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Periodontal Disease > Plaque Control and Patient Advice > Flashcards

Plaque Control and Patient Advice Flashcards

1
Q

which type of toothbrush ahas the most effective inter-proximal efficacy

A

one with multilevel profiles

NB. an oscillating powered toothbrush is the only type to outperform a manual tooth brush

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2
Q

will give toothbrushing instruction after using plaque disclosing tablet. what should the PFS be

A

> 70%

OR 80% if perio sugery

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3
Q

what should you consider when giving patient OH advice

A
  • patient tailored
  • never expect them to change more than 1 thing during a single session
  • evaluate patient progress from session to session
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4
Q

key features of the modified bass technique

A

bristles need to get a few mm inside the sulcus

locate brush 45 degrees on margin

back and forth OR circular motions

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5
Q

key toothpaste ingredients

A 
20-40%  abrasives
20-40% h20
20-40% humectants 
1-2% foaming agent
2% binding agent 
2% flavouring agent
2% sweetening agent 
5% therapeutic agent (fluoride/ de-sensitising)
less than 1% colouring/ preservative
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6
Q

what does ‘pharmacological plaque control’ mean and give examples

A

it means that chemical compounds are prescribed to supplement the usual brushing/ flossing

e. g. colgate total (tricoslan)
e. g. crest pro health (stannous salts like stannous fluoride are key against caries, plaque and gingivitis)
e. g. oral b expert (sodium hexmetaphosphate)

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7
Q

which pharmacological plaque controls have ADAs seal of acceptance for many toothpaste categories

A

crest pro health
colgate total

both have ADAs acceptance as ANTI CARIES products with 0.243% NaFl

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8
Q

features of tricoslan (found in colgate total)

A
  1. anti septic
  2. broad spectrum anti-bacterial agent
  3. used widely as an OTC product
  4. safe to use in dentrifies
  5. has no/ little substantivity
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9
Q

triclosan oral retention is improved by a copolymer called

A

gantrex (made of methoxy-ethylene and maleic acid)

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10
Q

definition of ‘anti-calculus agent’

A

designed to interrupt the process of mineralisation of plaque to calculus due to the super saturation of saliva with calcium and phosphate ions

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11
Q

example of an anti calculus agent

A

pyrophosphates

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12
Q

examples of anti-hyper sensitivity products and what they contain

A
  1. rembrandt sensitive = sodium citrate
  2. sensodyne total care F= potassium nitrate. also HAS NaF, and takes 2-4 weeks for relief
  3. sensodyne original = strontium chloride. NO NaF
  4. sensodyne rapid relief= strontium acetate. HAS NaF. NO novamin (sodium lauryl sulphate). 60 second relief!
  5. sensodyne repair and protect= calcium- sodium phosphosillicate.
    For patients with exposed dentine. builds up a reparative layer. HAS sodium mono- fluoro- phosphate (NA MFP), novamin
  6. colgate sensitive= potassium citrate. HAS NA MFP, novamin
  7. colgate pro relief= arginine. HAS NA MFP, novamin
  8. colgate gel kam sensitive= 0.4% stannuous fluoride.
    this is a low abrasive gel for caries prevention.
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13
Q

interdental brush is more superior to floss thus we use this except for when…

A

there is TIGHT inter-proximal contact

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14
Q

there are 4 types of interdental papillae.

type 1 interdental papillae features

A

INTACT interdental papillae

NARROW interdental space

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15
Q

type 2 inter-dental papillae features

A

MODERATE papillary recession

slightly open interdental space

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16
Q

type 3 interdental papillae features

A

complete loss of papillae

open interdental space

17
Q

type 4 interdental papillae features

A

wide embrasure space
diastema
furcation
posterior surface of most distal molar

18
Q

for each type of inter-dental papillae, which type of interdental cleaning method would you recommend

A

type 1= dental floss
type 2= dental floss/ small ID brush
type 3= TePes/ ID brushes
type 4= single tufted/ end tufted brush OR graze strip

19
Q

where is bacteria on tongue and why would you recommend tongue cleaning

A

posterior/ dorsum of tongue has a lot of bacteria= halitosis
tongue cleaning= reduces halitosis and tongue coating

20
Q

oral irrigators are effective against …but not___

A

gingivitis but not plaque accumulation

21
Q

anti-mircobials can be local or systemic. what is the difference between what they are effective against

A

local anti- microbials= directed against SUPRA gingival plaque (mouthrinses, enzymes, phenolic antiseptics, metal ions, natural products)

systemic anti-microbials= directed against SUB gingival plaque

22
Q

define substantivity

A

the ability of a drug to absorb / and bind to hard soft tissues. this depends on the concentration of drugs, pH, T, and length of time of contact of solution

23
Q

define plaque inhibitory

A

will inhibit plaque formation but not to a level we want it to

24
Q

define anti-plaque

A

prevents plaque formation and prevents gingivitis

e.g. chlorohexidine

25
Q

define anti- gingivitis

A

prevents inflammation, by reducing inflammation it prevents gingivitis

26
Q

key features of chlorohexidine (corsodyl)

A
  1. most effective anti plaque agent
  2. slowly released, inactive form, over 12-24 hrs therefore…
  3. high substantivity
  4. corsodyl= contains 0.2% w/v chloroheixidine di gluconate
  5. corsodyl daily= 0.06% chlorohexidine, 250 ppmFl, and 7% alcohol
  6. can be prescribed
  7. can cause staining, altered taste sensation. evidence of increase supra-gingival calculus, mucosal erosion, parotid swelling, anaphylaxis
27
Q

when would you prescribe chlorohexidine

A

if patient had perio treatment and cannot brush for 2-3 days

trauma

acute oral infection

28
Q

when prescribing chlorohexidine, what amount are you recommending/ advice would you give

A

0.2%, 10 ml volume per rinse = 20 mg of chlorohexidine

would advice its use for SHORT periods of time- up to 2 weeks after perio surgery, acute oral infection, trauma
—-> would NOT recommend for long periods of time

29
Q

active ingredients in essential oils such as listerine

A
  1. 21.7% alcohol (high percentage masks the odour)
  2. thymol
  3. menthol
  4. eucalyptol
  5. methyl salicylate
30
Q

active ingredient in colgate plax (mouthwash)

A

cetyl pyridinium chloride, CPC (0.05%)
fluoride
alcohol/ no alcohol versions are available

31
Q

e- cigarets are used to help quit because they are perceived to be less risky but…

A
  • more harmful
  • increases the risk of periodontitis and involved in the aetiology of NUG
  • causes pocketing in anterior segments of teeth
32
Q

smoking cessations aids which are NOT pharmacological include…

A 
will power
advice/counselling
hypnosis
acupuncture
behavioural therapy
33
Q

smoking cessation aids which ARE pharmacological include…

A 
nicotine gum/patches 
lozenges 
inhalators 
nicotine nasal spray
zyban/ champix tablets (prescription only) 
e- cigarettes

Periodontal Disease (9 decks)

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