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Clinical Lecture > Exam 4 > Flashcards

Exam 4 Flashcards

1
Q

When were the first communities fluoridated?

A

1945

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2
Q

Who was a dentist in the early 20th century?

A

Dr. Frederick S. McKay

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3
Q

When is the mineralization & maturation stage?

A

Pre-eruption

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4
Q

When does primary teeth formation begin?

A

In utero

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5
Q

When do first permanent molars begin mineralizing?

A

At birth

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6
Q

What does Hydroxyapatite become?

A

Fluorapatite

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7
Q

How does fluoride uptake after tooth eruption?

A

-First year after eruption
-Through surface exposure
-Drinking water

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8
Q

What is associated with levels over 2 ppm ?

A

Fluorosis

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9
Q

Adjustment of fluoride content in a water supply to the optimal concentration

A

Fluoridation

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10
Q

Chemical systems to remove excess fluoride

A

Partial defluoridation

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11
Q

How is fluoride absorbed?

A

GI tract

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12
Q

When does less absorption of fluoride in the GI tract take place?

A

When taken with milk or food

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13
Q

Fluoride not absorbed by the stomach will be absorbed in the ___

A

Small intestines

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14
Q

When is the maximum levels of fluoride in the blood stream reached?

A

Within 30 minutes of intake

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15
Q

What is the concentration in saliva after fluoride is absorbed?

A

0.01-1.04 ppm

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16
Q

Where is 99% of fluoride in the body stored?

A

Mineralized tissue such as bones & teeth

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17
Q

What does fluoride have a strong affinity for?

A

Calcified tissues

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18
Q

When teeth are fully matured, what can fluoride treatment be altered by?

A

Caries
Erosion
Mechanical abrasion

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19
Q

Where is most fluoride excreted through?

A

Urine

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20
Q

What is the limited transfer through for the excretion route?

A

Plasma to breast milk

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21
Q

What are the topical effects of fluoride?

A

o Inhibition of demineralization & bacterial activity
o Enhancement of remineralization

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22
Q

Where may the level of fluoride be greater in?

A

Dentin

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23
Q

Where is the level of fluoride high and increases with exposure?

A

Cementum

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24
Q

What bacterial activity does fluoride inhibit?

A

Enolase

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25
Q

An enzyme needed for bacteria to metabolize carbohydrates

A

Enolase

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26
Q

A result of acids produced by metabolism of fermentable carbohydrates by bacteria

A

Demineralization

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27
Q

o Saliva buffers and neutralizes the acid
o Calcium and phosphorus are returned to the enamel

A

Remineralization

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28
Q

What is the percentage of reductions in caries due to water fluoridation alone among adults of all ages?

A

27%

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29
Q

With fluoridation from birth, the caries incidence is reduced up to ___ in the primary teeth

A

40%

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30
Q

What are the dry compounds of fluoride?

A

sodium fluoride
sodium silicofluoride

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31
Q

What is the liquid compound in fluoride?

A

hydrofluorosilic acid

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32
Q

What are the delivery methods of fluoride to teeth?

A

Topical application
Systemic

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33
Q

diffuses into the surface of the enamel of an erupted tooth

A

topical application

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34
Q

delivered through circulation incorporation into enamel during tooth development

A

Systemic application

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35
Q

When were optimum fluoride levels 0.7 ppm. in warmer climates to 1.2 ppm in colder climates?

A

1962

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36
Q

When did The U.S. Department of Health and Human Services recommend the lower level of 0.7 ppm due to many sources available to the general population?

A

2015

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37
Q

How is fluoride delivered systemically?

A

Water
Food
Supplements
Mouth rinses
Dentrifrices

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38
Q

Teeth exposed to an optimum or slightly higher level of fluoride appear how?

A

White
Shiny
Opaque
Without blemishes

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39
Q

What are the food sources of fluoride?

A

Meat
Eggs
Vegetables
Cereal
Fruits

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40
Q

What food/drinks have higher levels of fluoride?

A

Tea
Fish

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41
Q

Where is fluoridated salt available?

A

Europe

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42
Q

increased fluoride intake by individuals living in non-fluoridated communities, providing them with some protection against dental caries

A

Halo/diffusion effect

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43
Q

What are the sources of water?

A

Well water
Bottled water
Filtered water

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44
Q

What removes fluoride from water?

A

Reverse osmosis & distillation

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45
Q

What does not remove fluoride from water?

A

Water softeners

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46
Q

What are taken to compensate for the fluoride-deficient drinking water?

A

Dietary fluoride supplements

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47
Q

What age are dietary fluoride supplements recommended for with a high risk of caries?

A

6-16

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48
Q

What are the prescribed sodium agents?

A

Drops
Lozenges
Tablets

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49
Q

What ages are no supplementation recommended?

A

birth-6 months old

50
Q

No more than how much sodium fluoride should be dispersed per household?

A

264 mg

51
Q

What should not be taken with sodium fluoride and why?

A

Dairy products because fluoride can combine with calcium and be poorly absorbed

52
Q

What are the professional topical fluoride applications?

A

2.0% NaF - Sodium fluoride
1.23 APF - Phosphate fluoride
5% NaF - Fluoride varnish

53
Q

How many fluoride ions are in 2.0% NaF?

A

9,050 ppm

54
Q

How many fluoride ions are in 1.23 APF?

A

12,300 ppm

55
Q

What is the concentration of fluoride varnish?

A

22,600 ppm

56
Q

What does fluoride varnish do?

A

Reduces demineralization of white spots on lesions

57
Q

What are the contraindications of topical applications?

A

-Cost
-Rosin

58
Q

Who should not use topical applications with rosin?

A

People with tree nut allergies

59
Q

o Only professional topical Fl to be used for children under 6 years old
o Can be applied at age 1

A

Fluoride varnish

60
Q

To arrest or reverse non-cavitated carious lesions on the occlusal surfaces of teeth

A

2018 ADA recommendations

61
Q

Where is 5% NaF varnish every 3-6 months

A

Proximal surfaces

62
Q

How is fluoride varnish applied?

A

o Apply to dry teeth
o Avoid eating for 30 minutes
o Avoid rough foods and brushing for 4 hours

63
Q

o Used “off label” for caries arrest and prevention in high-risk patients
o State practice act determines who can use it
o 2x year application
o FDA approved as a desensitizing agent for dentinal hypersensitivity

A

38% silver diamine fluoride

64
Q

What are some indications & advantages of silver diamine fluoride?

A

o Extreme caries risk
o Treatment challenged by behavioral/medical management
o Patients with carious lesions that may not be treated in one visit
o Patients with no access to dental care
o Noninvasive
o Cariostatic agent
o Reduces hypersensitivity

65
Q

What are the contraindications of silver diamine fluoride?

A

o Allergy to silver
o Pregnancy/breastfeeding
o Painful sores or raw areas on gingiva
o Teeth with pulpal involvement

66
Q

What is informed consent needed for?

A

Radiographs
Fluoride

67
Q

What are the limitations and risks for silver diamine fluoride?

A

o Consent
o Applied 1-2 times at separate visits
o Stain black permanently
o Brownish stain if in contact with gingiva or skin
o Metallic/bitter taste

68
Q

o Available as over the counter or prescription
o Not recommended for children under age 6
o High-risk preteens and adolescents
o Used for patients with demineralization, root exposure, orthodontics, xerostomia, hypersensitivity
o Applied from toothbrushing or rinsing

A

Self-applied fluoride mouth rinses

69
Q

How much fluoride dentifrice should be used for a child 3 years or younger?

A

a smear (grain of rice) 2x/day

70
Q

How much fluoride dentifrice should be used for a child 3-6 years old?

A

pea size 2x/day

71
Q

How much fluoride dentifrice should be used for adults?

A

½ inch 2x/day

72
Q

What is the lethal dose of sodium fluoride?

A

5-10 g

73
Q

What is the safe dose of sodium fluoride?

A

1.25-2.5 g

74
Q

What are signs & symptoms of an acute toxic dosage?

A

o Symptoms begin within 30 minutes of ingestion
o Nausea, vomiting, diarrhea, increased salivation & thirst
o Convulsions, cardiovascular & respiratory depression resulting in death in a few hours

75
Q

What are the chronic toxicities?

A

-Skeletal fluorosis
-Dental fluorosis
-Mild fluorosis

76
Q

What are the emergency treatments for a toxic dosage?

A

o Induce vomiting
o Call EMS
o If no vomiting: fluoride binding liquid (milk, lime water)

77
Q

What type of documentation needs to be taken for fluoride?

A

o Type
o Concentration
o Delivery

78
Q

What are the parts of a toothbrush?

A

Handle
Shank
Working end
Brush head
Brushing plane

79
Q

What are the factors to toothbrush selection?

A

Patients ability
Position of teeth
Gingiva
Compliance
Bristles
Type

80
Q

What are the guidelines for toothbrushing instructions?

A

Grasp
Sequence
Frequency
Duration
Force
General instructions

81
Q

o Removes biofilm from adjacent to and directly beneath the gingival margin
o Cervical/proximal areas, open embrasure
o Exposed root surfaces
o Abutment teeth of foxed partial dentures & orthodontic appliances

A

The bass and modified bass methods

82
Q

False teeth between a bridge

A

Pontics

83
Q

Designed for cleaning the sulcus, cervical areas, and massaging the gingiva

A

The stillman and modified stillman methods

84
Q

o Removes biofilm from teeth without emphasis on the gingival margin
o Recommended for children

A

Rolling stroke method

85
Q

o Removes biofilm from proximal surfaces
o Massage marginal &interdental gingiva
o Adapts to cervical areas below the height of contour
o To clean under margins of a fixed partial denture (bridge)
o Orthodontic appliances

A

Charter method

86
Q

Who is considered the father of dental hygiene?

A

Alfred Fones

87
Q

o Toothbrush placed at a 90-degree angle to the long axis of the teeth
o Circular motion

A

Fones method/circular

88
Q

o Horizontal scrubbing motion with bristles at a 90-degree angle to teeth
o Consider detrimental
o May produce toothbrush abrasion

A

The horizontal (scrub) method

89
Q

o May work well with small children
 Brush teeth edge-to-edge
 90-degree to long axis of teeth

A

Leonard’s (vertical) method

90
Q

o Facilitate mechanical removal of biofilm
o Found to be more effective than manual brushes
o Research proves a reduction in calculus & removes more stain

A

Power toothbrushes

91
Q

Who is recommended to use a power toothbrush?

A

o Any patient
o Orthodontics
o Dental implants
o Aggressive brushers
o Disabilities/limited dexterity
o Use by caregivers

92
Q

What does brushing the tongue reduce?

A

Bacteria
Halitosis
Coating & staining from smoking and tea

93
Q

How does toothbrushing work for acute oral inflammatory or traumatic lesions?

A

Clean areas unaffected and use saline solutions and or chlorhexidine

94
Q

How does toothbrushing work following periodontal surgery?

A

 Oral care
 Rinsing/brushing 24 hours after
 Gingival graft: no brushing until instructed
 Chlorhexidine

95
Q

How does toothbrushing work following dental extraction?

A

 Brush areas not affected
 Saline solution rinse 24 hours after

96
Q

What are soft-tissue lesions from toothbrushing?

A

Gingival abrasions

97
Q

What are hard-tissue lesions from toothbrushing?

A

Dental abrasions

98
Q

What are the adverse effects of toothbrushing?

A

Soft & hard tissue lesions
Bacteremia

99
Q

How do you take care of toothbrush?

A

-Replacement every 2-3 months
-Soak in hydrogen peroxide/listerine
-Store in dry area

100
Q

What’s the documentation for initial toothbrush instructions?

A

-Type of brush
-Recommended changes
-Soft tissue & toothbrush edu.
-Tongue cleaning

101
Q

What are the factors to teach patients on toothbrushing?

A

-Effects biofilm has on gingiva & teeth
-Daily removal of biofilm
-Ideal brush
-Hands-on instructions
-Proper care
-Tongue cleaner

102
Q

What is a type I embrasure space? What is used?

A

-No gingival recession
-Floss

103
Q

What is a type II embrasure space? What is used?

A

-Moderate papillary recession
-Intermediate brush

104
Q

What is a type III embrasure space?

A

-Complete loss of papillae or extensive recession
-Unitufted brush

105
Q

When/what would floss be used on?

A
  • Healthy sulcus
  • Good dexterity
  • Ability to slide through contacts
106
Q

When/what would a floss holder be used on?

A
  • Healthy sulcus
  • Dexterity problems
  • Ability to slide through contacts
107
Q

When/what would a water flosser/irrigation be used on?

A
  • Gingivitis
  • Implants
  • Orthodontic deeper pockets
108
Q

When/what would a interdental brush be used on?

A
  • Embrasure spaces II & III
  • Perio patients
  • Exposed root surfaces
109
Q

When/what would a wood stick be used on?

A
  • Embrasure spaces II & III
  • Perio patient
  • Exposed root surfaces
110
Q

What are the indications for use of interdental care?

A

o Proximal spaces adjacent to open embrasures
o Orthodontic appliances
o Fixed prosthesis
o Implants
o Exposed furcation
o Application of chemotherapeutic agents

111
Q

Most frequently recommended for interdental cleaning of type I embrasures

A

Dental floss and tape

112
Q

o Single precut or in a roll: super floss
o Removal of biofilm from teeth adjacent to wide embrasure spaces – loss of papilla

A

Tufted dental floss

113
Q

o Proximal surfaces of widely spaced teeth
o Tooth surfaces next to an edentulous area

A

Gauze strips

114
Q

What are the flossing aids?

A

o Power flossing aids
o Floss holders
o Floss threaders

115
Q

o Conical flexible rubber plastic tip
o Cleans interdental area at and just below gingival margin

A

Interdental tip

116
Q

o Bass or birch wood stick
o Triangular in cross section

A

Wooden interdental cleaner

117
Q

Perio-aid: round toothpicks

A

Toothpick holder

118
Q

Targeted application of pulsated or steady stream of water or other agent for preventative or therapeutic purposes

A

Oral irrigation/water flosser

119
Q

o Reduction of gingivitis and bleeding
o Reduction/alteration of biofilm
o Subgingival access to pathogenic microorganisms
o Subgingival delivery of antimicrobial agents or just water
o Some research supports the claims listed above; however, most funding is from a single manufacturer. (Bias)

A

Oral irrigation benefits

120
Q

What are other indicators for oral irrigation?

A

o Orthodontics
o Crowns and bridges
o Removes food debris

Clinical Lecture (5 decks)

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