Mod 9 Test 2 Flashcards
what is xerostomia a result of
polypharmacy, systemic conditions, nerve damage
what is xerostomia
pt perception of oral dryness
how many people experience dry mouth
1 in 4
what does xerostomia increase to in people over 55
40%
what are the top 10 medications that cause xerostomia
lipitor, hydrocodone/acetominophen, toporol, norvasc, amoxicillin, synthroid, nexium, lexapro, and albuterol
xerostomia is a _______
condition (not a disease)
what are some risk factors for dry mouth
canter tx, diabetes, hormones and stress, autoimmune disorders (sjogrens,aids, rheumatoid arthritis, lupus)
what can a sonicare tb do for dry mouth
helps to increase salivary flow
what are clinical signs of xerostomia
-inflammation tissue is tight and shiny secondary infections increase in caries halitosis painful cracked lips loss of taste difficulty swallowing
what home care would you give for a mouth breather
fluoride, biotene, sonicare, extrasoft tb, xylitol gum
saliva is _____% water
99
how many other components of saliva are there
60
what are some of the other substances contained in salvia
buffering agents enzymes minerals electrolytes proteins
What are the functions of saliva
- lubricate and protect
- buffer and clean
- tooth integrity
- antibacterial
- taste and digestion
what are important factors to look for when checking saliva
- pt report
- flow rate
- consistency (watery vs thick)
what is an unstimulated flow rate
pull the lip out and see how long it takes for saliva to come back
what are the dental impacts of dry mouth
higher decay rate
increase in tooth loss
secondary infection
increase effects of perio
what are the psychological impacts of xerostomia
quality of life
nutritional impact
non compliance iwth medications
which salivary gland produces the most saliva
submand–>parotid –> minor glands –>sublingal
what is sialometry
measurement of salivary flow rate below acceptable clinical levels
What saliva tests can be completed chairside
saliva check (wax cup, litmus paper), CRT buffer test
What is pathogen specific testing of saliva
take a sample collection, incubated for 48 hrs
what is the normal stimulated salivary flow?
unstimulated?
1-3 ml/min
.25-.35 ml/min
what is abnormally low stimulated salivary flow
1-.7ml/min
what is a hypofunction stimulated salivary flow
below .7 ml/min
what is a low unstimulated salivary flow
.1-.25 ml/min
what is a hypofunction unstimulated salivary flow
less than .1 ml/min
what is a health pH of the mouth
6.7 to 7.4
what is an abnormal ph of the mouth
5.5 to 4.5 acidic
what is the normal amt of saliva production per day
1 to 1.5 liters
what are some prescription meds used in drymouth tx
pilocarpine, fluorides
what are some OTC products used in tx of dry mouth
-saliva substitutes
-xylitol gums and rinses
sonic and ultrasonic tb
power toothbrushes
what is dentinal hypersensitivity
an exaggerated response to a sensory stimulus
in the US how many people have dentinal hypersensitivity
one in five
what kinds of things will be ruled out in a differential diagnosis for determining a pt has dentinal hypersensitivity
endo, cracked tooth, fractured restoration, malformations of enamel, sinusitis, caries
what is the pain like in a pt with dentinal hypersensitivity
mild to extreme pain
short, sharp
responds to stimuli
what are the 4 kinds of stimuli
evaporative, thermal, tactile, osmotic
what is evaporative stimuli
breathing, suction, drying teeth
what is osmotic stimuli
OJ, lemon juice, high sugar content
what are the two most common age ranges for dentinal hypersensitivity
20-30 and 40-50 (recession)
the more _______exposed the greater the degree of sensitivity
tubules
what is the most common cause of dentinal hypersensitivity
toothbrush abrasion
what are other etiologys of dential hypersensitivity
inadequate attached gingiva, perio disease/surgery, eating disorders, erosion caused by diet, RX, bruxism, abfraction, attrition, prominent teeth
what are the types of mechanical stimuli that cause hypersensitivity
toothbrush, instrumentation, clasps from partials, oral habits (toothpicks fingernails)
what are the types of thermal stimuli
air, food, drinks
what are the types of chemical stimuli
foods(wine, citrus, apple juice)
swimmers (chloriine)
what kind of stimuli is bleaching
chemical
the higher the percent of hydrogen peroxide in the bleach the ________ the chance of sensitivty
greater
what is the hydrodynamic theory*
fluid flow is disturbed by stimuli, and the osmotic changes of the fluid stimulate the nerve in the more pulpal portions of the dentin which causes pain
what kind of desensitizing mechanisms are there
nerve desensitization, protein precipitating agents, tubule occlusion, physical, laser
what is the mechanism of action of potassium nitrate
penetrated through tubules to the nerve and depolarizes it and prevents repolarization
what are prodcuts that have potassium nitrate
crest sensitivity, sensodyne max strength and proenamel, colgate senstivit
what are protein precipitating agents
fluorides
what is the mechanism of action of fluorides
group together to for blockage in tubules
what are examples of products with stannous fluoride
gel-kam, dentin bloc, omni, crest pro-health
what are examples of products with sodium fluoride
prevident
what can be used to seal tubules
dentin sealer without acid etch, precpitates and seals (bonding agent)
what are some products that provide tubule occlusion
gluma, quell sensitivity, ACT
what are 2 physical ways to help dentinal sensitivity
- periosurgery (conn. tissue grafting)
- restorations (composite, glass ionomer, crown)
Which laser is used in tx of hypersensitivity and how does it work
the Nd:YAG, fuses dentinal tubules
can senstivity improve with spontaneous remission
yes 20 to 40% do
what is demineralization
occurs almost immediately when we eat or drink fermentable carbs which get into the plaque and the bacteria produces acid which destroys minerals of the enamel
how does remineralization work
- calcium and phosphate penetrate into enamel and crystalize which fill in the space left by demineralization
what does fl2 do in remineralization
it a acts as a catalyst to move calcium phosphate more quickly in to the enamel and improves the quality of the crystal
what is amorphous calcium phosphate (ACP)
calcium and phosphor salts
what is ACP found in
arm and hammer toothpaste, enamel pro prophy paste
what is Recaldent
CCP-ACP
casien phosphopeptisdes and amorphous calcium phosphate
what does the CCP do
stablilizes the calcium phosphate and increases the level in dental plaque and saliva
who should you not use Recaldent on
pts with milk allergies
what are examples of recaldent products
MI Paste, trident white gum
what is microdent
patented ingredient for plaque control
what is the microdent product
control rx
What are the products in Novamin
bioactive glass compound made from calcium, phosphate, silica and sodium
what does novamin claim to do
relieve sensitivity and provide rapid remineralization
what are products that use novamin
-sultan products:
NUPRO NUsolutions
DuraSheild
ReNew
what product uses Pro Arginine
colgate sensitive relief
What does pro arginine doe
occludes tubule, amino acid, bicarbonate (buffers), calcium carbonate, applied in office with rubber cup
