Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pediatric Dentistry Boards > Prevention > Flashcards

Prevention Flashcards

1
Q

The critical regulator in the caries process?

A

Saliva

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What disease process is 5x more common than asthma? What is an important regulator?

A

Caries, saliva

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

The key to dental caries was discovered by who and when? What was the hypothesis?

A

WD Miller “Miller time!”, ‘Non-specific plaque theory’ : acid production by bacteria considered for tooth break down. 1890

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Clarke in 1924

A

Discovered strep mutans, could not prove it caused caries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Keyes to S. mutans?

A

1960- demonstrated S. mutans was the responsible bacteria for caries in humans. Along w/ Strep sobrinus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Cariogenic properties of strep mutans?

A

Ability to produce acid (primarily lactic acid), aciduricity- ability to withstand acidic environment, adherence to teeth (sticky glucans)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

MS is necessary and sufficient to cause caries. T/F

A

F. MS is necessary but not solely sufficient for dental caries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

MS acquisition and transmission: how does classic data regarding acquisition differ from new data?

A

1) Old: Colonization after eruption of teeth vs new:colonization may occur at birth, tongue fissures as a niche. 2)Older: MS is a poor biofilm competitor, if S. sanguis colonizes first there is less S. mutans. 3)Old: Vertical transmission, >70% New: horizontal and vertical 4) New: Early MS acquisition assoc w/Bohn’s nodules and high maternal levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Factors associated with MS acquisition

A

Sweetened fluids taken to bed, frequent sugar exposure, snacking, sharing foods w/adults, maternal MS levels (Wan et al 2003)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Factors associated with non-colonization of MS

A

Multiple courses of antibiotics and frequent toothbrushing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Prevention of Transmission–study by? effects of interventions?

A

(Soderling 2000) 1. Xylitol gum 2. CHX varnish 3. FV –xylitol lowest numbers of infants colonized by MS at ages 2,3, and 6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Lactobacilli and relationship to caries?

A

Found in large #s of children, considered opportunistic, not initatiors, good indicator of CHO intake, # increases after DEJ is invaded

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Children w/S-ECC have more or less microbial diversity?

A

Less diversity, w/a higher frequency of C albicans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Hopewood House Diet study- describe? Results?

A

Diets devoid of sugar and white flour, extremely low dental caries (1947)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Vipeholm Vive - Describe?

A
  1. Sugar consumption at meals = slight increase 2. Sugar between meals: marked increase 3. Sugar in sticky candies: greatest caries activity 4. Increased caries risk from increased frequencey of ingestion; decreases with less frequency 5. Caries activity differs among individuals.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Glucan- describe? Importance?

A

Adhesion properties make it difficult to disrupt the biofilm, inhibits diffusion properties of biofilm, reduces buffering capacity of saliva, inhibits transport.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Fructan- describe?

A

Lesser role than glucan, intracellular can be used by MSas energy source.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Fructose, sucrose, glucose, raw starch, soluble starch, refined starch, and their relative pH changing abilities?

A

Soluble starch and refined starch can be broken down by salivary amylase into sugars. Least acidogenic: raw starch. Frucose/glucose equally effective as sucrose.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

At what pH, begins demineralization? What is the curve called?

A

Stephan Curve, below 5.5 pH begins demineralization.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What food factors have a protective effect?

A

Fat content is protective, flavonoids in apples/cranberries-antibacterial, masticatory stimulus, cheese prevents enamel demineralization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Sohn’s beverage study results?

A

High carbonated bevereages saw the greatest number of caries- Sohn 2006

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

The relationship between sugar intake and caries is very strong. T/F?

A

The relationship between sugar consumption is strong in 2/30 papers, vs weak in 18/30. Relationship is much weaker now with modern F- exposure.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What factors in the host’s saliva effect caries formation?

A

Mineral content, pH, Flow rate, buffering capacity, antimicrobial composents (lysozyme, lactoferrin, peroxidase, IgG/M, etc), proteins.

24
Q

Caries factors: 3 main factors?

A

Host factors, dietary intake of refined CHO, oral flora principally MS

25
Q

What % of the US has access to F- water (1970-80s)

A

70%

26
Q

Describe the ethnic/SES destribution of caries

A

80% of caries is in 20-25% of the population. Disproportionately more caries found in lower SES groups

27
Q

Primary tooth considerations and progression for caries

A

More rapid caries progression (less mineral), thinner enamel/dentin, relatively larger pulp, flat contacts, caries sequence (lower molars, upper molars, anteriors); 2nd molars more susceptible than first

28
Q

Role of Milk, breast milk and formula in caries susceptible

A

milk is not cariogenic/cause pH drop, may aid in mineralization, promote growth of cariogenic bacteria. Formula - reduces pH significantly, Ad lib/prolonged breast feeding, longer than 1 year is a risk factor does not cause pH drop but could be a growth medium for bacteria (worst for children who are eating solids, greater than 1 year),

29
Q

Fluoride mechanisms of action in order of importance:

A
  1. Topical - most important inhibits demineralizaiton, promotes remineralization 2. Antibacterial (somewhat), disrupts enzyme systems (enolase), reduce acidogenesis, extracellular polysaccharide 3. Systemic (not important/no fx) improves enamel crystallinity, reduces acid solubility, recirculates through saliva
30
Q

F supplementation:
Birth <6 mo
6mo <3years
years <6 yo
6-16 years

A
31
Q

Outcomes of F toothpaste

1g of toothpaste has 1mg of F- in it

A

Effect was increased with :

higher baseline caries rate, higher F concentration, higher frequency of use, supervised brushing.

Little info concerning primary dentition

32
Q

Fluoride Rinse: concentration? Indication? Efficacy? Associated with?

A

!. .05% NaF; 220 ppm = 1mg/5mL

Indications: orthodontics, radiation therapy, prosthetics

Effect: preventive fraction 26%, w/an inconclusive benefit for those exposed to other F sources. Healthy kids probably won’t benefit, but high risk/special needs/appliance kids may benefit

Long term use assocaited with reduced salivary levels of MS

33
Q

Self-Applied Gel/Paste: Indications? Efffectiveness?

A

ie Prevident (APF 1.1% or NaF 1.1%) 5000, or .4% SnF (1000ppm)

Indicated: rampant caries, orthodontics, radiation therapy

Effective demonstrated w/NaF, APF (20-80% reduction)

34
Q

Professionally applied FV

Amount of F content in gels, foams, andvarnish,

A

Gels: NaF 2% (9000ppm)

APF 1.23% (12,300ppm)

Foam: APF 1.23%

Varnish 2.26%F = (22600ppm)

35
Q

FV effectiveness study

A

RCT: FV 1x/yr or 2xyr 2-3 times less likely to have new caries than from counseling along

36
Q

Prophy paste w/F in it : effectiveness?

A

Caries reduction ~0%, will remove F-rich enamel, should replace w/topical F treatment if you complete a rubber cup prophy

37
Q

Professionally applied topical F ADA guidelines by age

A

Under age 6 low caries risk likely no benefit, mod caries risk FV every 6 months, high risk FV every 3-6 months.

Over 6 years: low caries risk no benfit, moderate FV or gel every 6 months, high risk FV/gel every 6 months

38
Q

Acute Fluoride Toxicity: mechanisms of toxicity? Toxic doses?

A

Mechanisms: corrosive action on stomach lining, affinity for calcium>tetany, enzyme inhibition

Toxic doses: “certainly lethal dose” 32-64mg F/kg

Letal pediatric dose: 15mg F/kg

Probably toxic dose: 5-8mgF/kg

39
Q

Treatment of F ingestion and possible F toxicity

A

<8mg F/kg: give milk; observe >6hrs refer if symptoms develop

>8mgF/kg: induce vomiting, followed by milk and refer immediately

Unknown if asymptomatic give milk and observe, if symptomatic same as >8mg

40
Q

Xylitol : looks like/structure? Properties?

A

5 carbon sugar alcohol

Looks, tastes, and same relative sweet as sucrose w/40% fewer calories.

Reduces acid production of plaque, plaque mass, plaque adherence, numbers of MS, accumulates in MS intracellularly and inhibits its growth

41
Q

Xylitol best fx dosage?

A

Best effects seen at ~6.88g/day ~50cents per day (milgrom 2006)

42
Q

Xylitol recommended usage

A

chew 20-30 minutes 2-3x/day especially following meals. ~6.88g no more than 10/day

43
Q

Chlorhexidine: properties, effects on bacteria

A

A bis-biguanide w/bactericidal activity against gram positive and negative bacteria

  • Positively charged: binds to enamel pellicle, hydroxyapatite, mucous membranes, and enzyme systems

Reduces plaque and salivary MS, but these reboundafter you stop using

44
Q

Chlorhexidine: caries inhibiting effects?

Disadvantages?

A

Overall has a caries inhibiting effects of about 46% however not very effective for long term use to prevent caries due to rebound.

Disadvantages: staining teeth, taste, recolonization of MS

45
Q

Chlorhexidine recommended regimine?

A

1-2 tsp 1 minute per day for one week, repeat 1 week per month or 1 week per 3 months

46
Q
A
47
Q

Benefits of CPP-ACP (mi paste, mi paste plus)? What has it shown in studies to do?

A
  • Stabilizes Ca and Phosphate ions in the biofilm
  • as these stabilize, it binds F to the tooth surface
  • Demonstrated anticargionicity (rats), more effective than F mouthrinse in remineralizing white spots post ortho, increases CA and P levels in plaque
48
Q

What is the ration present in MI paste plus?

A

5:3:1 5Ca:3Phosphate:1F-

49
Q

Rationale for pit and fissure sealants?

A

Occlusal surface comprise 12.5% of total tooth surface area, however 50-80% of the decay is found there

50
Q

F has been effective in reducing pit and fissure caries. T/F

A

False- less decline of pit and fissure caries and relative increase in occlusal caries in recent years. F not as effective here.

51
Q

Effectiveness of sealants? Relative risk reduction? Evidence related to which teeth?

A

Relative caries risk reduction of 33% which is dependent on retention.

Cochrane Review: after 4.5 yrs sealed molars of kids 5-10 had 50% caries reduction. Caries reductions ranged from 86% at 12 months to 57% at 48-54 months.

  • Incomplete evidence for permanent 2nd molars, premolars, primary molars, and glass ionomer cements
52
Q

Fluoride varnish provides better protection than sealants. T/F

A

False: sealants provide better protection (Hiiri 2006)

53
Q

Anticipatory Guidance 6-12 months of age Dental and oral development, F supp, non-nutritive habits, injury prevention, diet and oral hygiene

A
54
Q

Anticipatory Guidance 12-24 months of age Dental and oral development, F supp, non-nutritive habits, injury prevention, diet and oral hygiene

A
55
Q

Anticipatory Guidance 24-36 months of age Dental and oral development, F supp, non-nutritive habits, injury prevention, diet and oral hygiene

A
56
Q

Mg of F ion per mL in Fluoride Varnish? Percent F?

A
57
Q
A

Pediatric Dentistry Boards (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions