Prevention of caries by saliva Flashcards
What are the 3 categories of caries intervention?
- Non-operative (diet and mineralisation)
- Micro-invasive (sealing)
- Minimally-invasive (restorative)
What are the names of the 2 types of care that can be used for caries?
- Standard care
- Active care
What is the main job of standard care for caries?
Maintaining the balance between demineralisation and remineralisation.
This includes diet and using fluoride.
What can the dentist advice to the patient to do for standard care?
Toothbrushing Fluoride toothpaste Inter-dental brushing Diet advice Patient motivation Maintenance Therapy
What can a dentist do to improve patient motivaiton?
- Give oral health advice
- Give diet advice
- Motivation tools (saliva check, plaque indicator)
- Visual explanation (leaflet)
- Education from home
What can a dentist give a patient to help with oral health advice?
A sheet for them to record what they are doing at home e.g.
When they brush, what toothpaste they are using, any rinses, any special devices (tongue brush).
What can a dentist do to motivate someone for diet control?
Give them a sheet to fill about quantity and type of food and drink consumption.
What can be done under active care?
Decontamination:
- Professional tooth clean
- Remineralisation (fluoride supplements)
- Sealants if necessary
What does the critical pH in the mouth depend on?
A specific solution of calcium and phosphate ions. If the solution changes, the critical pH can also change.
What is the efficacy of fluoride limited by?
The concentration of bio-available calcium and phosphate in saliva/plaque.
What are the two ways which fluoride can reduce the effect of caries?
- It enhances remineralisation leading to improved crystal structure and more resistance to acid attack.
- Suppresses bacterial enzymatic activity which decreases acid production
Where to we get fluoride from?
Intrinsic = salvia Extrinsic = solid calcium phosphate systems
What can we give to a patient with these conditions?
Dry Mouth:
- Saliva substitutes
- Dry Mouth Gel
Decreased buffering: capacity
- MI paste
Acidity:
- Modify factors, protect susceptible surfaces
What do sealants do?
What one is the best?
Put on the crown to stop acid getting into the tooth.
Composite
How do you deal with non-cavitated proximal lesions?
- Start non-operatively
- Assess the caries risk
- Preventative care (diet and fluoride supplements)
- Resin infiltration if needed
