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Periodontics > Prevention in Periodontics > Flashcards

Prevention in Periodontics Flashcards

1
Q

What is the prevalence of periodontitis?

A

11.2%

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2
Q

What are the basics of prevention in periodontitis?

A

Prevention of gingivitis, early detection of periodontitis using BPE, managing risk factors that increase risk of developing periodontitis/complicate its successful care, and supportive periodontal therapy

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3
Q

What will diagnosis of periodontitis dictate?

A

Patient risks and needs

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4
Q

What can gingivitis progress to?

A

Periodontitis (stable, non-stable, in remission)

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5
Q

What is required with professional mechanical plaque removal?

A

Education and behaviour modification

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6
Q

What is the first step in treatment of periodontitis?

A

Patient motivation, supragingival plaque control, and risk factor control

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7
Q

What is the second step in treatment of periodontitis?

A

Cause related therapy, control subgingival biofilm, and calculus

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8
Q

What is the third step in treatment of periodontitis?

A

Treatment of areas non-responding to second step (surgery)

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9
Q

What is the fourth step in treatment of periodontitis?

A

Supportive periodontal care: maintain periodontal stability

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10
Q

What are the existing motives for motivation?

A

Desire to be clean, to conform to social norms, be socially acceptable, avoid tooth loss, and avoid dentures

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11
Q

What does TIPPS stand for?

A

TALK, INSTRUCT, PRACTICE, PLAN, SUPPORT

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12
Q

What is TALK?

A

TALK with patient about causes of periodontal disease and discuss any barriers to effective plaque removal

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13
Q

What is INSTRUCT?

A

INSTRUCT patient on best ways to perform effective plaque removal

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14
Q

What is PRACTICE?

A

PRACTICE cleaning his/her teeth and to use interdental cleaning aids whilst in dental surgery

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15
Q

What is PLAN?

A

PLAN which specifies how patient will incorporate oral hygiene into daily life

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16
Q

What is SUPPORT?

A

SUPPORT patient by following up at subsequent visits

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17
Q

What are the recommendations from The Good Practitioners Guide to Periodontology?

A

Use open questions, listen and give information in small doses, use reflective listening, use a guiding approach, maintain an adult to adult conversation, sit patient upright, and consider information leaflets

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18
Q

What is the grade of patient motivation?

A

Grade A

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19
Q

What is the grade of motivational interviewing and cognitive behavioural therapy?

A

No evidence for

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20
Q

What is the optimal plaque score?

A

Below 15%

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21
Q

What is the optimal bleeding score?

A

Below 10%

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22
Q

What is the optional probing depth?

A

Less than 4mm

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23
Q

What is the grade of OHI?

A

Grade A

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24
Q

What is recommended as a primary means of reducing plaque and gingivitis?

A

Manual/power tooth brushing

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25
Q

What should be professionally taught to patients?

A

Inter-dental cleaning, preferably with interdental brushes

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26
Q

What is the average plaque reduction with a manual toothbrush?

A

42%

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27
Q

What is the average plaque reduction with an electric toothbrush?

A

46%

28
Q

What are the recommendations from 11th European Workshop (2015)?

A

Brush twice a day for 2 minutes

29
Q

Who is 2 minutes of brushing likely to be insufficient for?

A

Periodontitis patients

30
Q

How often should patients use interdental cleaning?

A

Once every 24 hours

31
Q

What are the different types of interdental cleaning?

A

Flossing, interdental brushes, woodsticks, and oral irrigators

32
Q

What are the most effective devices to remove interdental plaque?

A

Inter-dental brushes

33
Q

What is needed to make flossing effort worthwhile?

A

Proper instruction, sufficient motivation of patient, and a high level of dexterity

34
Q

What are the benefits of single tufted brushes?

A

BoP eliminated, PPD reduced by mean of 1.8mm, and periopathogens reduced 14% to 0.8%

35
Q

What are the other constituents of mouthwashes?

A

Solubilisers, flavourings, preservatives, alcohol, water, colourings, SLS, foaming agents etc.

36
Q

What are co-adjunctive chemicals?

A

Mouthwashes

37
Q

What are the 3 main categories of mouthwash?

A

Those for use against halitosis (cosmetic), those advocated to reduce plaque bacteria (and hence adjuncts against periodontal diseases) (chemo-therapeutic), and those advocated for prevention and repair of dental caries (chemo-therapeutic)

38
Q

What mouthwashes are advocated to reduce plaque bacteria?

A

M/Ws containing chlorhexidine gluconate (e.g., Corsodyl), essential oils (e.g., Listerine), and cetylpyridinium chloride/CPC (a quaternary ammonium compound) (e.g., Eludril, Plax)

39
Q

What mouthwashes are advocated for prevention and repair of dental caries?

A

M/Ws containing fluoride

40
Q

What do some mouthwashes have?

A

Both anti-plaque and remineralisation active ingredients

41
Q

What is chlorhexidine generally regearded as?

A

An ‘antiseptic’ rather than an antimicrobial

42
Q

What are the properties of chlorhexidine?

A

Bacteriostatic (inhibits growth) and bactericidal properties (kills bacteria)

43
Q

What type of molecule is chlorhexidine?

A

A positively charged molecule that binds to negatively charged sites on cell wall

44
Q

What does chlorhexidine do to the bacterial cell wall?

A

It destabilizes cell wall and interferes with osmosis, ultimately leading to lysis

45
Q

What is the mode of action of chlorhexidine in topical applications?

A

Shown to have unique ability to bind to proteins present in human tissues such as skin and mucous membranes with limited systemic/bodily absorption

46
Q

What is the substantivity of chlorhexidine?

A

Released slowly leading to prolonged activity

47
Q

What does chlorhexidine have cidal actions againt?

A

Fungi (Candida) so has uses in treatment and prevention of denture induced candidosis

48
Q

What is the concentration of chlorhexidine original?

A

0.2%

49
Q

What is the concentration of chlorhexidine daily?

A

0.06%

50
Q

How long should you use chlorhexidine original for?

A

2 weeks

51
Q

What are the adverse effects of chlorhexidine?

A

Taste disturbance/alteration, effects on oral mucosa including soreness, irritation, mild desquamation and mucosal ulceration/erosions and a general burning sensation/a burning tongue/both

52
Q

What are the four essential oils?

A

Eucalyptol, thymol, methyl salicylate and menthol

53
Q

What are essential oils?

A

Antibacterial antiplaque agents, and have ability to penetrate biofilm

54
Q

What are some of the proposed methods of action of essential oils?

A

Disruption of cell membranes, perturbation of proton pumps, and coagulation of cell content

55
Q

What does the Listerine range also contain?

A

Fluoride (anywhere from 100 to 450 ppm)

56
Q

What do essential oil containing mouthwashes kill?

A

A broad spectrum of planktonic bacteria and penetrate biofilm, allowing action upon sessile (within matrix) bacteria

57
Q

What is the optimum concentration of NaF in fluoride containing mouthwashes?

A

0.05% (or approx. 225ppm)

58
Q

How is triclosan thought to primarily function?

A

By inhibiting fatty acid synthesis (in bacterial rather than human cells)

59
Q

What is triclosan bacteriostatic in?

A

Concentrations used in toothpaste formulations

60
Q

What is triclosan biocidal in?

A

Higher concentrations

61
Q

What is the definition of biocidal?

A

Destructive to life

62
Q

Why has triclosan been phased out?

A

Not environmentally friendly

63
Q

What are the risk factors of periodontitis?

A

Genetics, stress, smoking, drugs, diabetes, and pregnancy

64
Q

How should smoking cessation be given?

A

ASK, ADVISE, ACT

65
Q

What is ASK?

A

Are you a smoker?

66
Q

What is ADVISE?

A

On benefits of stopping and best methods

67
Q

What is ACT?

A

Motivate and refer

Periodontics (5 decks)

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