Preventive Dentistry

Question 1

Caries Cause

Answer 1

Multifactorial; Bacteria, Supporting host diet of refined carbohydrates, Decreased host resistance and Time for cavity to develop

Question 2

Chemo-Parasitic Theory of Caries Development

Answer 2

Acids produced by bacteria in plaque dissolve enamel

Question 3

Exposure Time

Answer 3

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

Question 4

pH plot of dental plaque VS time

Answer 4

Stephan curve

Question 5

Critical pH

Answer 5

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

Question 6

Exposure Time 3F’s

Answer 6

Food type (fermentable carb), Form of food (retentive vs. non retentive) and Frequency of eating

Question 7

Sugars in Cariogenicity

Answer 7

Sucrose (table sugar)
Glucose (dextrose)
Maltose
Lactose (milk sugar)
Fructose (fruit sugar)
Sorbitol
Xylitol

Question 8

Intrinsic

Answer 8

Naturally in fruits and vegetables, Not readily fermentable by bacteria, Dried fruits are fermentable

Question 9

Extrinsic

Answer 9

Sugars added to food

Question 10

Obvious Sucrose Source

Answer 10

Candy, Cookies, Cakes, Pies, Soft drinks, Honey, Sugar, Jam, Jelly, Ice cream

Question 11

Hidden Sugars

Answer 11

Peanut butter, Cornbread, BBQ sauce, Sweet pickles, Cough drops, Antacids, Liquid medications, Ketchup, Bread, Salad dressing

Question 12

Fruit and Fruit Juice

Answer 12

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

Question 13

Milk and bread products

Answer 13

Slowly fermentable, Hazardous if long time in mouth

Question 14

Protective Effect

Answer 14

Milk and Cheese

Question 15

Artificial Sweeteners

Answer 15

Saccharin and Aspartame-not fermentable

Question 16

High fat or high protein

Answer 16

Contain carbohydrates that limit availability for fermentation

Question 17

Retentive Food

Answer 17

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)

Question 18

Non-Retentive Food

Answer 18

Do not stick to teeth and stay in mouth short time (Chocolate milk, Soft drinks, Milkshake)

Question 19

Detergent Food

Answer 19

Require lot of chewing and stimulate saliva production (Nuts, Fresh fruit, Vegetables)

Question 20

Frequency of Eating

Answer 20

Fermentable carb is more dangerous if eaten through day, little at time, than eaten all at once (Frequency more important than form)

Question 21

Erosion

Answer 21

Chemical action on tooth structure due to acid

Question 22

Causes of Enamel Erosion

Answer 22

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

Question 23

Bulimia Nervosa

Answer 23

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

Question 24

Purging

Answer 24

Self-induced vomiting, Misuse of laxatives, Misuse of diuretics, Misuse of other medications, Fasting, Excessive exercise

Question 25

Systemic Complications of Bulimia

Answer 25

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

Question 26

Dental Manifestations of Bulimic Patient

Answer 26

Perimolysis, Increase in cervical caries, Impairment of mucous membranes and periodontal tissue, Chronic swelling of parotid glands, Xerostomia

Question 27

Perimolysis

Answer 27

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

Question 28

Treatment of Bulimic Patient

Answer 28

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

Question 29

1992: Food Guide Pyramid

Answer 29

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

Question 30

2005: My Pyramid

Answer 30

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

Question 31

2011: MyPlate

Answer 31

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

Question 32

Website with practical info and tips to help build healthier diets

Answer 32

ChooseMyPlate.gov