Preventive Procedures - Outcome 1 Flashcards
Dental Caries
It is a disease of the hard (calcified) tissues of the tooth, also referred to as a cavity or tooth decay.
Oral
Pertaining to the mouth. Oral health – the health of one’s teeth and mouth.
Periodontal Debridement
Removal of all debris (plaque biofilm, stain, and calculus) from the crowns and roots of the teeth.
Periodontal Disease
It includes a variety of inflammatory and degenerative diseases involving the supporting tissues of the teeth.
Preventive Dentistry
The practice of caring for your teeth to keep them healthy; this can include the use of fluoride, application of dental sealants, proper nutrition, and plaque control to the prevention of disease.
Practice
To perform and/or provide skills or procedures.
Prophylaxis
pertains to the prevention of disease.
Registered
A term used by some provincial dental assisting regulatory bodies. In Alberta registration is mandatory when a person meets the requirements for registration (complete a dental assisting education program, completed National Board requirements or meet labour mobility requirements, have current practice and demonstrates good character) and intends to provide dental assisting services directly to the public (College of Alberta Dental Assistants [CADA], 2019).
Preventive Dentistry
Preventive dentistry involves such procedures and services that are provided in both private dental offices and community health programs which are aimed at preventing the occurrences of oral diseases. Optimum oral health is within the reach of every individual; it relies on the combined efforts of the oral healthcare team, the patient, and the community. Preventive dentistry places responsibility on both the patient and the oral healthcare provider to achieve optimum oral health for life.
Scaling
It is a procedure in which calculus (hard dental deposits), dental plaque, and some extrinsic (outer) stains are scraped (cleaned) off the teeth with specific dental instruments called scalers and curettes. Only dental assistants who have received additional training may perform scaling.
Root Planing
It is a procedure done to smooth the tooth root to remove any remaining calculus and bacterial toxins.
Gingival/subgingival curettage
Gingival curettage is a surgical procedure designed to remove the soft tissue lining of the periodontal pocket with dental instruments (curettes) to remove the diseased tissue.
The theory behind the use of gingival curettage in the treatment of periodontal disease is that it removes the diseased tissue, reducing the inflamed tissue and allowing the tissue to heal and reattach to the tooth. However, studies have shown that no new attachment occurs and that the results do not differ when only scaling and root planing procedures are done (American Academy of Periodontology, 2002).
Procedures included in an Oral Prophylaxis
Scaling, Root planing, curettage, Coronal polishing, Topical fluoride application
Coronal polishing
Coronal polishing is a cosmetic procedure used to remove extrinsic (outer) stains from the enamel surfaces of the teeth.
Research has shown that coronal polishing is a non-essential cosmetic procedure (Gutkowski, 2001). Instead of polishing the teeth, instruction in oral hygiene techniques can help reduce the buildup of dental plaque biofilm, and dental stains.
Selective coronal polishing is a procedure in which only those teeth or surfaces with visible, extrinsic stains are polished. Selective polishing minimizes enamel being worn away by the abrasives in the polishing paste that is used to remove the stain and allows the patient to realize the importance of maintaining good oral hygiene.
Dental flossing is the best way to ensure that bacterial plaque is removed from between the teeth. Neither the polishing procedure nor a scaling instrument can completely clean the tight contact areas between the teeth.
Topical fluoride application
Once deposits are removed from the teeth, an optional fluoride treatment can be provided for the patient to help prevent tooth decay and sensitivity.
Fluoride will be discussed in further detail in Outcome 6.
Deposits
Dental deposits refer to the various types of substances and stains that can build up on teeth. These deposits are classified into three main categories:
- Soft Deposits
- Hard Deposits
- Stains
Soft Deposits
Soft dental deposits are materials that form on the teeth and other structures in the mouth. There are four main types of soft deposits, each distinct from the others:
- Acquired Pellicle
- Dental Plaque (often called dental biofilm in current literature)
- Materia Alba
- Food Debris
disclosing agent
colouring agent used to make plaque visible when applied to teeth
fluoride varnish
concentrated form of topical fluoride applied to teeth that are at high risk for developing caries
systemic fluoride
fluoride that is ingested such as in the drinking water
topical fluoride
fluoride that is applied directly to the tooth
Non Surgical Periodontal Treatment
refers to noninvasive methods used to address periodontal disease. This can include the dental prophy, scaling and root planing, gingival curettage as well as introducing antimicrobial and antibiotic agents
calculus/tartar
plaque adhered to tooth structure that becomes mineralized by calcium and phosphate salts from saliva
endogenous
stains developed from within the structures of the teeth
exogenous
stains developed from external sources
extrinsic
stains that occur on the external surfaces of the teeth that may be removed by polishing
fulcrum
finger rest used when an instrument or handpiece is held for a specified time
instrinsic
stains that occur within the tooth structure that may not be removed by polishing
prophy paste
commercial premixed abrasive paste used for polishing teeth and restorations
selective polishing
is a term used when only certain teeth or surfaces of a tooth are polished - to avoid unnecessary removal of even small amounts of surface enamel
Why is dental plaque also called dental biofilm?
Dental plaque on teeth is a type of biofilm. Biofilms form when bacteria stick to a surface in a moist environment and produce a slimy, glue-like substance that adheres to that surface. Biofilms can be made up of a single bacterial species but usually consist of many species of bacteria and other microbes. Researchers have found that most bacteria in the mouth live in these complex biofilm communities rather than in isolation.
Two specific bacteria in mouth that are the primarily responsible for caries
mutans streptococci (MS) - is a major pathogenic (disease-producing) bacteria, found in relatively large numbers in dental plaque
lactobacilli (LB) - caused by high sugar intake
pellicle
thin film coating of salivary materials deposited on tooth surfaces
periodontium
structures that surround, support, and are attached to the teeth
signs and symptoms in patients with periodontal disease
red swollen gingiva
bleeding gingiva from brushing or flossing
loose or separating teeth
pain or pressure when chewing
pus around the teeth or gingival tissues
causes of periodontal disease
bacterial plaque - formation of bacterial plaque causes an inflammatory response and with damage the gingival tissue and eventually the loss of the alveolar bone
supragingival calculus
is found on the clinical crowns of teeth, above the margin of the gingiva. It is visible as a yellowish white deposit that may darken over time
subgingival calculus
forms on root surfaces below the gingival margin and can extend into the periodontal pockets. It can be dark green or black. The color is caused by stains that result from subgingival bleeding
Hard Deposits - Calculus
Calculus, or dental calculus, is a hard, calcified deposit that sticks firmly to teeth, restorations, and dental appliances. It’s a significant cause of periodontal disease because it harbours bacteria. Controlling bacterial plaque is crucial to prevent calculus formation. Once present, calculus provides a surface for more plaque, pellicle, and additional calculus to form, leading to a cycle of buildup, gum inflammation, and the progression of periodontal disease.
Difference Between Dental Plaque Biofilm and Calculus
Dental plaque biofilm is a sticky film of bacteria that constantly forms on teeth. If not removed by regular brushing and flossing, it hardens into calculus. Unlike plaque, calculus cannot be removed with a toothbrush and requires professional cleaning by scaling or root planing.
Common Periodontal Instruments
- Sickle Scalers
- Universal Curettes
- Area-Specific Curettes
- Periodontal Files
- Powered Hygiene Instruments - Magnetostrictive Devices & Piezo Devices
Sickle Scalers
- Used to remove supra-gingival calculus (above the gum line) from teeth crowns.
- Have a pointed tip, a pointed back, and two cutting edges.
- Types: Anterior (for front teeth) and Posterior (for back teeth).
Universal Curettes
- Remove calculus both supra-gingivally and sub-gingivally (below the gum line).
- Double-ended with paired working ends, rounded toe, and two cutting edges per end.
- Example: Columbia 4L-4R.
Area-Specific Curettes
- Designed for specific teeth and surfaces, with a longer shank and one cutting edge per end.
- Examples: Gracey 1/2 (for anterior teeth), Gracey 11/12 (for buccal, lingual, and mesial surfaces of posterior teeth), Gracey 13/14 (for distal surfaces of posterior teeth).
Periodontal Files
- Used to roughen heavy calculus deposits before removal with a scaler or curette.
- Have several cutting edges or diamond particles on the working end.
Powered Hygiene Instruments:
a. Magnetostrictive Devices:
b. Piezo Devices:
Powered Hygiene Instruments:
- Use vibrations to remove calculus.
- Types: Sonic (air-driven) and Ultrasonic (electric).
a. Magnetostrictive Devices:
- Convert electrical energy to vibrations using metal stacks.
- Tip moves in an elliptical motion.
b. Piezo Devices:
- Use crystals to produce vibrations.
- Tip moves in a back-and-forth motion, shaving off calculus and debris.
What Are Stains?
Stains on teeth happen when coloured materials stick to the surfaces or get absorbed into the tissues of the teeth.
Types of Stains by Location
Extrinsic Stains
Intrinsic Stains
Extrinsic Stains
Found on the surface of the tooth.
Can be removed by brushing, rinsing, or professional cleaning.
Intrinsic Stains
Located within the tooth.
Hard or impossible to remove with polishing.
Types of Stains by Source
Exogenous Stains
Endogenous Stains
Exogenous Stains
Originate from outside the body.
Appear on the external surface of the tooth.
Endogenous Stains
Originate from inside the body.
Develop within the tooth structure.
Categories of Stains
Exogenous Extrinsic Stains
Endogenous Intrinsic Stains
Exogenous Intrinsic Stains
Exogenous Extrinsic Stains
Caused by external factors like food, drink, or smoking.
Appear on the exterior of the tooth and can be removed.
Endogenous Intrinsic Stains
Caused by factors inside the body, such as certain medications.
Become part of the tooth structure and cannot be removed.
Exogenous Intrinsic Stains
Caused by external factors but become embedded within the tooth.
Hard to remove and require professional treatment.
Why Stains Matter
Stains affect the appearance of teeth but do not cause dental disease.
Thick stains near the gum line can irritate the gums.
Stains can indicate poor oral hygiene if embedded in plaque or calculus.
Role of Dental Assistants with stains
Recognize different types of stains.
Understand which stains can be removed through polishing.
Assist dentists and hygienists in identifying stains during procedures.
As a dental assistant, you don’t diagnose stains, but recognizing them helps you support the dental team in providing appropriate care.
materia alba
soft mixture of bacteria and salivary proteins also known as white material. It is visible without the use of a disclosing agent and is common in individuals with poor oral hygiene.
acquired pellicle
thin film of protein that quickly forms on teeth. It can be removed by coronal polishing with an abrasive agent such as a prophy paste
