Tea – Coffee – Soda – Blueberries – Some drugs – Exposure to metallic compounds
extrinsic stain
Characteristics affecting the abrasiveness of cleaning and polishing agents: Hardness: Determines if the abrasive agent
can scratch the surface of another material;
Measured using the ________
Mohs Hardness Scale.
Mohs Hardness scale range is :
Abrassive must be __-__ units higher on the scale than material being polished
1-10 with 1 being lowest hardness
1-2 units higher
Abrassive Particle shapes are
angular
round
blocky
semiround
Particle Size is
Grit
– Smaller size = finer grit
– Fine grit is least abrasive- smallest scratches
– Abrasive may be high on Mohs Hardness Scale,but if the particle size is small (fine grit), then the abrasiveness is low.
Superfine pumice has a Mohs Hardness Value of
- 3
- 6-7
- 6.5-7.5
6-7
Material and what is Mohs Hardness Value
Cementum:
Dentin
Enamel
Cementum: 2-3
Dentin: 3-4
Enamel 5-6
What does the A in ADPIE mean
Assessment
Oral Cancer Risk Assessment
- No SPF use during sun exposure
- Family history of head and neck cancer (skin)
- Use of tobacco/marijuana productsproducts
- Alcoholic beverages consumption >7 per week No HPV Vaccination Hx of HPV
Periodontal Risk Assessment
Risk Factor:
Smoke or use tobacco/ marijuana (M)
Systemic conditions (diabetes, osteoporosis, signs of active disease (M) heart disease, arthritis, pregnancy, immunocompromised, etc.) (M) High stress (M) Infrequent dental care (M) History of periodontal disease (gingivitis or periodontitis) (NM) Poor plaque control/visible plaque (M) Age (NM) Nutritional deficiencies and or obesity(M) Medications(M) Subgingival restorations or overhanging margins affecting oral health (M) Genetics(NM) Malocclusion/crowded teeth (M)
Caries Risk Assessment
Lack of fluoride exposure Visible plaque biofilm Inadequate salivary flow by
observation Deep pits and fissures Exposed root surfaces Open margin or overhang Appliances/orthodontics Frequent snacking (>3 times a day between meals) *Saliva-reducing factors (medications, radiation, systemic) Developmental or physical disabilities that limit OH practices Eating disorders Drug or alcohol abuse Infrequent dental care
D in ADPIE
Diagnosis
Identification of a condition, problem, or situation based on
the analysis of its cause and defining characteristics
AAP Classification is determined only upon completion of
all DH assessments
AAP Extent-
Health
Gingivitis
Health: <10 % teeth exhibiting bleeding upon probing
Gingivitis: >10 % teeth exhibiting bleeeding upon probing
Review writing dental hygiene diagnosis for caries, perio, and oral cancer. DUE TO = Etiology or causes of problem; AS EVIDENCED BY= clinical signs and symptoms of problem use notability
ASSESSMENT FINDINGS INDICATE SEVERITY OF RISK EXHIBITED, DUE TO _______, AS EXHIBITED BY CLINICAL SIGNS AND SYMPTOMS OF THE CONDITION.
ADPIE P means
Planning
3 domains of learning and examples of each
- Cognitive= Knowledge
Knowledge; providing information for the sake of gaining knowledge about something. - Affective= Belief
Beliefs; addressing the patient’s beliefs about something relating to their health. - Psychomotor= Skills
Skills incorporated into the patient’s home care routine to maintain or achieve health.
What 3 things should be considered when recommending oral hygiene aids for your patient?
Patient needs
Dexterity
Preference
what makes a toothbrush stiff vs. soft
Diameter range from 0.15mm-0.4mm smaller = softer larger=stiffer Length Shorter = stiffer longer-=softer Shape of ends Rounded bristle ends= sig reduction in TB abrasion
Toothbrush characteristics
- Powered toothbrushes
- Manual toothbrush
- Toothbrush size (infant, pedo, teen, adult compact, adult full size
- Handle/shank design and size (strength, rigigty and lightness)
Compare the three types of gingival embrasure spaces
Type I: Interdental papilla fills the gingival embrasure
Type II: Slight to moderate recession of the interdental papilla
Type III: Extensive recession or complete loss of the interdental papilla
Impact of incorrect flossing technique
Floss Cleft : snapping floss through contact, inclomplete c shape, using too long a peice of floss between fingers
Take about 18 inches of floss and wrap it around your middle fingers
Using your thumbs and forefingers, slide an inch of taut floss between teeth, using a gentle back and forth motion.
(notice the fulcrums)
Spool Method
What floss technique would you recommend for chidlren or limited dexterity issues
Loop Method: Circle of floss- Children or limited dexterity
Class I embrasure spaces
would need what kind of floss
Floss Holders
Waterpik (Irrigation)
Floss Threaders
Class I embrasure spaces
would need what kind of floss
- Floss Holders
- Waterpik (Irrigation)
- Floss Threaders
- Single-Tuft/ end-tuft Brush
Class II embrasure spaces
would need what kind of floss
Waterpik (Irrigation)
Floss Threaders
Tufted Floss
Interdental Brushes
Single-Tuft/ end-tuft Brush
Class III embrasure spaces
Waterpik (Irrigation) Floss Threaders Tufted Floss Interdental Brushes Single-Tuft/ end-tuft Brush
Wide embrasure areas
Pontics of fixed bridges
Implants
would need what floss
Tufted floss
fixed orthodontic or prosthetic appliance
crowded lower anteriors
**D and DB of molars, limiting opening, small mouth
indicate what kind of floss
Single-Tuft end tuft brush
Fones Horizontal scrub* Bass Modified Bass Stillman Modified Stillman Charters
Tooth brush methods
Children what tooth brush method
Fones
-horizontal scrub
sulcular cleansing for periodontal health and disease recommend what kind of tb technique
BASS METHOD
45 degree
Rolling Stroke- cleans facial and lingual surfaces
toward gingiva?
Recession needs what kind of tb technique
Modified stillman
away from gingiva
orthodontic appliances, temp cleaning for surgical sites, fixed prosthetic appliances
need what kind of tb technqieu
Charters
and use occlusal brushing
