medical waste Flashcards
medical waste managment
detracted teeth are regulated medical waste unless patient aks to take the twwth with them
dental caries
means tooth decay the common chronic disease in children. caries have affected human all ages and untreated destructive to teeth and entire oral cavity.
dental caries are infectious of recorded history
developement of dental caries
is a complex multistate process
caries tend to affect low income individuals more frequently than members of other groups.
signs and symptoms of disease
- in most cases sweet food and hot,cold food/drink
- there might be no symptoms until a cavity becomes large
basic tooth anatomy
enamel : is hardest tissue in the human body. it composed 96% mineral and the rest is water and organic material. the mineral component is hydroxyapatite which is crystalline calcium phosphate. The water and protein components in the teeth are important to allow acids to travel into tooth and minerals to travel out, causing the tooth structure to dissolve.
Dentin: is softer than enamel, harder than bone. it make up majoority of tooth stucture. dentin 70% hydroxyapatite and rest water and organic material. dentin consists of dentinal tubules that radiate outward from pulp.
these tubules provide a degree of permeability that increases the sensation of pain in tooth.
cementum: softer than dentin and is coposed of 50% hydroxyapatite and 50% water and organic material. cementum covers root of a tooth and allows connective tissue to anchor the tooth to the bone and soft tissue
Bacterials infection
two specific groups bacteria found in the mouth responsible for dental caries. both types are found in large number in dental plaque (coating that adheres to teeth)
when the number caries causing bacteria in mouth increases the risk od dental caries also increases.
- mutans streptococci: bacteria that causes lesion especially crown.
transmitted through saliva. happened mpst the mother and infant. - Lactobacilli : bacteria that causes carious lesions to especially crown.
Dental plaque
is colorless ,soft, sticky coating that adheres to the teeth formation of plaque on tooth millions of micooranisms on that tooth. many professionals stress that plaque is biofilms
Three factors must be present at the same time for Caries process
- a susceptible tooth
- diet rich of carbohydrates
- specific bacteria
acid breakdown of tooth can occur with bacteria in caries process
stages of caries development
caries is an ongoing process
- demineralization : dissolution of calcium phosphate from hydroxyapatite crystals
- remineralization: decomposition of calcium phosphate in demineralized areas.
it takes time ,months, years for carious lesion to develop. it is possible for demineralization, and remineralization to occurs without loss of tooth structure. Minerals that replaced during remineralization make tooth stonger against acid attack than the original.
three stages of caries develoment
- incipient lesion: develops when caries begins to demineralize
- overt or frank : development of cavity or hole in tooth
- Rampant caries: time between incipient lesion.
incipient lesion
white spot: white area not like healthy enamel. it is an area of decalcification (loss of Ca in tooth structure) the earliest sign decay. if fluoride is applied the enamel will remineralize.
-it would feel rough and enamel structure has broken down
- no pain with lesion other than sensitivity to sweet, cold, hot
- overt carious lesions: cavitation or hole in tooth or tissue affects dentinoenamel junction (DEJ) and dentinal layer and result tooth loss
rampant caries
are multiple carious lesions though the mouth with cavitation. can appear as dark areas between teeth and tooth surface near the gumline. This condition can be due to eating carbohydrates or dry mouth.
Baby bottle: tooth decay is example of rampant caries caused by exposure of child’teeth for long periods to liquid that contains sugars like milk
Classificed the caries based on their location on tooth
- pit and fissure caries
occlusal surface: chewing portion of posterior teeth
buccal surface: closest to face or cheek
lingual grooves: channels on the tooth surface nearest the tongue of an anterior tooth
posterior teeth: teeth closest to throat.
maxillary incisors: four anterior teeth in each dental arch using for cutting.
-smooth surface caries
-root surface caries: occur on any surface of root
-secondary or recurrent caries: occur on tooth surrounding
Diagnosis of caries
The pits and fissure can be filled with a material known as sealant that helps to cove the pit helps block bacteria attacks
Many choices in sealant surface protection
- An unfilled resin system: resin will wear naturally as patient chews
-glass ionomer sealant: releases high level of fluoride to aid remineralization of surround area.
-An amorphous calcium phosphate: release important minerals to aid in remineralization
Gingival or gum recession
can be seen on oder person’s front teeth.
Abfraction: loss of tooth structure due to flexing forces or clenching.
Root caries becoming more prevalent in elderly population.
-people are living longer and keeping their teeth longer
-older take medications known to reduce salivary flow
root surface and recurrent caries lesions
root surface: caries lesions are slow to form and do not cause pain until however rampant decay lead to pain and sufferings. found in buccal area
smooth surface caries area of occluding surfaces and proximal surface
secondary carries starts to form in small spaces or gaps between the tooth. Bacteria thrive in these area
saliva play role in oral health
if salivary function reduced the risk of decay increased
- physical protection thick saliva is less effective than more watery saliva in clearing carbohydrates.
- chemical protection contains calcium, phosphate, fluoride
-Antibacterial substances in saliva work against bacteria.
dry mouth
Xerostomia means dry mouth
causes: mental anxiety, allergies, high blood pressure medications
caries detection methods
-visual
-radiography
-laser caries detecter
- detectable explore
Radiograohy
Radiography can be useful tool to diagnose decay that cannot be seen.
-Radiographs will not show all types of decay.
- decay is often two deeper and more widespread than it appears on radiographs. using a radiograph alone is not the best way to diagnose decay. visual exam using an explore would not show this lesion.
Would it be possible to see early decay on the occlusal surface on a radiograph? NO, only extensive decay of the occlusal surface on a radiograph would be seen.
Indicator Dyes
Indicator Dyes used to assist dentist with identified area of excavation that still contain caries.
A laster caries detector is used to diagnose caries and reveal bacterial Carious tooth
is activity under the enamel surface. Carious tooth structure is less dense and gives off higher reading than non carious tooth structure.
Laser caries detector cannot detect caries inter proximally (surface between two teeth), under sealants, or restorations. It is useful in non rested areas and around the margins if restoration.
The laser comes with a chart that help the dentist determine what treatment needs to be preferment on the tooth surface.
Risk Assessment for dental caries
Categories of patients have higher risks of developing dental caries and should be given risk assessment tests.
- new patients with signs of caries activity
- pregnant patients
- patients experiencing sudden increase in the incidence of caries
- Individuals taking medication that can affect the flow of saliva
- Xerostomic patient
- patients about to undergo chemotherapy
- patients who frequently consume fermentable carbohydrates
- patients suffering from autoimmune diseases.
Risk Assessment tests for caries
Risk Assessment tests for caries for caries are based on amount of mutans streptococci and lactobacilli present in saliva
-high bacterial counts indicate hight caries risk
-low counts indicate a low risk for caries
prevalence of periodontal disease
periodontal disease : is infectious process that involves the structures of the periodontium.
periodontal disease can cause inflammation and breakdown of the periodontium, resulting in loss of the tissue attachment and destruction of the alveolar bone.
Periodontal disease leading cause of tooth loss in adults
- 75% American periodontal disease adults have a form of periodontal disease and most do not know they have the disease.
- most adult and children have calculus on their teeth. If detected and treated early, most people can retain their teeth for life
causes and type of periodontal diseases
patients must use proper home care. Most plaque is removed by brushing and flossing. can not be removed by rinsing
There are three major causes of periodontal disease
- Dental plaque: major factor
- dental calculus: provides a surface to plawue can attach
- Bacteria: produce enzymes and toxin that destory periodontal tissures and lower defenses
Gingival Disease
- Gingival is inflammation of gingival tissue.
- gingivitis is characterized area if reness swelling, there is a tendency for bleed easily
- gingivitis is limited to epithelium and gingival is connective tissues.
others types of gingivitis are associated
-puberty
-pregnancy
- use of birth control medication
- gingivitis is painless and often goes unrecognized until a dental emphasizes its importance. Improved daily oral hygiene will reverse gingivitis.
periodontitis
periodontitis is extension of inflammatory process from the gingiva into connective tissue and alveolar bone that supports the teeth. important area that involved is gingival sulcus a pocket between teeth and gums.
singns of periodontitis
-red, swollen
-bleeding during brushing or flossing
- pain, pressure when chewing
- loose or separating teeth
Bone loss from periodontal disease not grow back
Risk factors for periodontal disease
- smokingL have greater loss of attachment, bone loss, calculus formation and tooth loss.
- Poor oral hygiene: Plaque and calculus leads periodontitis.
- Osteoporosis: disease marked by porous bones. the lack of bone linked to loss of alveolar bone.
- medications: medication are a contributing factor to xerostomia. decrease in saliva leads to increased plaque and periodontal disease.
- stress: linked have been shown between high stress levels and periodontal disease.
systemic conditions linked to periodontal disease
studies shows shown that patinets woth periodontal disease have a higher development of cardiovascular disease
- cardiovascular disease
- respirort disease
- diabetes
-preterm birth and birthweight - HIV/AIDS
