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Pharm 129 > Oral care > Flashcards

Oral care Flashcards

1
Q

What is the most common childhood condition

A

dental caries

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2
Q

When do wisdom teeth appear

A

between ages 17 - 21

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3
Q

What is the order of the teeth in the permanent dentition

A 
central incisor (4)
lateral incisor (4)
cuspids/canines (4)
premolars/bicuspids (8)
molars (12)
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4
Q

What is the most common site of dental caries

A

molars

pits and fissures harbor cariogenic bacteria

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5
Q

how many teeth do adults have

A

28 +/- 4 wisdom teeth (third molars)

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6
Q

What is the function of incisors

A

bite off pieces of food

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7
Q

function of cuspids

A

sharp - cut food when you bite

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8
Q

functions of premolars

A

large and strong - crush and grind food

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9
Q

function of molars

A

grinding and chewing food

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10
Q

What is the anatomy of a tooth

A

Crown (above gums) and root (below)

Enamel -> Dentin -> pulp

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11
Q

What is saliva

A

alkaline, slightly viscous, clear secretion containing enzymes, albumin, epithelial mucin, immunoglobulin, leukocytes, and minerals (Ca+, phosphate, fluoride ions)

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12
Q

what are the 3 salivary glands

A

parotid
sublingual
submandibular

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13
Q

what is the function of saliva

A
  • Maintain neutral oral pH
  • Tooth remineralization, cleansing and shielding
  • Mouth lubrication
  • Local antimicrobial activity
  • Assists in taste, speech, chewing, swallowing, digestion and nutrition
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14
Q

What happens without saliva

A
  • risk of bacterial/fungal infections
  • certain medications will not work
  • gum disease more common
  • dry mouth
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15
Q

how much saliva is produced per day

A

500 mL

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16
Q

What is dental plaque (“biofilm”)

A
  • gelatinous deposit (aerobic & anaerobic bacteria) adherent to the tooth surfaces, fillings or dental prostheses
  • begins to calcify if not removed within 24 hours
  • Buildup is directly related to incidence of oral disease
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17
Q

What are the 2 types of dental plaques

A

Supragingival - white to yellow, can remove at home within 48 hours
Subgingival - can only be removed by professional cleaning

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18
Q

What is dental calculus (“tartar”)

A
  • The calcification of existing plaque deposits on the teeth or any other hard surface in the mouth
  • Dental plaque presence is a prerequisite for calculus
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19
Q

What are the types of dental calculus

A

supragingival - Yellowish colour that may be darkened by dietary or exogenous pigmentation (coffee, tea, red wine, nicotine)
subgingival - dark colour and is very adherent to the cementum of the tooth

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20
Q

How do bacteria lead to dental caries

A
  • bacteria metabolize carbs from diet to produce lactic acid
  • acid demineralizes tooth surface (due to lower pH)
  • saliva remineralizes
  • over time, saliva cannot keep up
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21
Q

What is the process of dental caries formation

A
  1. enamel demineralization
  2. extension of demineralized zone into dentin (+ bacterial invasion)
  3. collapse of surface layer to form cavity
  4. spread of caries lesion causing pulpits - (requires filling)
  5. extension of pulpits into apex (apical abscess) - (requires surgery)
22
Q

What are risk factors for dental caries

A

Patients with:

  • Poor oral hygiene
  • Orthodontic appliances
  • Xerostomia
  • Gum tissue recession that exposes root surfaces

Other Predisposing Factors:

  • Tobacco products
  • Alcohol
  • Certain medications
  • Head and neck radiation
  • Consumption of cariogenic foods
23
Q

Goals of treatment

A
  1. Protect & strengthen tooth structure
  2. Reduce the amount of substrate available to the bacteria (by modification of diet)
  3. Remove plaque and calculus regularly
24
Q

How to modify diet to prevent plaque

A
  • Avoidance of cariogenic foods (>15% sugar)
  • Limiting sucrose
  • Sugarless gum (stimulates salivary flow)
  • Limit carbs that can be metabolized by bacteria
25
Q

How to prevent oral bacteria

A

Plaque removal through brushing, flossing, and other devices

26
Q

How to prevent host resistance

A

Antiplaque products

27
Q

Pharm therapy: fluoride

A

Product: Prevident 5000 Plus
Ingredients: Sodium Fluoride (NaF), Stannous Fluoride, Sodium Monofluorophosphate (MFP)

*Caries protection and treatment; Stannous Fluoride may stain teeth- only for >12 years old

28
Q

Pharm therapy: Tartar-control

A

Product: Crest Tartar Gel/ Toothpaste
Ingredients: Pyrophosphates, Triclosan, Zinc Citrate

*Prevents supragingival calculus (not subgingival or existing tartar)

29
Q

Pharm Therapy: Antiplaque/antigingivitis

A

Product: Colgate total
Ingredients: Triclosan + Fluoride

*Antibacterial and promoter of substantivity

30
Q

Pharm Therapy: Whitening/antistain

A

Product: Colgate optic white
Ingredients: Peroxides, Sodium tripolyphosphate (STP),
Titanium dioxide (makes toothpaste white)

*May work by breaking down pigments that accumulate on or in the tooth enamel. Some stains can’t be removed by them.

31
Q

What are detergents and what do they do

A

Sodium Lauryl Sulfate, Sodium-N-lauryl sarcosinate (less irritating)

  • Foaming action may increase the solubility of plaque during brushing
  • not in childrens products

AE’s:

  • development of AU
  • aggravates dry mouth
  • SLS more irritating
32
Q

What are abrasive agents and what do they do

A

CaCO3, silicates, phosphate salts, MgCO3, Aluminum trihydrate
- Remove surface stains; whiten/ polish teeth

May cause burning sensation, drying of mucous membranes, taste alteration, gingival abrasion or enamel erosion

33
Q

What are ingredients that help with tooth densensitization

A

Potassium Nitrate, Strontium Chloride, Strontium Acetate

Reduce pain from sensitive teeth by physically blocking the tubules in the exposed dentin.

34
Q

What ingredients prevent tartar formation

A

Pyrophosphates, Triclosan, Zinc Citrate

  • Do not affect subgingival or existing calculus.
  • MOA not established
35
Q

What ingredients prevent gingival inflammation

A

Stannous fluoride, triclosan, zinc citrate
Reduce plaque accumulation through antibacterial activity.
SF may interact w chlorhexidine

36
Q

What are examples of humectants and what do they do

A

glycerol, propylene glycol, sorbitol
- Prevent toothpaste from drying out

Xylitol is an uncommon, but superior humectant, which also boosts fluoride’s cavity-fighting power (stimulates salivary flow, increases pH)

37
Q

What to look for on dental products

A

CDA approved

38
Q

How does fluoride prevent caries

A

Binding of fluoride to the hydroxyapatite leads to the formation of fluoroapatite, which makes the enamel harder and more resistant to decay.

39
Q

What are side effects of high intake of fluoride

A

N/V, abdominal pain, synovitis, GI bleeding

Weight loss
Anemia
Bone development issues
Fluorosis

40
Q

What is fluorosis

A

caused by an increased intake of fluoride during permanent tooth formation (irreversible)

  • Mild: chalk-like, lacy markings on the enamel.
  • Moderate: White opacity can be seen on more than 50% of the tooth
  • Severe: brown, pitted, brittle enamel
41
Q

What schedule are systemic agents of fluoride supplementation in

A

> 1 mg fluoride: Class I

<1 mg: Class III

42
Q

What is the optimal concentration of fluoride in drinking water

A

0.7mg/L (0.7ppm)

43
Q

Fluoride supplementation recommendations?

A
  • not recommended where community drinking water contains 0.7 ppm or more of Fluoride
  • not recommend the use of supplements before the eruption of the first permanent tooth
44
Q

What is the dosing for fluoride supplementation

A

appropriate dosing should ensure the total daily intake does not exceed 0.05-0.07 mg/kg body weight to minimize risk of dental fluorosis

45
Q

When is the most susceptible age for fluorosis

A

0 to 6 years, especially between the ages of 15 and 30 months.

46
Q

What are the requirements for taking fluoride supplementation

A

> 6 mo
fluoride in drinking water is <0.3 ppm
child does not brush teeth at least BID
child is susceptible to high caries activity

47
Q

Oral health tips for birth - 12 mo

A 
Wipe gums BID
Clean baby teeth and gums
Avoid bottles in bed
------------------
After 6 mo: 
Introduce sippy cup 
Avoid juice
Don’t sweeten a soother
48
Q

Oral health tips for ages 1-2

A 
First dental visit 
Brush BID
Check for signs of tooth decay monthly
Switch to regular cup for all drinks
Limit soother use
49
Q

Oral Health tips for ages 3-4

A

“2 for 2”
• Brush BID x 2 min each time
Start fluoride toothpaste

50
Q

Pacifier effect on dentition

A

Potential Complications: dental caries, malocclusion, gingival recession (Only occur with prolonged (>5y) or inappropriate use)

  • CDA: pacifiers over thumb sucking
    Easier to wean off
    Ensure pacifier is clean, unsweetened

Pharm 129 (14 decks)

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