Mod 9 Test 2 Flashcards by Hailey Fawson

what is xerostomia a result of

polypharmacy, systemic conditions, nerve damage

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what is xerostomia

pt perception of oral dryness

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how many people experience dry mouth

1 in 4

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what does xerostomia increase to in people over 55

40%

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what are the top 10 medications that cause xerostomia

lipitor, hydrocodone/acetominophen, toporol, norvasc, amoxicillin, synthroid, nexium, lexapro, and albuterol

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xerostomia is a _______

condition (not a disease)

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what are some risk factors for dry mouth

canter tx, diabetes, hormones and stress, autoimmune disorders (sjogrens,aids, rheumatoid arthritis, lupus)

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what can a sonicare tb do for dry mouth

helps to increase salivary flow

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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

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what home care would you give for a mouth breather

fluoride, biotene, sonicare, extrasoft tb, xylitol gum

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saliva is _____% water

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how many other components of saliva are there

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what are some of the other substances contained in salvia

buffering agents
enzymes
minerals
electrolytes
proteins

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What are the functions of saliva

lubricate and protect
buffer and clean
tooth integrity
antibacterial
taste and digestion

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what are important factors to look for when checking saliva

pt report
flow rate
consistency (watery vs thick)

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what is an unstimulated flow rate

pull the lip out and see how long it takes for saliva to come back

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what are the dental impacts of dry mouth

higher decay rate
increase in tooth loss
secondary infection
increase effects of perio

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what are the psychological impacts of xerostomia

quality of life
nutritional impact
non compliance iwth medications

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which salivary gland produces the most saliva

submand–>parotid –> minor glands –>sublingal

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what is sialometry

measurement of salivary flow rate below acceptable clinical levels

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What saliva tests can be completed chairside

saliva check (wax cup, litmus paper), CRT buffer test

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What is pathogen specific testing of saliva

take a sample collection, incubated for 48 hrs

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what is the normal stimulated salivary flow?

unstimulated?

1-3 ml/min

.25-.35 ml/min

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what is abnormally low stimulated salivary flow

1-.7ml/min

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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