Final: DRA and oral health

Question 1

which systemic conditions can periodontitis be linked ot

Answer 1

• heart disease
• stroke
• diabetes
• pregnancy complications (preterm and low birth weight)
• respiratory infections: COPD and pneumonia in elderly
• alzheimers/neurodegeneration
• obstructive sleep apnea

Question 2

what is type 1 diabetes/how common

Answer 2

body doesnt produce insulin and can happen at any age. 5-10% of population with diabetes

Question 3

how common is type 2 diabetes

Answer 3

insulin resistance ttype 90-95 % of diabetes

Question 4

gestational diabetes how common?

Answer 4

nearly 10% of pregnancies in the US unknown cause

Question 5

what is type 3 diabetes

Answer 5

related to alzheimers, insulin signaling pathway and tau protein

Question 6

what are signs of diabetes

Answer 6

• extreme thirst
• extreme hunger even tho eating
• blurry vision
• extreme weight losss (type 1) even tho eating
• tingling, pain and numbless in hands and feet (type2)
• cuts or bruises that are slow to heal

Question 7

what are type 2 diabetes risk factors

Answer 7

-overweight, family history, 45+, gestational diabetes, physically inactive, certain ethnic/races

Question 8

what is a high random blood glucose test

Answer 8

shouldnt exceed 200 mg/dl!

Question 9

what is the difference between prevalence and incidence

Answer 9

incidence: total number of NEW cases of an illness at a specific period of time
prevalence: total number of people with a certain illnesss at a specific period of time (diagnosed and undiagnosed) ALL

Question 10

what are some serious medical outcomes diabetes is a leading cause for

Answer 10

• atraumatic limb amputation
• kidney failure
• adult onset blindness
• stroke and heart attack

Question 11

what are 3 diabetes related oral health conditiosn

Answer 11

• xerostomia (dry mouth due to impaired salivary function, possibly due to decreased blood flow)
• oral candidiasis- thrush or candida; white patches that wipe off
• burning mouth syndrome

Question 12

when should you not treat a patient based on blood glucose

Answer 12

over 200!

Question 13

what is prediabetes/diabetes for A1c test

Answer 13

-a1c: diabetes= 6.5% or above
prediabetes: 5.7-6.4%
normal below 5.7%

Question 14

what is prediabetes/diabetes for fasting blood sugar test

Answer 14

diabetes: 126 mg/dl or more
prediabetes : 100-125 mg/dl or more
normal up to 99

Question 15

what is prediabetes/diabetes for random blood sugar test, normal?

Answer 15

diabetes: 200 or more
prediabetes 140-199
normal: up to 140

Question 16

what are the 4 steps of ODTP

Answer 16

History (medical dental and social)

periodontal disease status (soft tissue)

caries disease status (hard tissue)

treatment plan

Question 17

what are the 4 fundamental oral diseases

Answer 17

-periodontal, caries, occlusal, and oral/oropharyngeal cancers

Question 18

what are risk factors for chronic adult periodontitis

Answer 18

diabetes, diet, and smoking

Question 19

which has a greater risk for periodontal disease type 1 or 2 diabetes

Answer 19

type 1 is 3-7x greater risk! depends on control of diabetes
-type 2 is 2-4x greater risk, dependent on diet control.

-well controlled diabetics with effective hygiene is similar to non diabetics!!

Question 20

how much risk does smoking add and whats it proportional to

Answer 20

periodontal risk is 2.5-7x greater! pack years – packs a day x years
– periodontitis onset is earlier and more rapid progression in smokers but it MASKS THE SIGNS!

Question 21

what are predictors for periodontal disease examples

Answer 21

age, obesity, gender, bacteria, genetics, stress, occlusion, dental visits

Question 22

how is gender related to periodontitis

Answer 22

its a predictor: greater in males than females 2:1

Question 23

how is age related to periodontitis

Answer 23

its a predictor: can increase as much as 4x with age but this isnt inevitable.
-inflammation is root cause of many chronic diseases of aging and periodontal disease is a major source of chronic inflammation

Question 24

what is the relation between obesity and periodontitis

Answer 24

it is a predictor and goes up with degree of excess weight
-body over produces inflammatory mediators when over weight- same that cause periodontal disease.

• inflammatory mediators released by gingival cells in presence of periodontal disease also stimulate an increase in appetite, which compounds both diseasess.
• both obesity and periodontal disease increase risk of heart/cv disease, diabetes, gallstones etc

Question 25

list caries identification technology

Answer 25

• fiber optic transilllumination (FOTI and DIFOTI)
• light induced fluorescence (QLF)
• laser fluorescence (DIAGNOdent)
• laser induced infrared photothermal radiometry and modulated luminescence
• electrical conductance
• alternatin current impedance spectroscapy
• ultrasound
• optical coherence tomography (OCT) using near infrared (NIR) transillumination

Question 26

what are the BEST caries risk INDICATORS found so far

Answer 26

• the number of existing caries lesions

- the number of restored or missing teeth!

Question 27

what are caries risk factors

Answer 27

anything that lowers oral pH or harbors plaque:

• acid producing bacteria are high
• readily visible heavy plaque on teeth
• snacking more than 3x a day
• deep pits and fissures
• recreational drug use
• inadequate saliva flow
• saliva reducing factors (medications, radiation etc)
• exposed root surfaces
• orthodontic appliances

Question 28

what issues can malocclusion lead to

Answer 28

• secondary occlusal trauma leading to loss of periodontal attachment
• accumulation of plaque/inability to thoroughly clean tooth and gingival surfaces leading to periodontal and/or caries disease

-occlusla disease is a risk factor for periodontal and caries! and loss of teeth due to periodontal/caries is a risk factor for occlusal disease

Question 29

what are caries disease indicators? how many do you need for high risk?

Answer 29

just ONE makes you high risk!

• new/progressing visible cavitations or radiolucencies into dentin
• new/progressing approximal enamel lesions by radiogrpah
• new/active white spot lesions
• restoration for caries in the last 3 years due to decay

Question 30

STATS 2: how do you get the mean variance?

Answer 30

subtract value from mean and square for each value, add these all together and divide by the number of measurements.

Question 31

STATS 2: how do you get the standard deviation

Answer 31

square root of variance (now same unit as measurement)

Question 32

what % is in each normal standard deviation (+ or - 1, 2, and 3)

Answer 32

+ or -1 standard deviation is 68.3%
+ or -2 standard deviations is 95.4%
3 standard deviations + or - is 99.7%

-also remember that it goes 34.1% on one side for 1 standard deviation, 13.6% more for 2 standard deviations, 2.1 % more for 3 standard deviations