Preventive Dentistry Flashcards
Caries Cause
Multifactorial; Bacteria, Supporting host diet of refined carbohydrates, Decreased host resistance and Time for cavity to develop
Chemo-Parasitic Theory of Caries Development
Acids produced by bacteria in plaque dissolve enamel
Exposure Time
Exposure of teeth to acid production when cariogenic food is ate; Cariogenic bacteria ferment, break down, carbs to form acid which demineralizes teeth; Each time fermentable carb enters mouth-teeth are exposed to acid production; Upon exposure, acid is produced in 30sec, Acid production continues for 30min; pH of plaque (6.2-7) drops
pH plot of dental plaque VS time
Stephan curve
Critical pH
5.5; Below 5.5-Enamel will decalcify; Demineralization VS Remineralization; Repeat exposure (more than 4X 30min) prevent remineralization; Bacteria must organize to produce acid; Oral hygiene techniques (brushing/flossing) decrease or stop acid production by disorganizing
Exposure Time 3F’s
Food type (fermentable carb), Form of food (retentive vs. non retentive) and Frequency of eating
Sugars in Cariogenicity
Sucrose (table sugar) Glucose (dextrose) Maltose Lactose (milk sugar) Fructose (fruit sugar) Sorbitol Xylitol
Intrinsic
Naturally in fruits and vegetables, Not readily fermentable by bacteria, Dried fruits are fermentable
Extrinsic
Sugars added to food
Obvious Sucrose Source
Candy, Cookies, Cakes, Pies, Soft drinks, Honey, Sugar, Jam, Jelly, Ice cream
Hidden Sugars
Peanut butter, Cornbread, BBQ sauce, Sweet pickles, Cough drops, Antacids, Liquid medications, Ketchup, Bread, Salad dressing
Fruit and Fruit Juice
Fresh (low), dried and fruit juices cause dental caries; Prolonged, repeated use of sugared fruit-flavored drinks are significant caries cause; Citrus fruits aren’t associated with caries development; Erosion from consumption of fruit or fruit juice; Increase consumption of fruit and decreasing consumption extrinsic sugar will decrease caries
Milk and bread products
Slowly fermentable, Hazardous if long time in mouth
Protective Effect
Milk and Cheese
Artificial Sweeteners
Saccharin and Aspartame-not fermentable
High fat or high protein
Contain carbohydrates that limit availability for fermentation
Retentive Food
Stick to teeth and stay in mouth long time; Acid production continues as long as food are in contact with teeth (Caramel, Dried fruit and Bread, Bananas)
Non-Retentive Food
Do not stick to teeth and stay in mouth short time (Chocolate milk, Soft drinks, Milkshake)
Detergent Food
Require lot of chewing and stimulate saliva production (Nuts, Fresh fruit, Vegetables)
Frequency of Eating
Fermentable carb is more dangerous if eaten through day, little at time, than eaten all at once (Frequency more important than form)
Erosion
Chemical action on tooth structure due to acid
Causes of Enamel Erosion
Vomiting (bulimia or gastric disturbance), Frequent intake of acidic food, Habitual eating or sucking on Vit C tablets, Medication with hydrochloric acid, Exposure to industrial acid, Antabuse therapy for alcoholism
Bulimia Nervosa
Psychological, Repeated episodes of binge eating followed by purging (at least twice a week for 3 months), Excessive emphasis on body shape and weight, Usually begins late adolescence or early adulthood, 90% bulimic individuals are female, Chronic or intermittent
Purging
Self-induced vomiting, Misuse of laxatives, Misuse of diuretics, Misuse of other medications, Fasting, Excessive exercise
Systemic Complications of Bulimia
Protein malnutrition, Weight loss, Dehydration and electrolyte disturbance, Cardiovascular or renal failure (due to hypokalemia), Cardiac arrest, Trauma to esophagus and stomach lining, Chemical erosion of teeth
Dental Manifestations of Bulimic Patient
Perimolysis, Increase in cervical caries, Impairment of mucous membranes and periodontal tissue, Chronic swelling of parotid glands, Xerostomia
Perimolysis
Erosion of enamel on lingual, occlusal and incisal surface of teeth; May be recognized by loss of enamel with rounded margins-notched appearance on incisal surface of anterior teeth, amalgam restorations appear as raised islands or loss of occlusal contours on unrestored teeth
Treatment of Bulimic Patient
Maintenance of good oral hygiene, Rinsing with sodium bicarbonate or magnesium hydroxide solution, Neutral pH sodium fluoride rinses (0.5-2.0%), 0.4% stannous fluoride gels, Composite resins, Full crown
1992: Food Guide Pyramid
Total diet approach-goals for both nutrient adequacy and moderation; Developed using consume research to bring awareness to new food patterns; Illustration focused on concepts of variety, moderation and preparation; Included visualization of added fats and sugars throughout five food groups and in tip of pyramid
2005: My Pyramid
Introduced with updating food guide pyramid food patterns for 2005 Dietary Guidelines for Americans, including daily amounts of food at 12 calorie levels; Continued “pyramid” concept, based on consumer research, but simplified illustration, detailed info on mypyramid.gov; Added band for oils and concept of physical activity; Illustration used to describe concepts of variety, moderation and proportion
2011: MyPlate
Introduced along with updating of USDA food patterns for 2010 Dietary Guidelines for Americans; Different shape to help grab consumers attention with new visual cue; Icon serves reminder for healthy eating, not intended to provide messages, Visual linked to food and familiar mealtime symbol in consumers’ minds, as identified through testing; “my” continues personalization approach
Website with practical info and tips to help build healthier diets
ChooseMyPlate.gov
