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Pharm 129 > Oral Hygiene > Flashcards

Oral Hygiene Flashcards

1
Q

What is the total population affected by oral health across the world

A

3.9B (34% of world pop)

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2
Q

Inequities in oral health in canada

A
  • lower income more likely to have dental problems/worst outcomes
  • Inuit
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3
Q

What is enamel

A

hard outer coating protecting crown

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4
Q

What is dentin

A

hard substance beneath enamel; makes up bulk of tooth

transports nutrients from pulp

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5
Q

what is pulp

A

soft tissue in middle of the tooth
consists of vascular and neural tissue
if exposed to decay, infection can occur

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6
Q

what is cementum

A

hard tissue covering root & attaches it to jawbone

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7
Q

What is biofilm

A

Sticky, mat-like microbial communities
• Organisms cooperate (synergistic)
• Teamwork ensures their mutual survival
• 700 oral microbial species contribute to dental plaque biofilm

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8
Q

How does biofilm form

A
  1. Initial adherence
    - tooth surface covered by acquired pellicle (protects tooth from lactic acid)
    - primary bacteria (mainly G+) bind to pellicle
  2. Lag phase
    - shift in genetic expression, lag in bacterial growth
  3. Rapid growth
    - other types of bacterial bind
    - primary: G+ cocci (streptococcal)
    - secondary: fusobacterium species
    - final: pathogenic G-
  4. Steady state/detachment
    - some bacteria disperse to colonize other areas of the mouth
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9
Q

How does biofilm cause oral disease?

A
  • accumulation on tooth surfaces often leads to caries
  • Accumulation along & under the gingival margin often leads to gingivitis
    • Chronic gingivitis -> periodontitis
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10
Q

What bacteria is involved in endocarditis, brain abscesses, artery plaque, aneurysmal wall and tissues

A

A. actinomycetemcomitans

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11
Q

What bacteria is involved in diabetes, heart attack, artery plaque, aneurysmal wall and tissues

A

T. forsythia

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12
Q

What bacteria is involved in oral cancers, oral abscesses, ASVD, CVD, CVA

A

T. denticola

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13
Q

What bacteria is involved in diabetes, rheumatoid arthritis, kidney disease, MS, atheromatosis, atherosclerosis

A

P. gingivalis

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14
Q

What is the keystone pathogen of many systemic diseases

A

P. gingivalis
• Translocates during normal oral hygiene activities
• Deposits in the tissues of the heart, liver, placenta
• Systemic spread happens quickly and gradually -> chronic & pathologic inflammatory response
• Highest proteolytic activity; induces dysbiosis; produces endotoxins (e.g., LPS) -> pro-inflammatory cytokine release

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15
Q

What is the relationship between cardiovascular health and PD

A
  • association (not causative)
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16
Q

What is the relationship of diabetes and PD

A

Diabetes: have a higher prevalence of PD as diabetes is a risk factor, poor blood glucose control is associated with PD

PD: increases systemic inflammation which reduces ability to use insulin - contributes to blood glucose control problems

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17
Q

Relationship between gastrointestinal health and PD

A
  • GI = highway from oral cavity

- Pancreatic cancer associated with H. pylori and P. gingivalis

18
Q

Relationship between pulmonary health and PD

A

Pulmonary diseases characterized by:
• Inflammatory mediators found in saliva & gingival crevicular fluid
• Oropharyngeal structures serve as reservoirs that harbour bacteria

*no evidence that PD CAUSES disease

19
Q

Liver disease and PD

A
  • contain large number of oral microbes like P. gingivalis

- cirrhosis

20
Q

Systemic Lupus Erythematosis and PD

A

Characterized by persistent inflammation -> organ damage

• Linked to microbial dysbiosis

21
Q

Rheumatoid arthritis and PD

A
  • Characterized by chronic inflammation
  • Linked to microbial dysbiosis
  • Oral antiseptic treatment for PD has been shown to be protective against RA-induced bone loss
22
Q

Dementia and PD

A
  • strong association
  • P. gingivalis (and proteases called gingipains) found in brain of Alzheimer’s patients

Bi-directional relationship
• Cytokines from oral cavity -> bloodstream/brain
• Alzheimer’s patients -> poorer oral hygiene, inability to report pain

23
Q

Pregnancy and PD

A

Hormonal changes can cause: Pregnancy gingivitis, Gestational diabetes, Gingival hypertrophy, Gastric reflux

PD increases risk of
• Preeclampsia
• Low-birth weight
• Preterm birth
• Stillbirth
• Spontaneous abortions
24
Q

What are risk factors for caries and PD

A
  • poor oral hygiene
  • age
  • poor nutrition
  • diabetes
  • xerostomia
  • frequent alcohol use
  • tobacco use
  • medications
  • gum tissue recession
  • orthodontic appliances
  • pregnancy
25
Q

What info to assess (from patients)

A
  1. Medical, medication, and social history
  2. State of dentition and other considerations for oral care
  3. Current oral care regimen
  4. Visible changes to teeth or oral cavity, or other dental/oral-related complaints
26
Q

What are non-pharm prevention measures

A
  • Tooth brushing 2x per day with an CDA-accepted fluoride toothpaste + floss everyday +/- mouthwash
  • Limit alcohol & avoid smoking
  • Dietary Modifications
  • Visit a dental professional regularly for professional cleanings and examination
27
Q

When and how long to brush teeth

A

Should be done after every meal and at bedtime (or at least twice daily)
• Minimum time required to effectively remove plaque is 2 minutes

28
Q

What type of toothbrush should be used

A
  • soft/ultra soft
  • round bristles
  • should reach back teeth
  • replaced every 3 months
  • powered brushed > manual
29
Q

When to floss

A
  • every 24 h (before bed)

- before brushing teeth

30
Q

Who should use waxed vs unwaxed floss

A

Unwaxed floss is suitable for most people, but if it does not slide easily between the teeth, a waxed floss can be used
• However, hypersensitivity to waxed floss has been reported

31
Q

Who would benefit from interdental brushes

A

Useful for patients with braces, dental implants, etc
May be helpful for removing plaque from areas difficult to
reach with a toothbrush and regular floss

32
Q

Who would benefit from irrigating devices

A

Might be useful for patients with orthodontic appliances, after oral surgery, or patients with manual dexterity issues
• Removes food debris and possibly some plaque from teeth

33
Q

What is a stimulator

A

Removes plaque by applying contouring pressure to hyperplastic gingival papillae

34
Q

What are the 2 types of mouthwashes

A
  1. Cosmetic - May temporarily control bad breath and leave behind a pleasant taste (does not address cause)
  2. Therapeutic - Have active ingredients intended to help control or reduce conditions like bad breath, gingivitis, plaque, and tooth decay
35
Q

Chlorhexidine gluconate

A

Schedule 1
plaque reduction
binds to dental surfaces and releases over time (“timed release of antimicrobial”)
cannot be used long-term
interacts with stannous fluoride (wait 30 mins between if using both)

36
Q

Cetylpyridinium chloride (CPC)

A

moderate plaque reduction
Releases from dental surfaces at a much faster rate than chlorhexidine, resulting in lower effectiveness
concentration as active ingredient is 0.07%, in cosmetic mouthwash <0.045%

37
Q

Essential Oils

thymol, menthol, eucalyptol, methyl salicylate

A

High plaque reduction
some products have a high alcohol content; may cause burning sensation, bitter taste, or mucosal drying
not recommended for children

38
Q

Sodium Fluoride

A

Treats and prevents caries
• 0.2% rinse once weekly is recommended as nonrestorative treatment for caries
• Lower concentrations (0.05%) are used to prevent caries in high-risk individuals

not for <6 years of age
oxygenating agents (e.g., 1.5% hydrogen peroxide (Peroxyl®)) are not recommended because of lack of efficacy and potential adverse effects
39
Q

Common inactive ingredients in therapeutic mouthwashes

A

Water: vehicle for carrying ingredients to site of action
Alcohol: Acts as a solvent, vehicle, and preservative
Flavouring agent: Adds a freshening or cooling quality; improve breath aroma
Humectant: Adds “body” to the liquid; provides a feeling of cleanliness
Surfactant: Solubilizes the flavor oils; stabilizes the mouthwash formula

40
Q

What mouthwash does the CDA recommend for daily use

A

essential oil

Pharm 129 (14 decks)

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