Plaque control Flashcards

1
Q

Why is it important to control plaque?

A

important in control of gingivitis and maintaining good oral health, preventing dental caries and periodontal disease

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2
Q

How can we control plaque?

A

mechanical removal via brushing or flossing or prophylaxis using antimicrobials

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3
Q

What is the optimum concentration of fluoride in water supply and why is it used?

A

1 ppm, influences remineralization of enamel, makes it more resistant to acids therefore reduces caries, can inhibit the metabolism (glycolysis) of some plaque bacteria

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4
Q

What is fluoridosis?

A

staining from excess fluoride

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5
Q

Because there is a short contact time in the mouth, what must antimicrobials be able to do?

A

bind to the oral mucosa

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6
Q

Why are antimicrobials formulated into oral health products?

A

Most people cannot maintain oral health using mechanical methods alone

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7
Q

Once antimicrobial agents are adsorbed to the mouth what happens?

A

they are slowly released back into oral environment, re-distributed around the mouth

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8
Q

What is Chlorhexidine?

A

a broad spectrum oral antimicrobial which binds to surfaces well and reduces plaque, caries and gingivitis

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9
Q

What can long term use cause?

A

staining and mucosal irritation

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10
Q

What type of formulation is chlorhexidine added to?

A

mouthwash, gel, varnish

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11
Q

What is Triclosan and how does it work?

A

a broad spectrum antimicrobial, a phenol, it selectively inhibits obligately anaerobic gram-negative bacteria, multiple modes of action: Inhibits acid production, reduces inflammation, inhibits bacterial fatty acid metabolism

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12
Q

How can Triclosan be enhanced?

A

by formulation with a co-polymer or zinc citrate because zinc ions inhibit sugar transport, acid production and protease activity.

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13
Q

What formulation is triclosan used in?

A

paste

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14
Q

What do Dextranases and glucanases do?

A

modify plaque matrix

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15
Q

What does glucose oxidase and amyloglucosidase do?

A

boost salivary peroxidase system (antimicrobial system in saliva)

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16
Q

What does menthol, thymol and eucalyptol do?

A

can penetrate plaque also adds colour and taste

17
Q

Why are oils used in formulations?

A

disrupt cell membranes and inhibit enzymes

18
Q

What do quaternary ammonium compounds do?

A

broad spectrum antimicrobials, cationic, binds to bacterial cell membranes and disrupts integrity, Inhibits glucan synthesis and co-aggregation step of plaque formation

19
Q

QACs can only be formulated as what?

A

mouthwash

20
Q

What type of metal ions are used in formulations?

A

zinc or stannous salts

21
Q

What do zinc salts do?

A

inhibits bacterial glycolysis (from making glucose), may be synergistic with other antimicrobials

22
Q

What does Zinc lactate do?

A

inhibits VSC (volatile sulfur compounds) production, end product of bacterial anaerobic metabolism (foul smell)

23
Q

What does stannous fluoride do?

A

inhibits caries formation, reduces dental hypersensitivity

24
Q

What surfactant is commonly used in oral health products?

A

SLS, Sodium Lauryl sulfate

25
Q

Why are surfactants used in oral health products?

A

they have detergent properties therefore disrupts lipids, they are bactericidal and inactivate bacterial enzymes, they foam to coat the teeth and remove organic matter to bulk phase

26
Q

What is a downside to surfactants?

A

some people may be allergic, foaming can inhibit enzymes from working

27
Q

What happens to arginine when in contact with oral bacteria and what is it used for?

A

metabolised to ammonia containing end-products by oral bacteria, arginine salts increase pH keeping it above critical caries levels

28
Q

What is an additional use of arginine

A

As a sensitivity blocker (blocks dental tubules).

This use requires a higher conc of arginine

29
Q

What sugar substitutes are used and what is the purpose of using them?

A

aspartame & saccharin, prevent caries as they are not metabolised by plaque bacteria. Sorbitol, mannitol & lactitol used in sugar free chewing gums

30
Q

What are the potential benefits of using oral probiotics?

A

potential life-long protection, good patient compliance

31
Q
  1. What is the role of pharmacists in oral health?
A

health promotion, encourage patients to brush twice daily, encourage patients to reduce intake of free sugars, smoking cessation, encourage patients to reduce alcohol consumption