Oral Healthcare Issues

Question 1

What keeps your teeth from falling out?

Answer 1

periodontal ligament

glues teeth to bone

Question 2

How many teeth by age 3?

Answer 2

20

8 incisors + 4 canines + 8 molars

Question 3

How many teeth does an adult have?

Answer 3

32

8 incisors + 4 canines + 8 premolars + 12 molars

Question 4

Early Childhood Carries

Answer 4

Infectious and transmissible
Destroys tooth structure
Affects children under 5

Question 5

Etiology of carries

Answer 5

Oral bacteria (Mutans Strep) break down dietary sugars into acids which eat away the tooth

Mutans Strep is vertically transmitted from primary caregiver

How often sugar is eaten is more important than how much sugar is eaten at once

Question 6

White spots on teeth

Answer 6

Indicate that acids have demineralized enamel

First clinical signs of caries

Indication for dental referral

Question 7

Preventing early childhood caries

Answer 7

Screening exams
Oral hygiene: brush 2x daily
Dietary guidance
Fluoride
Inform/advise about dental sealants
Age 1 dental visit
Improve parent oral health and dietary habits

Question 8

Oral cancer and pre-cancer

Answer 8

Alcohol and tobacco increase risk of oral cancers
Early lesions may be asymptomatic
Look at lateral tongue, floor of mouth, inside of lips

Question 9

Periodontal disease (etiology and types)

Answer 9

Etiology: Chronic plaque at gum line, bacterial infection, host inflammatory response

Types: Gingivitis, chronic periodontitis, aggressive periodontitis

Question 10

Gingivitis

Answer 10

Mildest form of PD

Mild gum swelling, tenderness, erythema, gums bleed during brushing, can occur acutely with foreign body, reversible

Etiologies: Plaque, pregnancy, disease, trauma

Question 11

Chronic periodontitis

Answer 11

More severe than gingivitis

Infection and inflammation induce loss of bone and tooth attachment

Rare in children, present in 50% of adults

Smoking a major risk

Prevention: good oral hygiene, brushing and flossing, avoid tobacco

Question 12

Aggressive periodontitis

Answer 12

Otherwise healthy

Rapid attachment loss and bone destruction

Amount of microbial deposits inconsistent with disease severity

Familial association

Question 13

What systemic diseases are linked to oral health?

Answer 13

Invective endocarditis
Prosthetic device infection
Diabetes

Emerging evidence: 
Obesity
CAD
Adverse pregnancy outcome
Lower respiratory disease

Question 14

Diabetes and oral heath

Answer 14

Poor glycemic control associated with 3x increase risk of periodontitis

A chronic infection (like periodontal disease) complicates glucose control

Question 15

Coronary heart disease and periodontitis

Answer 15

Associated but causation is not clear

Systemic Ab response to periodontitis IS associated with CHD

Smoking is associated with both

Elevated CRP levels in both

Question 16

Pregnancy: preeclampsia

Answer 16

Women with periodontitis were twice as likely to develop preeclampsia and specific organisms were associated

Endothelial cell damage due to inflammatory mediators is a proposed mechanism

Question 17

Lower respiratory disease

Answer 17

Chronic aspiration of bacteria

Hospitalized/ventilated pts are particularly at risk

Question 18

Iatrogenic: xerostomia

Answer 18

Decreased saliva promotes periodontal disease

Steroids
Antihistamines
Diuretics
Antihypertensives
Anticholinergics 
Antidepressants

Question 19

What is the most common chronic disease of childhood?

Answer 19

Dental caries
5x more likely than asthma
50% in low income children

Question 20

Until what age do kids need help brushing their teeth?

Answer 20

6 years

Question 21

What age do kids start to get teeth

Answer 21

6 months

Question 22

What causes dental cavities

Answer 22

sugar, bacteria, teeth