exam 4 Flashcards
implementation?
provide motivating demonstration and supervision for daily self care…intro tobacco cessation where indicated, spread instructions over several appts…
remember, learning takes time and reinforcement,,
what are endogenous stains?
develop or originate from within the tooth. always intrinsic and usually are discolorations of the dentin reflected through the enamel. (such as amelogensis imperfecta)
what are the temporary causes of dry mouth?
occurs in diseases accompanied by high fever with dehydration or fluid loss, with control of certain diseases such as diabetes or hyperthyroidism, salivary flow returns to normal..
Why are power brushes more effective than manual?
they move in speed an motions that manual bruhses cannot. very helpful for those who cannot remove biofilm well on their own.
when something is stained entirely within?
intrinsic
what are volatile sulphur compounds?
VSC’s are produced consisting of hydrogen sulfide, methyl mercaptan, and lesser amounts of dimethyl sulfide and disulfide.. much higher in pts. with perio disease
rapidly progressive caries occuring in many teeth simultaneously also called acute caries in contrast to chronic caries (slow developing)
rampant caries
what is… when an intrinsic stain come from an outside source, not from within the tooth?
exogenous intrinsic
what does produced within or caused by factors within mean?
endogenous
when you recommend mouth wash to a pt. with xerostomia, what should you not recommend?
anything with alcohol
early stage of the caries process when demineralization causes a change in the enamel to appear chalky white.
white spot lesion
what are the systemic factors that cause halitosis?
renal or hepatic failure, carcinomas, diabetes, upper resp. infections, blocked nasal passages, sinus drainage, cirrhosis of liver.
what does green stain result from?
oral uncleanliness, chromogenic bacteria, and gingival hemorrhage
may occur at any age, primarily found in childhood and collects on both primary and permanent teeth
What was the percentage of the reduction of caries in the U.S since the public water supply was fluoridated in 1945?
40-60 percent
what is the most effective means of biofilm removal for facial and lingual surfaces, and proximal surfaces?
toothbrush and flossing
plan short and long term maintenance?
determine appropriate maintenance intervals (3-4-6 months)
what are the four acids produced by the metabolic breakdown process?
acetic, lactic, formic, and propionic..
what are the four types of fermentable carbohydrate?
sucrose, glucose, fructose and cooked starch
what is halitosis?
an unpleasant odor of exhaled air, a symptom of importance in the complete consideration of health promotion and disease prevention..
failure to carry out a prescribed healthcare plan, for example, failure to take medication as prescribed?
noncomplaince
procedure to assess risk for future dental caries development and identify approaches to managing caries risk..
CAMBRA (Caries Assessment and Management by Risk Assessment)
after remineralization, the caries process is halted, the area usually becomes discolored with a brownish tinge, darker with age or in tobacco user..
arrested caries
what bacteria are namely responsible for caries formation?
mutans streptococci, lactobacillus..
what is xerostomia?
dryness of the mouth caused by the diminishing of saliva.. it is a symptom, not a disease.
what are the major causes of permanent xerostomia?
radiation to head and neck for cancer therapy where permanent damage to the salivary glands can result, surgical removal of glands..
Describe the bass method of tooth brushing
direct filaments epically (up for maxillary and down for mand)
turn the brush head toward the gingival margin to make a 45 degree angle to the long axis of the tooth
direct the bristles into the gingival sulcus
press lightly and do not bend the bristles with excess pressure
vibrate the brush back and forth with very short strokes
apply brush to next two or three teeth and repeat
mechanism of action when enhances remineralization?
as the saliva flows over the biofil, its buffering properties neutralize the acid produced by the bacteria.. the pH rises toward neutral and prevents further dissolution of the minerals.. minerals in the saliva can go back into the tooth for remineralization..
what other ingredient does air powder polisher include besides air and water?
sodium bicarbonate or aluminum trihydroxide
what are the three steps in the fluoride mechanisms of action?
inhibits demineralization
enhances remineralization
inhibits bacteria in the biofilm
why do we avoid polishing teeth on the same day as quadrant deep scaling and root planing?
particles can become embedded out of reach of the most careful irrigation and rinsing because the disease lining of the pocket has usually been removed and the pocket wall is wide open.
with reference to abrasive agents, this is the particle size
grit
best way or instrument to detect coronal caries on a remineralizing tooth surface?
probe or explorer, unless you can visually see it
contraindications for air powder polishing?
phys. directed sodium restricted diet
resp. disease
pt. with end stage renal disease
avoid polishing cementum and dentin and free gingival tissue
chromogenic bacteria and fungi
decomposed hemoglobin
inorganic elements include calcium, potassium, sodium, silicon, magnesium, phosphorus, and other elements in small amounts
composition of green stain
common in people among eastern countries and has caries inhibiting effect. dark discoloration of the teeth, mahagony brown and almost black.. can become thick and hard, with partly smooth and rough surfaces. microscopically, the black deposit consists of microorganisms and mineralized material with a laminated pattern characterisitc of subgingival calculus and can be removed by scaling
betel leaf
what is the objective of a dental hygienist?
to provide the pt. with care and education so that dental health will be maintained indefinitely.
what are the functions of saliva?
buffers the acids and to supply minerals to replace those calcium and phosphate ions dissolved from the tooth during demineralization..
what does producing color or pigment mean?
chromogenic
the two ways stains are classified by source?
exogenous and endogenous
air powdered device using air and water pressure o deliver a controlled stream of specifically processed sodium bicarbonate slurry through the handpiece nozzle.. also called air abrasive, airpolishing, air powdered abrasive, or airbrasive
air powder polisher
infectious disease caused by acidogenic bacteria with dissolution of enamel and dentin (coronal caries) and cementum and dentin(root caries)
dental caries
where does pumice come from?
volcanic origin and consists chiefly of complex silicates of aluminum, potassium and sodium
perform clinical preventive services?
complete scaling and bacterial debridement and apply fluoride and sealant
name the four sources brown stain can result from
stannous fluoride
foodstuffs
antibiofilm agents
betel leaf
what stains can occur on the external surface of the tooth and may be removed by procedures of tooth brushing, scaling, and or polishing?
extrinsic stains
a term used to describe a power toothbrush that operates in audible range of human hearing
sonic
bacteria in dental biofilm capable of metabolizing fermentable carbohydrates into acids..
acidogenic bacteria
what additives are put into prophy pastes and their purpose?
to provide specific function such as enhancing the mineral surface of enamel, diminishing dentin hypersensitivity or tooth whitening
what are the properties of an acceptable disclosing agent?
intensity of color duration of intensity taste non-irritating to mucous membranes diffusability astringent and antiseptic properties
a brush driven by electricity or battery also called power assisted, automatic, electric or mechanical (in contrast with manual tooth brush)
power toothbrush
what type of stain when the pellicle can take on stains of various colors that result from chemical alteration?
brown stain, brown pellicle
composition of tobacco stain
tar and products of combustion
brown pigment from smokeless tobacco
Cavitation
process in formation of cavities, final stage in the caries process..
dental fluorosis
originally called brown stain, later by dr. frederick s mckay who studied the condition described it as mottled enamel.
when something is derived from or situated on the outside(external?)
extrinsic
What is the primary concern with dental stain?
appearance or cosmetic effect
three general ways discolorations of the teeth and restorations can occur
stain adhering directly to the surfaces (removed by scaling)
stain contained within calculus and soft deposits(removed by scaling)
stain incorporated within the tooth structure and restorative material(cannot be removed by scaling)
this type of tooth brushing technique is an unlimited sweep of horizontal scrubbing motions that bears pressure on teeth most facially inclined or prominent..
with the use of abrasive dentrifice, it may produce tooth abrasion
biofilm can remain undistrubed on interndetal areas.
horizontal brushing
what is the wearing away of the tooth surface material by friction?
abrasion
healing process in which minerals are redeposited in the demineralized tooth structure, accomplished by the protective factors of the saliva and the action of fluoride to inhibit demineralzation and intefere with the enzymatic requirements of bactiera..
remineralization
what color is the stain from betel leaf and what does it inhibit in the oral cavity?
dark mahogany brown, sometimes black.. caries inhibiting effect.
what are the contraindications for polishing?
pts. with respiratory problems tooth sensitivity restorations newly unerupted teeth conditions that require postponement for later evaluation
what instrument should be used to check the surface of a white areas of remineralization?
blunt probe
how is tobacco stain distributed on the tooth surface?
cervical third
any surface as well as pits and fissures, most likely on lingual surfaces.
individual synthetic fiber.. a single element of a tuft fixed into a tooth brush head,
filament
what is pilocarpine therapy?
prescription medicine that increases salivary output..
chlorhexidine and alexidine are used in mouth rinses and are effective against biofilm formation. a brownish stain of the tooth surfaces results usally more pronounced on proximal and other surfaces less accessible to routine biofilm control procedures. the stain also tends to form more rapidly on exposed roots than on enamel. tooth staining has been considered a significant side effect (#1 side effect from brown stain)
antibiofilm agent
what are the six steps in a preventive program?
assess patient needs plan for intervention implementation perform clinical preventive services evaluate progressive changes plan short and long term matience
medical and dental history
developmental complications, medications, use of tobacco and fluoride histories all contribute necessary information. accurately prepared medical and dental histories can provide information to supplement clinical observations
what is the mechanism of action when inhibiting demineralization?
when fluoride is present in the flui of the biofilm around the enamel crystals (or dentin of the root), it will pass thru the diffusion channels with the acid and increase the fluoride of the subsurface lesion to prevent the continued dissolution of the minerals..
what is the most common type of extrinsic stain?
yellow stain, from not brushing teeth
what is a disclosing agent?
a preparation in liquid, tablet, or lozenge form that contains a dye or other coloring agent.. in DH, this is used to identify biofilm deposits for instruction, evaluation and research..
characteristics shape each of tooth brush filament.. a special manufacturing process removes all shark edges and provides a smooth, rounded end to prevent injury to gingiva or tooth structure during use
end rounded
oral hygine methods for removal of dental biofilm from tooth surfaces using a tooth brush and selected devices for inter dental cleaning.. contrast with chemotherapeutic biofilm control in which an antimicrobial agent is used
mechanical biofilm control
mechanism of action when inhibits bacteria in the biofilm?
fluoride can change to HF (hydrogen fluoride) when it is contacted by the acid produced by the bacteria from the carbohydrates in the pt.’s diet.. in the HF form it can then diffuse over the cell membrane of the acidogenic bacteria.. inside it dissociates again and the fluoride ions interfere with essential enzyme activity within the bacterial cell..
light brown, sometimes yellowish stain that forms on the teeth in the pellicle after repeated use of stannous fluoride gel or other product. the brown stain resuluts from the formation of stannous sulfide or brown tin oxide from the reaction of the tin ion in the flouride compound
stannous flouride
what is the name for something that contains red color dye?
erythrosyn
what stains occur within the tooth substance and cannot be removed by scaling or polishing?
intrinsic
a cluster of bristles or filaments secured togehter in one hole in the head of a tooth brush
tuft
assess pt. needs?
review all histories and clinical findings including exams, radiographs, severity of disease, etc..
tea, coffee and soy sauce are often implicated in the formation of a brownish stained pellicle. as with other brown pellicle stains, less stain occurs when the personal oral hygiene and biofilm are excellent (common in asains)
food stuffs
what does originating outside or caused by factors outside?
exogenous
what are chlorhexidine and alexadine?
used in mouth rinses and are effective against biofilm formation… antibiotic mouth wash
do all pulpless teeth discolor?
no, because of improved endodontic procedures
evaluate progressive changes?
uses indices and probing depths at each apt. to compare tissue quality, BOP, and pocket depths.. provide preventive counseling for corrective action when goals are not met.
revolutions per minute
rpm
this is the loss of a tooth structure produced by a mechanical cause such as a hard bristled tooth brush used with excessive pressure and an abrasive dentrifice, abrasion contrasts with erosion which involves a chemical process
abrasion (tooth)
formula for caries?
acidogenic bacteria+fermentable carbs=acid formation>demineralization and or cavity..
what are exogenous stains?
develop or originate from sources outside of the tooth.. may be extrinsic and stay on the outer surface of the tooth or intrinsic and become incorporated within the tooth structure
what type of stain has an unknown cause and found in very healthy mouths?
black line stain- forms along the gingival third near the gingival margin
more common in young women
major stage in dental caries process in which minerals, primarly calcium and phosphorus, are removed from tooth structure by acids formed by acidogenic bacteria, primarly mutans streptococci and lactobacilli
demineralization
what are habits, behaviors, lifestyles or conditions that, when present increase the probability of a disease occurring?
risk factors
what are the two locations stains are categorized by?
extrinsic and intrinsic
what is xylitol?
sugar free gum that can be chewed at the end of meals to prevent cavities
plan for intervention?
apply pt. info (educational level, occupation, etc.); outline needed procedures and work out goals with pt.
manner of formation of dental fluorosis
enamel hypomineralization results from ingestion of excessive flouride in drinking water (more than 2 parts per million) during the period of mineralization. the enamel alterations are a result of toxic damage to the ameloblasts
when the teeth erupt, they have white spots or areas that later become discolored from oral pigments and appear light or dark brown
severe effects of excess flouride during development may produce cracks or pitting, the discoloration goes righ into these areas. this condition and appearance led to the name mottled enamel
when does learning occur?
when an individual changes behavior and when beneficial changes are incorporated into everyday living..
this method is widely accepted for all patients for plaque removal adjacent to and directly beneath the gingival margin. the gingival margin and col are the most important in the control of gingival and perio infections
bass method (sulcular brushing)
extent to which a person’s health behaviors coincide with dental/medical counseling?
compliance
