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Dental nurse exam revision > Unit 311 > Flashcards

Unit 311 Flashcards

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1
Q

What are the 4 main oral diseases that raise concern for the dental team?

A
  • dental caries
    -gingivitis
  • periodontitis
    -oral cancer
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2
Q

what is dental caries?

A

bacterial infection of the tooth

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3
Q

what is gingivitis?

A

inflammation of the gingival tissues

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4
Q

what is periodontitis?

A

inflammation of the surrounding structures of the tooth.

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5
Q

what is oral cancer?

A

squamous cell carcinoma

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6
Q

What is a good way to promote communication?

A

advice delievered in a way the patient understands.

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7
Q

Communication:what are the 3 age groups?

A

style of communication and advice given will vary between age groups
adults, young people, children

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8
Q

patient motivation:

A

regardless of the help of the dental team, some patients are not interested in their own OH and are unwilling to follow advice

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9
Q

mental capacity:

A

as people get older health conditions will affect the mental functions e.g. dementia so the understanding and retention of info being given may be forgotten

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10
Q

In regards to patients general health, how may this affect oral hygiene?

A

some medical and physical conditions will cause oral disease development in some patients, while other conditions affect the patients ability to carry out effective OH

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11
Q

what are the causing factors of dental caries?

A
  • high sugar diet NMES
  • poor oral hygiene
  • stagnation areas e.g. overhangs, occlusal fissues, abutments (dentures).
  • bacteria within the plaque biofilm + sugars = acid
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12
Q

What are the causing factors of gingivitis and periodontitis?

A
  • poor OH
  • stagnation areas e.g. gingival crevice
    -failure to treat and eradicate the ginigvitis allowing the inflammation to progress to periodontitis
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13
Q

dental plaque biofilm is..

A

plaque

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14
Q

What is plaque

A

thin transparent layer of saliva, oral debris and normal mouth bacteria that sticks to the tooth surface it can only be removed by cleaning.

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15
Q

What causes plaque to grow thicker?

A

food debris

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16
Q

If plaque is in contact with a tooth surface caries will develop unless the plaque is removed.

A
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17
Q

If plaque is in contact with the gingiva, gingivitis and then periodontitis will develop unless the plaque is removed.

A
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18
Q

caries is mainly a disease for those of what age groups?

A

children and young adults

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19
Q

periodontal disease develops at what stage in life?

A

Later in life
It can be found in younger patients but this is uncommon

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20
Q

In regards to sugars what age group is more likely to eat more?

A

young children - their teeth are more vulnerable to caries

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21
Q

what is saliva?

A

the watery secretion from the salivary glands that bathes the oral cavity to keep the tissues moist.

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22
Q

What does saliva protect our oral cavity against?

A
  • caries by promoting remineralisation of early enamel caries due to its MINERAL CONTENT and BUFFERING effects
  • Periodontal disease by its cleansing and antibacterial properties due to its ANTIBODY and WHITE BLOOD CELL content and ANTIBACTERIAL ENZYMES.
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23
Q

How does saliva promote overall health of the mouth?

A

lubricating and cleansing effects

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24
Q

what is xerostomia?

A

dry mouth

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25
Q

Patient who have xerostomia are at more risk of getting what oral diseases?

A

caries and periodontal disease

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26
Q

what do acids cause?

A

enamel demineralisation

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27
Q

What are the 3 examples of advice we will give to a patient in relation to caries prevention?

A
  • increase the tooth resistance to acid attack - fluoride
  • modify the diet - fewer cariogenic foods and drinks and reduce frequency intake
  • control the build up of bacterial plaque - good OH routine
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28
Q

what is the main cause of periodontal disease?

A

poor oral hygiene

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29
Q

What are the 3 examples of advice we will give to a patient in relation to periodontal disease?

A
  • control the build up of bacterial plaque - good OH
  • modify the contributory factors - smoking
  • control the host response - frequent dental attendance for monitoring and evaluation and intervention - 3 months.
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30
Q

Plaque forms within what time frame?

A

hours

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31
Q

Oral hygiene techniques that are given to a patient to carry out at home:

A
  • toothbrushing - effective technique and recommended toothpaste
  • interdental cleaning - brushes or floss
  • suitable mouthwashes
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32
Q

Toothbrushing is the method used to remove..

A

surpagingival plaque + food debris on the tooth surface

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33
Q

Should the patient be told to rinse after brushing?

A

No - the patient should spit not rinse as it removes the residual toothpaste and prevents chemical constituents from continuing to act in the mouth e.g. flouride

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34
Q

What is the recommended age that parents should brush their childs teeth up until?

A

8 years old

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35
Q

95% of Toothpastes in the UK contain fluoride, what is the normal PPM for fluoride for children and adults?

A

sodium monofluorophosphate and sodium fluoride at 1400PPM

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36
Q

High fluoride toothpastes should contain what PPM?

A

between 2800 and 5000ppm for use of adult patients with high caries risk

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37
Q

What else does toothpaste contain?

A

triclosan with zinc this acts as an antiseptic plaque suppressant

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38
Q

what do sensitive toothpastes contain?

A

arginine, NovaMin and stannous fluoride

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39
Q

what do whitening toothpastes contain?

A

mild abrasives as micro-crystals - use of biological enzyme systems

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40
Q

toothpastes that contain titanium dioxide and phosphosilicates help to protect the teeth against…

A

acid erosion + help enamel repair

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41
Q

what is dental floss used to do?

A

achieve interdental plaque removal
instructions on the usage is important

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42
Q

why are flossettes easier to use than floss?

A

patients can floss with one hand - makes it easier with posterior teeth

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43
Q

Indental brushes are used to clean:

A

interdentally around every tooth and they are also used with orthodontic appliances.

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44
Q

What are interspace brushes usually used for?

A

help the patient to clean in wider interdental spaces as well as fixed ortho appliances

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45
Q

Are woodsticks usually recommended?

A

No as they can easily become stuck into the gum and cause problems if used incorrectly

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46
Q

The main aim of interdental aids is?

A

to dislodge food particles and accumulated plaque from the interdental areas of the teeth.
mesial and distal surfaces of teeth

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47
Q

general use mouthwashes contain various ingredients to promote good OH for example…

A

sodium fluoride - provides TOPICAL fluoride application to teeth
triclosan - chemical that suppresses the formation of plaque

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48
Q

what ingredient does the mouthwash contain that is given to patients with soft tissue inflammation:

A

hydrogen peroxide

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49
Q

specialist mouthwashses are advised to patients suffering from both acute and chronic periodontal infections they contain:

A

chlorhexidine - antiseptic plaque suppressant

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50
Q

Can loose food debris be removed by sugar-free chewing gum or finishing a meal with detergent food?

A

Yes - it is recommended

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51
Q

Examples of detergent foods:

A

raw, firm, fibrous fruits or vegetables e.g. apples, pears, carrots and celery.

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52
Q

What does having HARD cheese at the end of a meal stimulate?

A

salivary flow, neutralises acid and enhances remineralisation of enamel = calcium content

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53
Q

Chewing gum should be advised for what time of the day?

A

after a meal not continuously
after 10 mins should be disposed of
will increase the amount of tooth wear that occurs

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54
Q

fluoride occurs naturally in water and is added artifically to water supplies in other areas during the process of water fluoridation.

A
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55
Q

fluoride replaces the hydroxyapatite crystals with:

A

fluorapatite crystals = fluoride protects the teeth from developing caries.

56
Q

topical fluoride is

A

application of various oral health products

57
Q

systemic fluoride is

A

fluoride that is taken internally with food/drink products

58
Q

Topical fluoride that patients can use:

A
  • fluoride toothpastes
    -Not to rinse after brushing
  • flouride mouthwash
  • dental floss
59
Q

Children under 3 years old should be using toothpastes containing no less than what PPM?

A

1000

60
Q

Topical fluoride that the dental team can provide for a patient:

A
  • fluoride varnish for patients with high caries risk contain 22,600PPM fluoride, reduce the indicience of caries by 30-40%
  • Fluoride varnish - duraphat
  • high concentration fluoride toothpaste on perscription
61
Q

What is the risk of perscribed fluoride supplements?

A

fluorosis

62
Q

Examples of systemic fluorides:

A
  • fluoridated water supplies 1ppm
  • fluoride drops and tablets - for children on perscription to be taken up until the age of 13 years old
63
Q

What does fissure sealant do?

A

used to seal the natural stagnation areas of pits and fissures therefore preventing the patient from acid attacks and avoiding onset of dental caries.

64
Q

What is enamel fluorosis?

A

Occurs when excessive fluoride is ingested during enamel formation.
dotted white areas in the enamel surface which very in severity.
restorative techniques can disguise this

65
Q

Reducing which foods will help prevent dental caries:

A
  • free sugars NMES
  • dietary acids from daily food and drink intake
66
Q

After eating the oral cavity will experience an acid attack what level will the PH go to?

A

5.5

67
Q

what is the neutral PH level?

A

7

68
Q

Free sugar foods should be ate at meal times only what is the reason behind this?

A

Because the acids involved are neutralised to some extent by the buffering action of saliva and the extent of demineralisation will be reduced.

69
Q

Foods containing “hidden sugars” can be identified by reading the contents label of each product.

A
70
Q

What was the reasoning behind the “Eatwell guide” being made?

A

help advise the public on what constitutes to a healthy balanced diet by dividing standard food plate into thirds and indicating the amount of products that should come from each group

71
Q

What are the 4 food groups:

A
  • 1/3 protein
  • 1/3 carbohydrate 33%
    -diary
  • 1/3 fruit n veg
72
Q

Department of health publication: delivering better oral health for adult patients

A
73
Q

Dietary advice that should be given to a patient in regards to reducing dental caries:

A
  • healthy balanced diet - foods of low cariogenic
  • any high in sugar foods should be ate at meal time
  • use of diet sheets to see if any hidden sugars are being taken
  • advice to mothers when using cariogenic drinks in bottles
74
Q

contributing factors of periodontal disease cause the disease to worsen, what are common factors:

A

-smoking
- stress
- hormonal imbalance
- history of radiotherapy treatment
- medical conditions - diabetes, leukemia, vitamin c deficiency, Aids
- plaque retention factors - crowding, unopposed teeth, overhangs

75
Q

Patients who are unable to properly fight infection or to heal when attacked by pathogens are called:

A

immunocompromised

76
Q

Tissue overgrowth is called:

A

gingival hyperplasia

77
Q

What medications can cause gingival hyperplasia?

A

phenytoin (epilepsy), antihypertensive agents, immunosuppressant drugs

78
Q

What are the two main contributing factors of periodontal disease?

A
  • masticatory stress
  • localised plaque retention
79
Q

Patients suffering with gingival hyperplasia can undergo what procedure to remove the excess tissue?

A

gingivectomy

80
Q

What is the service that can be offered to patients during smoking cessation advice?

A

NHS stop smoking service

81
Q

Can periodontal disease be caused by genetics?

A

patients can develop periodontal disease genetically
require a high level of support and maintenance by the dental team to ensure the disease does not spiral out of control and result in loss of teeth.

82
Q

Dental treatment that is recommended to help patients who are suffering with genetic periodontal disease:

A
  • scaling
    toothpastes containing - triclosan and zinc citrate
    mouthwashes containing - chlorhexidine
  • antibiotic gel if necessary once debrided
  • periochip
  • periodontal specialist ref
83
Q

what is periochip used to do?

A

inserted into the debrided pocket to provide a slow release delivery of chlorhexidine directly into the problem area.

84
Q

Good communication skills are really important when giving advice to patients regarding oral hygiene.

A
85
Q

what does communicating mean?

A

to give or exchange information
verbally or non - verbally

86
Q

ways to communicate to a patient correctly:

A
  • talking directly or over the phone
  • written explanations
  • information leaflets/posters
    -body language = friendly and open
  • eye contact = maintaining eye contact
    -facial expressions
  • body positions - talk face to face
  • touching - calm patients down and reassure them
87
Q

Ethic group: hindus: how could this religion affect a patients oral health?

A

diets are high in fats

88
Q

Ethic group: Sikhs : how could this religion affect a patients oral health?

A

diets are high in diary

88
Q

Ethic group: muslems: how could this religion affect a patients oral health?

A

diet is rich in fish

88
Q

Asian groups tend to breastfeed their children til around 2 years old, is breast milk high in sugar?

A

yes

89
Q

The aim of good communication is to identify a patients level of motivation, if a patient is unmotivated we will try and think of ways to help

A
90
Q

Risks factors of poor OH tend to be because of:

A

complex social attitudes and outside pressures

91
Q

Childrens oral health very much depends on who:

A

parental guidance + support

92
Q

Parents who have little interest in their own oral health will influence these behaviours on their children.

A
93
Q

Oral health messages to children need to come across in what way?

A

as fun
use of games, drawings and competitions

94
Q

Lack of motivation could be because of:

A
  • lack of knowledge
  • lack of interest
  • presence of known risk factors
95
Q

As the dental team we have to understand the reasons behind why a patient is not motivated and try to help.

A
96
Q

Successful communication with adult patients can be achieved by:

A
  • health leaflets
    -one to one discussions
    -eye contact maintained
    -any queries listened to and answered
97
Q

Successful communication with young people can be achieved by:

A
  • relevant leaflets
  • good patient management
  • one to one sessions
98
Q

Successful communication with children can be achieved by:

A
  • disclosing tablets
  • supervise individual attempts at toothbrushing
    -relevant games to play
    -encourage parental involvement
99
Q

What factors could be affecting a patients oral health?

A

social, environmental, economic, patients knowledge and skills

100
Q

oral health education should aim to..

A

modify a patients poor behaviour towards their oral health not reverse it

101
Q

Low socioeconomic groups may have poor OH for what reasons?

A
  • not likely to attend for regular examinations
  • poor diet
    -high rate of smoking and drinking
  • dental ignorance - low self esteem
102
Q

Aids to help stop smoking:

A

nicotine patches or chewing gum
NHS stop smoking service

103
Q

When progress has been made the patient should be congratulated, how would we show this with children?

A

stickers, badges, certificates

104
Q

Current guidelines regarding oral health assessment recall intervals are issued by whom?

A

NICE

105
Q

High risk patients should be viewed every:

A

3 months

106
Q

mod risk patients should be viewed every:

A

6 months

107
Q

low risk patients should be viewed every:

A

12 months

108
Q

What affects does smoking have on general and oral health?

A

general = heart and respiratory disease
oral = periodontal disease, oral cancer

109
Q

What affects does diet (free sugars) have on general and oral health?

A

general = obesity, risk of heart disease
oral = dental caries

110
Q

What affects does excessive alcohol have on general and oral health?

A

general = liver disease
oral = periodontal disease, dental trauma, oral cancer

111
Q

What affects does eating disorders have on general and oral health?

A

general = anorexia, bulimia
oral = acid erosion of enamel

112
Q

What affects does diabetes have on general and oral health?

A

general = poor wound healing
oral = poor wound healing and prone to infections including periodontal infections

113
Q

what medical condition can reduce salivary flow:

A

sjogrens syndrome

114
Q

Disabilities can be:

A

mental or physical

115
Q

Mentally disabled patients should have:

A

minor learning disabilities, elderly suffering with dementia such as alzheimers disease, down syndrome

116
Q

Severe cases of disability patients will be referred for specialist care in community special needs clinics.

A
117
Q

Those with some learning disabilities may present themselves in what way to the dental team:

A
  • short attention span
  • poor memory retention
    -reduced level of understanding
118
Q

Patients who have physical disabilites may present themselves in what way to the dental team:

A
  • hearing impaired patients - lip reading
  • visually impaired patients - touch n feel or listen to the sound of dental equipment before use
  • downstairs surgeries
  • stroke victims - struggle with speech, rely on family members
119
Q

What effective oral hygiene can be advised to patients who are disabled?

A
  • adapting a toothbrush handle
  • oral health may be of responsibility to a career - important they understand in great detail
    -angled toothbrushes
    -several floss holders
120
Q

The dental team may be the first people to notice a change in a patients behaviour - onset dementia what can we do to help?

A
  • the dentist can write a letter to the patients GP describing their concerns
121
Q

For patient consent with a patient who has dementia what protocol must be followed?

A

GDC standards for the dental team
code of practice set out in the mental capacity act

122
Q

In regards to dementia what does cognitively impaired mean?

A

their disease worsens

123
Q

Patients with dementia should be perscribed high fluoride toothpastes.

A
124
Q

What is bruxism?

A

teeth grinding - gum shield

125
Q

Bruxism can occur in patients with dementia

A
126
Q

What is the correct word for difficulty in swallowing?

A

dsyphagia

127
Q

What is gerodontology?

A

dentistry for the elderly

128
Q

Elderly patients: possible changes to the skin with age?

A
  • less underlying fat, increased risk of tissue fragility and soft tissue trauma and bruising.
129
Q

Elderly patients: possible changes to the bone with age?

A
  • more brittle, jaw bones increased risk of fracture during xla
130
Q

Female elderly patients with osteoporosis who are taking bisphosphonates are likely to be referred for extractions, what is the reason behind this?

A

risk of postoperative bone necrosis

131
Q

Elderly patients: possible changes to the oral mucosa with age?

A
  • thinner less elastic - easy to trauma during routine treatment
    ridge areas less tolerant to bearing dentures - discomfort and ulceration
    -gingival recession - root caries
132
Q

Elderly patients: possible changes to the salivary glands with age?

A
  • suffer from dry mouth Xerostomia - increase in caries rate
    swallowing, speech dentures
133
Q

Elderly patients: possible changes to the teeth with age?

A
  • gradual darkening colour
    -narrowing and sclerosis of the pulp chamber = difficulty RCT
  • reduced sensitivity
134
Q

Elderly patients may experience difficulty in accessing dental care due to:

A
  • poor mobility - unable to attend, downstairs surgeries
    -complicated medical problems - limit treatments
  • dementia, visual or hearing impairment
135
Q
A

Dental nurse exam revision (13 decks)

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