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Dental Hygiene-III > Test 2 > Flashcards

Test 2 Flashcards

1
Q

What is the prevalence of any form of perio in the US?

A

80%-including gingivitis

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2
Q

What is the prevalence of chronic adult perio?

A

35%

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3
Q

What are the inflammatory cells?

A

Lymphocytes
Polymorphonuclear leukocytes (PMN’s)
Macrophages

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4
Q

What is chemotaxis?

A

Process which attracts inflammatory cells to areas of the body by stimuli such as trauma and microbial presence

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5
Q

What are cytokines?

A

Substances produced by stimulated immune cells

Stimulate release of the inflammatory cells

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6
Q

What is mechanical treatment?

A

Root debridement

Effective but 10-20% of bacteria still remain within the sulcus after treatment

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7
Q

What are types of adjunctive chemical therapies?

A

Systemic and topical

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8
Q

Systemic Antibiotic Therapy

A

Aggressive perio
Perio that does not respond to treatment
Perio abscess

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9
Q

Disadvantages of systemic antibiotic therapy

A

allergic reactions
bacterial resistance
contraindication-pregnant, nursing, birth control

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10
Q

What is the drug of choice for systemic antibiotic?

A

Tetracycline
Stays highly concentrated in crevicular fluid
-careful with this due to photosensitivity

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11
Q

What is enzyme suppression therapy?

A

Periostat
Low dose systemically delivered antibiotic
Doxycycline 20 mg 2xd
9-12 months
Sub antimicrobial dose produces enzyme inhibition
*inhibits collagenase from activating inflammatory response

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12
Q

what is local antimicrobial therapy?

A

placement of antibiotic or antimicrobial agent at a periodontal site
very concentrated

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13
Q

What is substantivity?

A

ability of an agent to be bound to the pellicle and tooth surface.
Released over an extended period of time
retention of potency

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14
Q

Perio Chip

A

Chlorhexidine
biodegradable gelatin mix
40% of drug released in 24 hours
difficult to place

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15
Q

Atridox

A

10% doxycycline hylcate
two syringes-mix
can pack with instrument
tx time: 7-10 days
can use the whole syringe for multiple sites
leaves behind fiber-bring pt back 2 weeks later to remove

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16
Q

Arestin

A 
Minocycline hydrochloride 1 mg
polymer microspheres in powder form
attaches to tooth and sulcus wall
antimicrobial
tx time: 14 days
easy to apply
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17
Q

Advantages of local antimicrobial therapy

A

concentration up to 100 times higher than systemic
minimal or no systemic involvement
delivered where needed
prolonged release over time

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18
Q

When do we utilize local periodontal medicaments?

A

initial non-surgical therapy
reveal appointment
non-responsive site

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19
Q

What are three types of fulcrums?

A

Intraoral
Extraoral
Advanced

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20
Q

What are some elements of an extra oral fulcrum?

A

broad surface area contact between hand and patients face
extended grasp of instrument
appropriate pressure into skin

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21
Q

Advantages of extra oral fulcrum?

A

access to deep pockets
access to maxillary molars
neutral wrist position

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22
Q

Disadvantages of extra oral fulcrum?

A

operator may feel unstable

decreased strength

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23
Q

T/F: Extra oral fulcrums decrease control.

A

FALSE

Control is dependent on the fulcrum pressure

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24
Q

What is an advanced fulcrum?

A

Variations of both intramural and extra oral fulcrums to gain access to deep pockets

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25
Q

Disadvantages of advanced fulcrum?

A

Requires greater amount of muscle coordination and instrumentation skills
greater chance of instrument stick

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26
Q

Split fulcrum

A

weak fulcrum
finger action rather than wrist action
does not allow for deep access into pockets

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27
Q

What is oral irrigation

A

The targeted application of water or other irrigation fluid for preventative or therapeutic use

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28
Q

Advantages of patient applied irrigation

A

Removal of loosely attached biofilm

special needs areas -bridges, implants, ortho

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29
Q

Disadvantages of patient applied irrigation

A

possible dexterity issues
limited reach sub
possibility of tissue trauma
patient compliance

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30
Q

Uses of professionally delivered irrigation

A

post root debridement during non surgical perio therapy
during perio maint appt
acute periodontal infections

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31
Q

What are some agents used for irrigation?

A 
CHX
Water
Stannous Fluoride
Listerine
Herbal solutions
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32
Q

Uses of mouthrinses

A 
pretreatment
biofilm control
reduce inflammation
caries prevention
remineralize
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33
Q

Stannous Fluoride

A

F ion depositedo n enamel/carious lesion

Tin ion interferes with cell metabolism/antimicrobial effect

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34
Q

Sodium Fluoride

A

Deposits F ion on the enamel/carious lesion

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35
Q

Chlorhexidine

A 
Broad spectrum antibacterial
binds to hard and soft tissues
released over time
causes cell lysis
8-12 hour substantivity
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36
Q

Phenolic related essential oils-Listerine

A

Thymol, eucalyptol, menthol
disrupts cell wall, inhibits bacterial enzymes
decreases biofilm effects
low substantivity

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37
Q

Cetylpyridinium Chloride CPC

A

rupture cell wall
decreases ability of bacteria to attach to pellicle
poor substantivity

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38
Q

Oxygenating agents

A

alters cell membrane, increases permeability
release of oxygen helps to debride area
questionable efficacy
poor substantivity

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39
Q

What is Xerostomia?

A

patients perception of oral dryness
1 in 4
increases to 40% in people over 55 years

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40
Q

What are some clinical signs of xerostomia?

A 
inflammation/redness
tissue tight and shiny
secondary infections
increase in caries
halitosis
painful, cracked lips
coated, dry, shiny tongue
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41
Q

What is saliva made up of?

A 
over 99% water
buffering agents
enzymes
minerals
electrolytes
proteins
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42
Q

What are the functions of saliva?

A 
Lubrication and protection
Buffering and cleaning
Maintaining tooth integrity
Antibacterial action
Taste and digestion
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43
Q

What is sialometry?

A

measurement of salivary flow rate below acceptable clinical levels

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44
Q

What are the normal salivary flow rates?

A

stimulated: 1-3 mL/minute
unstimulated: .25-.35 mL/minute
abnormal: anything below those

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45
Q

What is the healthy pH of saliva?

A

6.7-7.4

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46
Q

What is an abnormal pH of saliva?

A

5.5-4.5

47
Q

How much saliva do we produce per day?

A

1-1.5 liters per day

48
Q

What is dentinal hypersensitivity?

A

an exaggerated response to a sensory stimulus

1 in 5

49
Q

What are the clinical symptoms of dentinal hypersensitivity?

A

mild to extreme pain
short, sharp pain
thermal, evaporative, tactile, osmotic stimuli

50
Q

What is the most common cause of dentinal hypersensitivity?

A

toothbrush abrasion!

51
Q

What is Brannstrom’s hydrodynamic theory?

A

Fluid flow in dentinal tubules disturbed by thermal, chemical, mechanical, & osmotic stimuli
Fluid flow osmotic changes stimulate the nerve processes in the more pulpal portions of the dentin and dentin itself=pain

52
Q

What are the desensitizing mechanisms?

A 
nerve desensitization
protein precipitating agents
tubule occlusion/seal
physical
laser
53
Q

How does potassium nitrate work?

A

penetrates through tubules to the nerve, keeps nerve from firing

54
Q

How do protein precipitating agents work?

A 
ions precipitate (group together to form blockage in tubules)
F varnish
55
Q

How does tubule occlusion work?

A

tubules are sealed over to prevent stimuli
gluma
bond/sealer
ACP

56
Q

What are physical mechanisms for desensitization?

A

connective tissue graft
composite restoration
Crown

57
Q

How do lasers work?

A

fuses dentinal tubules

when used with fluoride effectiveness is increased

58
Q

What is demineralization?

A

fermentable carbs get into plaque–bacteria in plaque use these to produce acid–the acids destroy minerals in the enamel

59
Q

What is remineralization?

A

Calcium and phosphate ions penetrate into the enamel–crystals fill in the space left by demin.–pH of saliva becomes more neutral

60
Q

What is ACP?

A

Amorphous Calcium Phosphate
combines soluble calcium and phosphorus salts
Arm&Hammer tp
Enamel Pro

61
Q

What is recaldent?

A

stabilizes the calcium phosphate and increase the level in dental plaque and saliva
casien=byproduct of milk
MI paste

62
Q

What is novamin?

A

bioactive glass, compound made of calcium, phosphate, silica and sodium
claims to relieve sensitivity and provide rapid remineralization
NUPRO

63
Q

What is Pro-Arginine?

A

Colgate sensitive relief
occludes tubules
applied in office with rubber cup

64
Q

What is osteonecrosis?

A

necrosis of the bone due to an obstruction of the blood supply

65
Q

Osteonecrosis of the jaw ONJ can occur because:

A 
radiation therapy
chronic corticosteriod therapy
immunocompromised patients
uncontrolled infections
major trauma
66
Q

What are bisphosphonates?

A

class of drug used in the treatment of bone diseases
affects bone metabolism
they bind to the bone surface and are ingested by osteoclasts, osteoclastic function is slowed
new bone made faster than it can be resorbed

67
Q

What are some diseases most commonly associated with bisphosphonate use?

A 
osteoporosis
metastatic bone disease
pager's disease
hypercalcemia
breaste and prostate cancers
68
Q

Is it more likely to develop ONJ when taking bisphosphonates orally or IV?

A

IV

greater the length of time using bisphosphonates the greater the risk

69
Q

What are some symptoms of ONJ?

A 
non healing extraction sites
exposed jaw bone
radiographically large areas of radiolucency
pain in jaw with no trauma
mobility of teeth
70
Q

What are the oral bisphosphonates?

A

Fosamax
Boniva
Actonel

71
Q

What are the IV bisphosphonates?

A

Reclast-1xyear
Aredia
Zometa

72
Q

What are methamphetamines?

A

CNS stimulant which acts on the brain
causes increased release of neurotransmitters
euphora
weight loss

73
Q

Where is decay found in a meth mouth?

A

anterior ipx

posterior cervical buccal and lingual

74
Q

How does meth work?

A

induces high faster than cocaine-absorbed quicker
high lasts longer than cocaine
high is more intense

75
Q

What are the immediate effects of meth?

A

intense state of euphoria up to 12 hours
increase wakefulness
rapid heart rate
dilated pupils

76
Q

What is formication?

A

most common visual effect of long term meth use
skin lesions
meth mites
result of excessive scratching or picking

77
Q

What are some long term effects of meth?

A 
stroke, increase BP and heart rate
violent behavior
confusion
paranoia
delusions
78
Q

What are the dental effects of meth?

A 
rampant caries
gingivitis/perio
xerostomia
bruxing
tmj symptoms
tooth fractures
79
Q

What is the #1 reason for rampant caries?

A

lack of home care

drink of choice is mountain dew

80
Q

What are some effects of oral piercings on oral tissues?

A 
decalcification
recession
malodor
caries
abrasion
allergic reactions
81
Q

What can we recommend to patients with oral piercings?

A 
remove frequently
thorough dental assessments
regular dental visits
removable over fixed
clean daily
good oral hygiene habits
fluoride paste or gel
82
Q

What are the initial dental impacts of oral piercings?

A 
initial inflammation
hemorrhage
asphyxiation of jewelry
nerve damage
communicable disease
trauma
infections
altered speech
83
Q

What teeth are most likely to be broken with oral piercings?

A

maxillary premolars

84
Q

What can we instruct our patients with oral piercings to do if they have problems?

A

daily, mild non-iodized sea salt rinses 4-5 times a day

removal of jewelry

85
Q

Factors contributing to oral cancer

A 
quantity and frequency of tobacco use
quantity and frequency of alcohol consumption
tobacco and alcohol combined
genetic tendency
sun exposure
HPV
86
Q

Tissue changes that may indicate oral cancer

A 
white lesions-filmy to thick
red velvety lesions
indurated growths in a white lesion
papillary masses
brown/black pigmented areas
87
Q

What are the symptoms of oral cancer?

A

ulcerations that bleed easily and or not resolve within 2 weeks
persistant pain, parasthesia
bleeding

88
Q

High risk sites for oral cancer

A 
lower lip vermillion border
tongue
floor of mouth
soft palate
tonsillar pillars and palatine tonsils
89
Q

What is dysplasia?

A

an abnormal growth of cells that begins in the epithelium
can appear as white, red or mixed
can often resolve if stimulus is removed

90
Q

What is leukoplakia?

A

a white patch or plaque that cannot be scraped off

91
Q

What is erythroplakia?

A

bright red lesions of the oral mucosa that cannot be characterized as any specific disease
more of a concern than leukoplakia

92
Q

What is a degree 1 lesion?

A

slight superficial wrinkling
pale white or gray
no thickening and lesions may disappear when stretched

93
Q

What is a degree 2 lesion?

A

distinct white gray or red color changes
wrinkling is obvious
mucosa is not thickened
color change remains when mucosa is stretched

94
Q

What is a degree 3 lesion?

A

white or grayish color
deep furrows
thickening of the mucosa
lesions persist when tissue is stretched

95
Q

What is basal cell?

A 
common in areas exposed to the sun
open, bleeding crusted lesions
red, raised or itchy
shiny, pink, red, white, or translucent nodules that don't resolve
crusted craters
96
Q

What is squamous cell?

A

most common
open, painless lesions that do not resolve in 2 weeks
wart-like
persistent, scaly red patches with irregular borders
may bleed easily
rough surfaces and central depression

97
Q

What is melanoma?

A

very often fatal
develop near or from mole
ABC’s

98
Q

What are the ABC’s for melanoma?

A 
Asymmetry
border
color
diameter
evolving
99
Q

HPV

A

most common STD
leading cause of oral pharyngeal cancers
HPV 16 and 18
back of the mouth

100
Q

What are some side effects of cancer therapy?

A 
oral mucositis
xerostomia
caries
candidiasis
trismus
osteonecrosis
101
Q

What is an impairment?

A

an abnormality of structure or function of a limb or body organ

102
Q

What is a disability?

A

the inability to perform a task or activity as a result of the impairment

103
Q

What is a handicap?

A

disadvantage or limitation that an individual has when compared with others of the same sex, age, background that has resulted from the impairment or disability

104
Q

T/F: disabilities are always permanent

A

false

105
Q

T/F: restraint requires consent from parent or guardian

A

True

106
Q

What is protective stabilization?

A

any manual method, physical or mechanical device, material, or equipment that immobilizes or reduces the ability of a patient to move his or her arms, legs, body or head

107
Q

What is active immobilization?

A

restraint by another person

108
Q

What is passive immobilization?

A

utilizes a restraining device

109
Q

What are supportive straps?

A

placed on wrists and ankles tied to chair

110
Q

What is a pediwrap?

A

nylon mesh that encloses the patient from neck to ankles

111
Q

What is a papoose board?

A

board with padded wraps to enclose a patient

112
Q

What are some chemical restraints?

A 
xanax
adavan
versed
prpofol
valium
halcion
113
Q

What are some adjunctive therapies for special needs patients?

A 
xylitol products
fluoride products
fluoridated water
reduction of fermentable carbs
chx rinse
114
Q

What are the guidelines for informed consent?

A 
nature of oral disease condition
reason for recommended care
alternatives
consequences
potential complications

Dental Hygiene-III (1 decks)

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