Plaque control Flashcards
Why is it important to control plaque?
important in control of gingivitis and maintaining good oral health, preventing dental caries and periodontal disease
How can we control plaque?
mechanical removal via brushing or flossing or prophylaxis using antimicrobials
What is the optimum concentration of fluoride in water supply and why is it used?
1 ppm, influences remineralization of enamel, makes it more resistant to acids therefore reduces caries, can inhibit the metabolism (glycolysis) of some plaque bacteria
What is fluoridosis?
staining from excess fluoride
Because there is a short contact time in the mouth, what must antimicrobials be able to do?
bind to the oral mucosa
Why are antimicrobials formulated into oral health products?
Most people cannot maintain oral health using mechanical methods alone
Once antimicrobial agents are adsorbed to the mouth what happens?
they are slowly released back into oral environment, re-distributed around the mouth
What is Chlorhexidine?
a broad spectrum oral antimicrobial which binds to surfaces well and reduces plaque, caries and gingivitis
What can long term use cause?
staining and mucosal irritation
What type of formulation is chlorhexidine added to?
mouthwash, gel, varnish
What is Triclosan and how does it work?
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
How can Triclosan be enhanced?
by formulation with a co-polymer or zinc citrate because zinc ions inhibit sugar transport, acid production and protease activity.
What formulation is triclosan used in?
paste
What do Dextranases and glucanases do?
modify plaque matrix
What does glucose oxidase and amyloglucosidase do?
boost salivary peroxidase system (antimicrobial system in saliva)
What does menthol, thymol and eucalyptol do?
can penetrate plaque also adds colour and taste
Why are oils used in formulations?
disrupt cell membranes and inhibit enzymes
What do quaternary ammonium compounds do?
broad spectrum antimicrobials, cationic, binds to bacterial cell membranes and disrupts integrity, Inhibits glucan synthesis and co-aggregation step of plaque formation
QACs can only be formulated as what?
mouthwash
What type of metal ions are used in formulations?
zinc or stannous salts
What do zinc salts do?
inhibits bacterial glycolysis (from making glucose), may be synergistic with other antimicrobials
What does Zinc lactate do?
inhibits VSC (volatile sulfur compounds) production, end product of bacterial anaerobic metabolism (foul smell)
What does stannous fluoride do?
inhibits caries formation, reduces dental hypersensitivity
What surfactant is commonly used in oral health products?
SLS, Sodium Lauryl sulfate
Why are surfactants used in oral health products?
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
What is a downside to surfactants?
some people may be allergic, foaming can inhibit enzymes from working
What happens to arginine when in contact with oral bacteria and what is it used for?
metabolised to ammonia containing end-products by oral bacteria, arginine salts increase pH keeping it above critical caries levels
What is an additional use of arginine
As a sensitivity blocker (blocks dental tubules).
This use requires a higher conc of arginine
What sugar substitutes are used and what is the purpose of using them?
aspartame & saccharin, prevent caries as they are not metabolised by plaque bacteria. Sorbitol, mannitol & lactitol used in sugar free chewing gums
What are the potential benefits of using oral probiotics?
potential life-long protection, good patient compliance
- What is the role of pharmacists in oral health?
health promotion, encourage patients to brush twice daily, encourage patients to reduce intake of free sugars, smoking cessation, encourage patients to reduce alcohol consumption
