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Preventative Dentistry > Final > Flashcards

Final Flashcards

1
Q

Salivary flow is controlled by what system

A

ANS

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2
Q

Within the ANS what is the main controller of saliva production

A

PSNS

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3
Q

Pressure in the mouth __ salivary nuclei in the medulla and __ saliva secretion

A

stimulates
increases (Vasodilation)

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4
Q

T/F: sight, smell, taste, and sound can stimulate saliva production

A

True

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5
Q

T/F: There is a decrease in salivary production during sleep

A

True

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6
Q

Sympathetic division stimulates __ secretion, decreasing __ , this produces __ saliva

A

mucus
serous (vasoconstriction)
viscous

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7
Q

Saliva is a filtrate of __

A

Blood

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8
Q

Transport in the acinar cells, end with __

A

isotonic solution

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9
Q

Transport in the ductal cells, end with __

A

hypotonic solution (b/c Na+ and Cl- reabsorption greater than K+ and HCO3- secretion)

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10
Q

Water has impermeability in __ so it cannot follow Na+ and Cl-

A

Ductal cells

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11
Q

The final saliva product by ductal cells is __

A

hypotonic

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12
Q

Tonicity and ion concentrations depend on __

A

Rate of salivary flow (ion channels have a maximum rate of transport ( I Love Lucy video))

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13
Q

What gland opens via stensons duct

A

Parotid gland

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14
Q

This gland opens via whartons duct

A

submandibular gland

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15
Q

What gland opens via excretory ducts

A

sublingual gland

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16
Q

This gland produces serous, watery secretion only - dominant in stimulated saliva

A

Parotid Gland

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17
Q

This gland produces mixed, serous and mucous - dominant in unstimulated saliva

A

Submandibular gland

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18
Q

This gland has predominantly mucous secretions

A

sublingual gland

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19
Q

These cells secrete serous fluid for mastication

A

serous cells

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20
Q

These cells secrete mucus rich secretion for protection

A

mucous cells

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21
Q

Normal mean for unstimulated saliva

A

0.5 mL/min (abnormal = less than 0.2)
70% submandibular gland

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22
Q

Normal mean for stimulated saliva

A

1.5 mL/min (abnormal = less than 0.5)
90% parotid gland

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23
Q

What is resting flow rate of saliva, and what shows hypo salivation

A

30-60s
Greater than 60s

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24
Q

What is the stimulated saliva flow and what would make it hypo salivation

A

Greater than 5 mL
lower than 5 mL

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25
Q

This is the major buffer in stimulated saliva

A

Carbonic acid/ bicarbonate buffer

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26
Q

Bicarbonate acts mainly to __ produced by bacteria

A

neutralize acids

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27
Q

The concentration of the bicarbonate ion depends largely on the __

A

Salivary flow rate

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28
Q

A high bicarbonate concentration linked to a high flow rate in __ would keep saliva pH above __ so that the risk of erosion of tooth structure is low

A

stimulated saliva
6.3

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29
Q

Below the critical pH of __ calcium phosphate salts dissolve from the enamel and leads to cavities

A

5.5

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30
Q

Major buffer of unstimulated saliva

A

Phosphate buffer

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31
Q

What is the maximum buffering capacity of the phosphate buffer

A

pH 6-8

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32
Q

Perform more than one function

A

Multifunctional

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33
Q

Mucin proteins are involved in antimicrobial activity , maintenance of tooth integrity, and lubrication / protection. This means they are __

A

Multifunctional

34
Q

Perform both a good and a bad function, dependent of location or site of action

A

Amphifunctional

35
Q

In solution amylases facilitate clearance of viridian streptococci but when absorbed on tooth surface they promote adherence of bacteria. This means they are __

A

amphifunctional

36
Q

critical pH of enamel

A

5.5

37
Q

Critical pH of dentin

A

6.5

38
Q

Every time you eat or drink you experience a drop in __
The more time you spend above pH 5.5 =
The more time you spend below pH 5.5 =

A

pH
more remineralization = low caries risk
more demineralization = high caries risk

39
Q

The acquired enamel pellicle is a __

A

selective protein rich film covering enamel surface

40
Q

The acquired enamel pellicle forms __

A

immediately after the tooth is cleaned

41
Q

What protects the enamel against acid dissolution (prevents continuous deposition of calcium and phosphate)

A

Acquired Enamel Pellicle

42
Q

What is the base attachment for oral bacteria adherence

A

Acquired enamel pellicle

43
Q

Early biofilm formation: The first bacteria to attach to the pellicle glycoproteins are __ from the __ family (30 min to an hour)

A

gram positive aerobic cocci
Mutans Streptococci

44
Q

Early biofilm formation: The bacteria are able to replicate in the__ environment of the oral cavity and form micro-colonies within __ after attachments (12 to 24 hours)

A

oxygen rich
minutes

45
Q

Early biofilm formation: These bacteria produce an enzyme known as __ (12-24 hours)

A

gluccosyltransferase

46
Q

Early biofilm formation: Glucosyltransferase converts sucrose into a sticky extracellular polysaccharide called __ (12-24 hours)

A

Glucan

47
Q

This creates a sticky environment that allows other early colonizing bacteria to attach to the initial colonies and protect them from acidic environments (12-24 hours)

A

Glucan

48
Q

As the plaque begins to develop and expand __ (1-3 days)

A

oxygen can no longer diffuse into the colonies

49
Q

After a few days __ begin to colonize the plaque (1-3 days)

A

anaerobic gram negative cocci, rods, and filaments

50
Q

After several weeks the bacteria grow together forming colonies known as __

A

Corncobs

51
Q

The anaerobic environment causes facultative anaerobes such as __ and __ to break down sucrose through fermentation pathways

A

S. mutans
Lactobacilli

52
Q

The facultative anaerobes produce __ as a metabolic byproduct

A

Lactic acid

53
Q

How to read a caries risk chart

A

Draw a line at 5.5
Above the line = low risk more remineralization
Below the line = high risk more demineralization

54
Q

Recommend ppm of fluoride in public tap water

A

0.7 ppm

55
Q

ppm of fluoride in OTC toothpaste

A

1000 ppm
(0.22% SF, 0.76% SMFP, 0.4% STF)

56
Q

From a radiograph, identify as E1, E2, D1 or D2 (ADA caries classification system)

A

E1 = enamel only
E2 = At the DEJ
D1 = into outer 1/3rd of dentin
D2 = into middle 1/3rd of dentin
D3 = into inner 1/3rd of dentin
Look at pic

57
Q

Xylitol is used for __

A

moderate and high risk patients (caries management chart)

58
Q

Naturally occurring, low calorie sugar substitute with anticariogenic properties (found in gum and sweeteners)

A

Xylitol

59
Q

Short term consumption of xylitol is associated with decreased __ in saliva and plaque

A

streptococcus mutans levels

60
Q

Bacteria are unable to produce what in the presence of xylitol

A

acid ( no decrease in plaque pH –> no demineralization)

61
Q

This hardens the lining of cavities, making untreated cavities less sensitive, and increases salivary flow to optimize pH

A

xylitol

62
Q

During tertiary prevention of periodontal disease, use this as an antimicrobial therapy agent

A

Chlorohexadine (0.12% peridex solution)

63
Q

Chlorohexadine can also be used as an antimicrobial oral rinse for __ and __

A

plaque control
salivary hypofunction

64
Q

Used for the treatment of fungal infections

A

Nystatin
(comes as rinses, lozenges, troches, pastilles, cream, ointment, powder)

65
Q

If the patient has active non-cavitated caries you want to prescribe __

A

Prevident 5000
(2.2% sodium fluoride)

66
Q

Prevident 5000 contains __ sodium fluoride which helps it to __ and __

A

2.2%
Prevent cavities
reduce pain from sensitive teeth

67
Q

White spot lesions can have both __ and __ occurring simultaneously

A

demineralization
remineralization

68
Q

An advancing subsurface lesion with a remineralizing surface lesion

A

White spot lesion ( sub surface shows greater degree of demineralization

69
Q

If the outer enamel stays intact, the white spot lesion will remain stable / arrested, an arrested lesion is considered __

A

More resistant to demineralization

70
Q

What 5 disease indicators automatically place the patient as high caries risk classification

A
  1. Visible cavitated lesions into dentin
  2. Active proximal enamel demineralization radiographically
  3. Visible active smooth surface enamel demineralization
  4. Restorations due to cavitation in the last 3 years
  5. Extractions due to extensive cavitation in the last three years
71
Q

How many yeses are needed for a pt to be high, moderate and low risk when looking at risk factors

A

low risk = <3
moderate risk = 3-6
high risk = > 6
(opposite for protective factors)

72
Q

List some risk factors

A

Visible plaque on more than 25% dentin
< 3 fluoride exposures per day
Deep pits and fissures
Reduced Salivary flow
Head and Neck radiation history
Restorations with open margins / overhangs
Exposed root
Ortho
Limited access to care
> 3 snacks and sugar exposures
Recreational drug use

73
Q

What are the codes for low, moderate and high risk

A

D0601
D0602
D0603

74
Q

Fluoride salt, highly reactive fluoride ion, silica abrasives are compatible, more stable than stannous

A

Sodium Fluoride 0.22% (1000ppm)

75
Q

Not an ionic fluoride salt, covalently compound fluoridated compound that requires enzymatic activation by a salivary enzyme to release bioavailable fluoride, compatible with more abrasives

A

Sodium Monofluorophosphate 0.76% (1000ppm)

76
Q

Tin (II) fluoride - chemical compound with formula SnF2, fluoride that is highly reactive, abrasive calcium pyrophosphate, adheres to the surface of tooth enamel and forms a protective layer, shields tooth from erosion

A

Stannous fluoride 0.4% (1000ppm)

77
Q

Acidulated fluoride is the __

A

most commonly professionally applied topical fluoride (12,300ppm)

78
Q

If someone is low risk for caries what caries management should you perform

A

OTC fluoride toothpaste
12-18 months recall frequency
BWINGS 18-24 months

79
Q

Difference in radiograph frequency between moderate and high risk

A

Moderate = every 12 months
High = every 6 months

80
Q

Recall frequency for moderate and high caries risk

A

Moderate = 6-12 months
High = 3-6 months

Preventative Dentistry (2 decks)

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