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Periodontics > Lecture 11 > Flashcards

Lecture 11 Flashcards

Chemical Agents in Periodontal Care

1
Q

systemic delivery

A

the chemical agent is circulated systemically throughout the body

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2
Q

topical delivery

A

intraoral placement of topical chemical agents/controlled-release devices

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3
Q

criteria for effective chemical agents

A

must reach the site of the disease activity
efficacy: ability to inhibit oral bacterial growth and be delivered in bacteriostatic/bactericidal concentrations
substantivity: remain in place long enough to be effective

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4
Q

therapeutic mouthrinses

A

many contain chemical ingredients that have little or no effect against gingivitis

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5
Q

clinical studies support the effectiveness of therapeutic mouthrinses used in addition to

A

proper home care

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6
Q

why not just mouthrinse

A

the surface of dental plaque biofilm is covered by the extracellular protective matrix/protective barrier
mechanical biofilm control is a must in order to disrupt the structure of the biofilm and allow the chemical agents to reach the bacteria themselves

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7
Q

therapeutic mouthrinses uses

A

can provide therapeutic benefit: decrease biofilm to decrease gingivitis, decrease risk of dental caries, aid in dentinal hypersensitivity

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8
Q

two mouthrinse ingredients that have demonstrated effectiveness against gingivitis are

A

chlorhexidine gluconate
essential oils

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9
Q

chlorhexidine gluconate

A

most effective
available by prescription
rinse twice daily
bactericidal
displays substantivity (binds to tissue, slowly released)

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10
Q

what is the most effective antimicrobial agent for long term reduction of biofilm and gingivitis

A

chlorhexidine

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11
Q

cons of chlorhexidine

A

may cause discoloration of the tongue, taste alteration, increased extrinsic stain, increase in calculus formation, prescription, costly

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12
Q

patients who benefit from chlorhexidine gluconate

A

special needs patients
postsurgical care patients
candida infections
high caries risk
oral piercings/implants
preprocedural rinse for powered instrumentation

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13
Q

essential oils

A

also control biofilm: antibiofilm/antigingivitis
over the counter
less expensive
lack the side effects

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14
Q

4 essential oils

A

thymol, menthol, eucalyptol, methyl salicylate

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15
Q

controlled-release antimicrobial agents

A

consists of an antibacterial chemical embedded in a carrier material
placed directly into the perio pocket, dissolving slowly providing a steady release of the antimicrobial agent
most subject subgingival bacteria to therapeutic levels of antimicrobial agents for approx. 1 week
non-responsive pockets/sites

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16
Q

controlled-release antimicrobial agents methods

A

products expelled into the pocket
adhere to tooth surfaces and dissolve slowly
arestin, atridox

gelatin chip inserted into pocket
adheres to tooth surface and dissolves slowly
periochip

17
Q

why not antibiotics for all since gingivitis and periodontitis are bacterial infections

A

most cases can be controlled through conventional mechanical periodontal therapy
concern of antibiotic resistance
more frequent in treating rarer forms of periodontitis (necrotizing gingivitis/necrotizing periodontitis)

18
Q

examples of stimuli for hypersensitivity

A

mechanical stimuli: toothbrush bristles, fingernail
thermal stimuli: ice cream, iced tea
chemical stimuli: acidic foods

19
Q

exposed dentin

A

dentin that is visible in the oral cavity due to gingival recession or absence of enamel due to damage
not all exposed dentin displays hypersensitivity

20
Q

hydrodynamic theory of dentinal hypersensitivity

A

dentinal tubules are filled with; an odontoblastic process, fluids
stimulation of the root surface may result in fluid flow within the tubules which is theorized to activate the nerve endings near the pulp leading to painful sensations

21
Q

dentinal hypersensitivity associated with NSPT

A

most NSPT does not result in DH
resolution of inflammation frequently results in gingival recession which can result in dentinal hypersensitivity

22
Q

dentinal hypersensitivity post NSPT

A

may not occur because of the smear layer
home-care is important
exposed root surfaces must be kept biofilm free

23
Q

how to address DH

A

ask patients if they have existing DH
D-sense crystal/LA can be used to control discomfort
patient education: discuss possibility of DH following NSPT, management strategies

Periodontics (11 decks)

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