Prevention & control of Periodontal disease

Question 1

Why might diabetics be more susceptible to periodontal disease?

Answer 1

Risk for all infection, including periodontal disease, is greater for both Type I & II diabetics. Because…

• Vascular abnormalities
• Altered collagen metabolism
• Altered monocyte response
• changes in crevicular fluid
• High blood sugars cause xerostomia

Question 2

Why is it especially dangerous for people with cardiovascular disease to contract periodontal disease?

Answer 2

Periodontal bacteria are found in Atheromas. Can increase chance of stroke and heart attack.

Question 3

What is a possible adverse affect of periodontal disease on pregnancies?

Answer 3

Prostaglandins (PGE) stimulate uterine contractions and may cause premature birth.

Question 4

Why are Gram Negative Anaerobic bacteria so problematic?

Name 5.

Answer 4

• Reside gingivally
• Very difficult to access & control daily by patient
  1. Campylobacter Rectus
  2. Porphyromonas Gingivalis
  3. Prevotella Intermedia
  4. Tannerella Forsythia
  5. AA: Actinobacillus Actinomycetemcomitans

Question 5

What are 5 ways to target bacteria in priodontium?

Answer 5

1. Mechanical plaque removal
2. Antimicronial rinses & toothpastes
3. Locally placed antiseptics or antibiotics (gels or threads)
4. Systemic antibiotics
5. Pocket reduction therapy

Question 6

What percentage of adult periodontal cases are attributable to cigarette smoking?

Answer 6

More than 50% of all cases and 75% of cases in current smokers. Quitting tobacco ESSENTIAL in periodontal care

Question 7

What are 4 changes to the local environment that can help periodontal disease?

Answer 7

1. Identify and eliminate Iatrogenic restorations
2. Eliminate pocket depth
3. Complete orthodontic therapy
4. Evaluate and adjust occlusion

Question 8

What are the 4 advantages of power toothbrushes?

Answer 8

1. Reduce physical skill & cognitive abilities necessary for brushing. Provides easier compliance for patient.
2. Removes more plaque in less time
3. Reduce gingivitis and bleeding
4. Reduce stains

Question 9

When comparing electric toothbrushes, the Cochrane Collaboration study in 2003, found what toothbrush to be the most effective at reducing plaque, gingivitis, and bleeding?

Answer 9

Rotation Oscillation (oral B Braun)

Question 10

Is there any difference in interproximal plaque control using waxed vs. unwaxed floss? Added fluoride?

Answer 10

NO

Question 11

Besides floss, what are some other devices used for interproximal plaque control? 6

Answer 11

1. Proximal brush
2. Toothpick
3. Perio aid
4. Stimudent
5. Floss swords
6. Powered flossers

Question 12

We know 0.12% chlorhexidine results in a complete microbial kill in 30 seconds with 15 ml rinse twice a day, controls gingivitis & candida, disrupts cell walls, and is substantive for 12 hours. What problems arise from this fluoride rinse?

Answer 12

1. Can stain brown
2. Has a strong bitter flavor that is made worse by water.
3. Reduces taste
4. Can’t use in combination with toothpaste b/c the SLS (sodium lauryl sulfate) in toothpaste inactivates the chlorhexidine

Question 13

What makes essential oil mouth rinses effective?

Answer 13

They disrupt cell walls and function

Question 14

How does Crest pro health (0.07% Cetylpyridinium Chloride (CPC)) compare to essential oils at reducing plaque, gingivitis, and bleeding? What are its attributes?

Answer 14

“At least as good as” essential oils.

Alcohol free rinse that is designed to fight plaque and gingivits but does not have an ADA seal.

Question 15

What is a major procedure used to remove ALL supragingival and subgingival calculus?

Answer 15

Scaling and root planing

Question 16

What is gingivitis?

Answer 16

Gingivitis is inflammation and redness of the gums. Often associated with frequent bleeding. No bone of gun recession.

Question 17

What is periodontitis?

Answer 17

Periodontitis is inflammation, bleeding, PLUS bone and gingival recession. Tooth loss also often seen due to these symptoms.

Question 18

Hujoel, et al. J Dent Res 2006, found what about self-performed flossing compared to professional flossing?

Answer 18

Self-performed flossing didn’t significantly reduce caries risk but professional flossing did reduce interproximal caries.

Question 19

What were Slots, 2008 findings about interproximal brushes compared to flossing?

Answer 19

Interproximal brushes removed more plaque and reduced gingivitis as well as flossing.

Question 20

What two mouth rinses and what two toothpastes do the ADA recommend for perio disease?

Answer 20

Mouthrinses:
1. 0.12% Chlorhexidine Gluconate Rinse
2. Essential Oil Mouth Rinse
Toothpastes:
1. 0.454% Stannous Fluoride Toothpaste
2. .3% Triclosan Toothpaste

Question 21

Did the Boyle, 2013 study find CHX an Essential Oils effective in reducing plaque and gingivitis?

Answer 21

Yes

Question 22

According to Sharma, 2004, what reduces more plaque and gingivitis, essential oil + brushing OR flossing + brushing?

Answer 22

Essential Oils mouth rinse + brushing removed more plaque and was more effective in reducing gingivitis