W2: Cario: FS for Caries Prevention Flashcards
Discuss the distribution of caries within communities and describe the
characteristics of susceptible populations
- caries more due to sugar, esp low SEB (socioeconomic backgroud) as less FS placed
Explain the concept of ‘polarization of caries experience’ within the population
and provide evidence to support this
Discuss the site-specific distribution of caries
- green = caries free
- btw 74’ and 1990 we are getting better with prevention
grey= occlusal
orange= IP
red= incisive anteriors
in 74’ more caries in incisor and IP, shrinks in 1990
occlusal band has kinda stayed the same.
OCCLUSAL= fissures, so anatomy pays role in caries (apart of multifactorial risk),
Understand the ‘risk-based’ approach to considering the placement of the
sealants for patients
- are they high or low SEB? look of them as a whole
- look at tooth risk status: diet, OH good (kids under 8 not good at brushing teeth)
- F exposure?
- fissure anatomy, is it deep/ stained?
- sealants retentive? can you make it more?
- what material might you use?
Describe the evidence on the effectiveness of sealants in caries prevention
- study with bunch of kids, one side sealed, no seal contralat tooth
- post 5 yrs
- did not repeat 10 yrs bc not ethical
- after 5 years 352 kids (1 sealed 1 not)
- 1 decay
in control= 18% decay
Describe the relationship between sealant retention and sealant efficacy
Describe the clinical considerations before choosing materials that are to be
used for the placement of fissure sealants and fissure protections.
DMFT and dmft
permanent vs primary
decay decrease with FS
comment
F help caries.
gingival= 86 reduction in caries
IP= 75% reduction
BUT pits and fissures = 36% reduction (significantly lower.
which is lower?
b. lower bc of distal cusp.
upper or lower?
oblique ridge prominent
extra cusp of carabelli (always look out for it bc sometimes fissure is there and you may need to seal it)
classify occlusal fissures
4 types
describe occlusal fissure types
- U: the bottom is wide
- V looks like V
- I long skinny
- IK: long skinny, lil opening
can’t really tell clinically, you just have to use clinical judgement
what types are easiest occlusal type to seal
V and U
Whats the problem of Pit/ fissures on teeth?
Not all pits/fissures can be reached by toothbrush bristles
– Dietary carbohydrates can become lodged in the fissures and
provide a source of nutrients
– Note that the anatomy of some pits/fissures is very complex and
impossible to clean
fissure Cross section reveals…?
tooth brush not going to go pass black part
less cariogenic= need to cover it
What’s a good fissure system?
nice, smooth, F system covered, buccal and palatal considered. easy to clean
type of fissure
more of I type, demineralisation on base of fissure due to acid from biofilm.
- hard to see early demin on occlusals, more easier on IP surface
I vs U
material cannot get into I style fissure, what you can do is technique.
If you place it well, you can arrest demin, bc if no food access to bacteria= no demin
The role of fissure sealants
A) benifits of fissure seal?
B) why is baby teeth more decay prone?
A) clean(easier), caries resistant (no carbs = no bacteria food), can remin if use GIC
B) has more HA than Fha (no strong enamel)
Fissure sealants are placed in the caries susceptible pits and fissures of primary and
permanent in order to form a physical barrier.
- use GIC= can add fluoride even years after placing it
- occlusals of permanent molars= most sus sites for dentition (occlusals >IP> B> L)
Why is lingual< buccal less susceptible to caries
tongue mechanical movement
Does the placement of fissure sealants prevent caries ??
dependent on how well it is sealed, need monitor
- better than no sealant/no varnish F
nosealant= more decay
