Prevention in Restorative Dentistry Flashcards
Describe “Prevention v Cure” approaches to healthcare
- Greater emphasis on prevention and reduction of inequalities
- Giving advice, provision of support to change behaviour and evidence informed actions
- Advice and support given to all patients
What are 3 pillars of prevention in dentistry?
- Oral hygeine instruction
- Diet
- Fluoride
Describe 5 components of toothbrushing advice for all adult patients
- Regular toothbrushing with fluoride toothpaste
- Start as soon as first primary tooth erupts
- Twice daily as a minimum, at least once before bed for two minutes each time
- Spit and don’t rinse
- Brushing with small headed toothbrush with medium texture bristles
What may be used to give the patient a visual aid for toothbrushing?
Disclosing tablets to highlight areas where plaque is left
Describe fluoride’s role in preventative dentistry
- Reduces caries levels in individuals and communities
- Works topically
- Higher concentrations should be balanced with risk of fluorosis
What type of patient would be of higher concern to suffer from fluorosis?
Children as their teeth are still developing
Name 4 vehicles of fluoride delivery
- Water / milk fluoridation
- Fluoride toothpaste
- Fluoride varnishes / rinses
- Fluoride tablets
Why are fluoride tablets not used often as a vehicle of fluoride delivery?
They have a high association with fluorosis
What is the recommended amount of fluoride in toothpaste?
> 1000ppm (usually 1450ppm)
Why may fluoride varnish be used?
- Two or more applications a year reduce caries by around 40%
- Can arrest existing lesions
- Sodium fluoride 22,600ppm varnish used
Describe 2 contraindications of duraphat varnish
- Stomatitis
2. Ulcerative colitis
What are 2 strengths of prescription only high fluoride concentration toothpastes?
- 2800ppm
2. 5000ppm
What 3 types of patients may have 2800ppm high fluoride toothpaste prescribed?
- High caries risk patients aged 10+
- Patient with caries and ortho appliances
- Patients with cariogenic diet or medication
What 4 types of patients may have 5000ppm high fluoride toothpaste prescribed?
- High caries risk patients aged 16+
- Present or potential root caries
- Patients with caries and ortho appliances or overdentures
- Patients with cariogenic diet / medication
Describe the uses of fluoride rinses
- Must be over age 8 and have ability to spit
- Rinse for 1 minute and spit out
- Used in conjunction with brushing at different time of day
- Concentration of 225ppm
Why is it important to spit out fluoride rinse?
Ingestion leads to increased risk of fluorosis
Name 3 components of diet advice provided to patients in preventative dentistry
- Avoid sugar containing foods at bedtime
- Eat a range of foods in line with Eatwell Guide
- Reduce amount and frequency of consuming food and drinks with high sugar content
Describe 3 pieces of information which may help to assess overall pattern of patient’s eating
- Number of intakes of food and drinks per day
- Number of intakes which consume free sugars and how many consumed between meals
- Any intakes containing sugar where within one hour of bedtime
What is a useful tool to gain an overall picture of someone’s diet?
Diet diary
Describe what should be recorded in a diet diary
- Recorded for 3 days including one weekend and two week days
- Include what time going to bed
- Quantities of food taken at which time
What is a caries risk assessment?
Assessment of probability of carious lesions developing
What are 3 advantages of caries risk assessments?
- Allows understanding of why patient has disease activity
- Enables creation of personalised caries management plan
- Helps patients engage and understand
Describe 4 components of prevention of caries given to adult patients with high risk of caries
- Apply fluoride varnish twice yearly
- Prescribe fluoride rinses for those with active caries
- Prescription of high fluoride toothpaste for active caries
- Investigate diet
What is tooth wear?
Loss of tooth structure involving mechanical and chemical factors leading to attrition, abrasion and erosion
