Operative Dentistry

Question 1

FLOURIDE

Answer 1

1 promote remineralization
2 resist acid challenges
3 children up to 6years are prone to fluorosis
4 flouride water conc : .7 - 1. Ppm
5: flouride supplement like drops and tablets are illegal
6 first line in prevention of caries

Question 2

,. Recommended concentration of fluoride
toothpaste according to age and risk of dental ( not elevated risk)

Answer 2

1: . child younger than 18 months. - twice-daily brushing without toothpaste
2: child 18 months to younger than6 years- . 500 to 550 ppm (0.5 to 0.55 mg/g) fluoride
twice daily, pea-sized amount
3: . child 6 years to adolescent- 1000 to 1500 ppm (1 to 1.5 mg/g) fluoride twice daily
4. adolescent or adult. 1000 to 1500 ppm (1 to 1.5 mg/g) fluoridetwice daily

Question 3

Toothpaste for people at elevated risk of dental caries

Answer 3

18 month. - twice-daily brushing with toothpaste may be
recommended .
18-6 years. - 1000 ppm twice
6 yrs - adolescent -1000-1500

Adolescent- adult- 5000 ppm

Question 4

Flouride mouthwash

Answer 4

Above 6 years and adult. 220 ppm neutral mw. rinse in the mouth for 1 minute at a time of day when
900 ppm. Use in adults and children 6 years or older weekly or more frequently if indicated. Patients should rinse in the-mouth for 1 minute at a time of day when toothpaste isn’t used

Question 5

Flouride varnish

Answer 5

22600 ppm
Above 1 year. Twice a year

Question 6

acidulated phosphate
fluoride gel or foam
12 300 ppm

Answer 6

Twice a year , 10 year above
4 min tray

has better enamel uptake;
however, avoid acidulated gels and foams in patients
with ceramic crowns and bridgework, direct restorations
containing glass particles, or poor salivary flow (eg
patients undergoing head or neck irradiation

Question 7

neutral fluoride gel or foam

Answer 7

5000-9000 ppm. adults and children (age restriction variable)
usually twice a year depending on dental caries risk.
Can be used for patients with ceramic crowns and
bridgework, direct restorations containing glass particles,
or poor salivary flow
4 min using tray

Adults can use neutral fluoride gel or foam at home,
according to recommended instructions

Question 8

silver fluoride formulations. SDF

Answer 8

Adult and children twice a year arrest caries stain teeth black

Question 9

Flouride + acp-cup

Answer 9

900-10% cream
Non cavitation white spot twice daily after brushing with flouride tooth paste

Patients should apply the cream to the teeth, hold in
the mouth for 3 to 5 minutes, spit out excess and avoid
rinsing the mouth

Question 10

Flouride+ cop-acp

Answer 10

22600+2% varnish
Non noncavitated white spot

Question 11

Chlorhexidine

Answer 11

Limited role in prevention of dental caries
Preventive plaque formation on cleaned tooth surface
Reduce level of cariogenic bacteria
Uses
Chlorhexidine+flouride 0.2% + 0.0033%gel brushed on to the teeth daily or weekly

Chlorhexidine 0.5% gel brushed on to the teeth daily or weekly

For dental caries management, chlorhexidine gel is preferred to
mouthwash:
• alcohol-containing chlorhexidine mouthwashes may increase the risk
of oral cancer, and cannot be used in children younger than 12 years
• alcohol-free chlorhexidine mouthwashes have a short expiry after
opening.
*When used for more than a few days, chlorhexidine may cause a superficial discolouration

Question 12

Dental caries radiographic scoring

Answer 12

C0: no radiolucency
C1 radiolucency is evident within the outer half of enamel
C2 inner half of enamel
C3 just beyond DEJ
C4 outer third of denting
C5 inner two third of denting may reach pulp

Question 13

Progression of dental caries

Answer 13

Pulpit is - pulp necrosis- infection to root canal system- apical periodontitis- periapical abscess- spreading odontogenic infection