FINAL
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| Health is defined as: | defined as a condition of complete physical, mental, social, spiritual and psychological well-being.
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| Preventive dentistry is classified into three different levels: define each level and provide example for each : | primary prevention- prevention of disease
secondary prevention- treatment of early disease- root canals
tertiary prevention- replacement of lost teeth due to disease - implants
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| Accumulative microbial changes in Biofilm occur when plaque is left undisturbed, describe by day and forms of bacteria: | 1- primary gram positive cocci dominate 2-4 cocci dominate filamentous forms slender rods replace cocci 4-7 filaments form increase biofilm thickens more mature flora of gram spirochetes 7-14 spirochetes & flora prevalent gingivitis evident
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| patient asks what will happen if i don't brush my teeth for two days describe | Gingivitis appears in 2-3 weeks; reversible after 3-5 days of effective brushing and flossing.
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| Imagine that you are holding an "interview" with bacteria living in an oral biofilm. How might the bacteria respond to your question about advantages of living in a biofilm? | microcolonies of bacteria in biofilm say- theyre protected by extracellular slim layer-resistant to antibiotics, antimicrobial agents & bodies immune response. this Aids in long term bacterial survival which are not easily destroyed. they can communicate
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| A patient in the dental operatory asks, " what is the most effective way to control the bacteria in my mouth from dental plaque biofilm?" | Correct I would tell them to brush and floss twice a day, or after each meal if necessary, as well as talk to your dental provider about how often it is recommended that you receive professional cleaning.
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| The film that serves to protect the bacteria from physical and chemical destruction and aids in adherence for bacteria: | Extracellular Polysaccharides
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| The acquired pellicle: | Is thought to serve as a protective layer against acids
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| Which of the following describes undisturbed plaque biofilm components approximately 2 to 3 weeks old: | Vibrios & spirochetes are prevalent
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| A well established case of gingivitis is clearly evident clinically between days: | 14 & 21 days
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| This material is a loosely adherent mass of bacteria and cellular debris, can be removed by the mechanical action of strong water spray: | materia alba
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| The subgingival biofilm consists of mainly _______ organisms. | gram-negative
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| Root canal therapy is an example of the primary prevention | false
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| If left undisturbed (supragingival plaque), subgingival plaque biofilm results from the apical proliferation of microrganisms from the supragingival biofilm. | true
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| What two TYPES of bacteria primarily cause dental caries? | STREPTOCOCCI MUTANS and SORBINUS
LACTOBACILLUS
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| What is the critical level of the ph whereby enamel begins to demineralize? | 5.5
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| Caries is a multifactorial process dependent upon what THREE factors that must occur simultaneously? | Bacteria, Tooth surface, and Fermentable Carbohydrates all over time= DECAY
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| Define rampant caries and provide an example | Rampant caries are caries that develop quickly in the mouth causing rapid decay, for example 'bottle rot' or early childhood caries
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| What is the importance of saliva and provide THREE reasons why? | saliva = defense against demineralization. Protective: physical chemical and antibacterial properties Physical as salivary flow decreases caries increase chemical promotes remineralization secreation of histamine statherin antimicrobial: antibodies
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| Of the following, which has the greatest influence on exacerbating caries formation: | . Frequency of carbohydrate ingestion
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| All of the following regarding caries is TRUE EXCEPT: | Once demineralization begins, it is a continual ongoing process which always results in cavitation
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| Regarding caries, which of the following statements is FALSE? | Lactobacilli are usually found even earlier than the streptococci mutans at the incipient lesion site
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| Why is it important for pregnant women to have excellent dental health before their babies are born and even after the babies are born in relation to caries development? | food they take in can implement their child grows, if they don't have fluoride caries can become prominent in childs forming teeth
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| Caries can occur in four general areas of the tooth. Define each of these areas. | pits & fissures: decay on the occlusal surfaces Smooth surface caries: intact enamel Root caries: on exposed root recurrent caries: decay within immediate vicinity of restorative
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| Discuss the stages of demineralization and remineralization in caries development: | the tooth is attacked by acids and plaque in saliva, calcium and phosphate dissolve in the enamel in the process of demineralization, Fluoride, Calcium and phosphate re-enter the enamel in a process of remineralization.
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| twins are in the office for a routine visit, the mother informs that the twins eat the same amount of sweets. One twin eats the sweets all at once the other eats it throughout the day which one is more likely to have decay | the twin that eats candy throughout the day is more apt because she is continuously eating candy throughout the day and is demineralizing more. Whereas the other twin just demineralizes one time.
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| patient takes many meds for arthritis and blood pressure; these make her mouth dry. She sucks on candies to help with dry mouth. she drinks one glass of water a day as well as ginger ale.. Now has root lesions what do you suggest about fluid intake | would suggest that she drink more water, and try to eat more cheese, milk, nuts, butter, meat fish and poultry because these foods help protect agains caries.
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| patient takes many meds for arthritis and blood pressure; these make her mouth dry. She sucks on candies to help with dry mouth. she drinks one glass of water a day as well as ginger ale. Describe what CAMBRA is and assess the individual's risk factors | cambra- caries management by risk assessment. Meds that cause dry mouth are risk factor and the candy as well as ginger ale are too. All of these are factors which contribute to her caries. she should drink more water and eat less sugary foods
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| patient takes many meds for arthritis and blood pressure; these make her mouth dry. She sucks on candies to help with dry mouth. she drinks one glass of water a day as well as ginger ale. what is the most likely factor of her new root caries |
The most likely risk factor would be the dry mouth followed by the sugary substance because the sucrose in her candy causes the ph level to drop below crtical level.
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| denitrifice | substances used with a toothbrush or other applicator for removing plaque materia alba and debris from teeth
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| abrasives | cleans and polish
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| examples of abrasives | calcium carbonate
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| detergents | help loosen debris
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| examples of detergents | sodium laryl sulfate
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| water and humectants | maintain moisture: sorbitol, glycerin propylene glycol mannital
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| binders (thickeners) | prevent separation of ingredients: alginate or gums
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| preservatives | prevent mold and bacterial growth alcohol sodium benzoate
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| sweetening agents | flavor: saccharine, sorbitol, mannitol, xylitol glycerin
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| flavoring agents | for flavor peppermint spearmint
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| coloring agents | give attractiveness: vegetable dyes
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| anti caries agents | fluoride
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| therapeutic agents | active ingredient to prevent dental disease
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| anti gingivitis agent | triclosan anti bacterial agent
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| anti calculus dentrifices contain? | pyrophosphates or zinc citractes
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| Abrasives | hydradted silica
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| anti hypersensitivity agents | pottasium nitrates, strontium chloride and sodium citrate
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| purpose of rinsing with mouthwash | dislodges debris in mouth.
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| is rinsing effective against subginigival flora? | no
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| classifications of mouth rinses are | therapeutic or cosmetic
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| therapeutic | depresses oral bacteria count, prevents or moderates disease process
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| cosmetic | removes debris causes a pleasant mouth feel
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| who wrote the first textbook on preventative denstitry | dr. fones
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| severe periodontal disease affects what percentage of people | 14% of adults age 45-54 23% 65-74
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| what percentage of 65 year old people are edentulous | 30%
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| primary prevention | so disease does not occur
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| secondary prevention | treatment of early disease
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| tertiary prevention | measures taken to replace lost teeth due to disease
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| stages in biofilm formation | 1 formation of pellicle 2 bacteria attach to pellicle 3bateria multiplies 4.bacterial growth and maturation
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| changes in biofilm in one day | gram positive cocci dominiate
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| changes in biofilm 2-4 days | cocci dominate still, filamentous forms, slender rods grow and replace cocci
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| changes in biofilm 4-7 days | filaments form increase, biofilm thickens and develops more mature flora of gram and spirochetes and virbous
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| change in biofilm 7-14 days | vibrous and spirochetes apparent, signs of inflammation are beginning to be observed
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| change in biofilm 14-21 days | vibrous and spirochetes are prevalent gingivitis is evident clinically.
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| calculus is | mineralized bacterial plaque
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| fluoride | defined as a salt of hydrofluoric acid
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| since the 1950 this has been natures cavity fighter | fluoride
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| The following is an example of primary prevention: | sealant
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| Root canal therapy is an example of: | secondary prevention
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| The film that serves to protect the bacteria from physical and chemical destruction and aids in adherence for bacteria: | extracellular polysaccarides
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| A well-organized community of bacteria that adheres to surfaces and is embedded in a protective slime layer is termed: | biofilm
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| Calculus is considered a local risk factor of periodontal disease because: | A. The surface of the calculus is irregular and provides a handy place for bacteria to grow undisturbed
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| The most harmful biofilm bacteria are characterized as gram positive, anaerobic, and non-motile. | false
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| Which structure of a biofilm protects the bacterial microcolonies from systemic antibiotics and the body’s immune system? | extracellular slime layer
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| The critical pH range for enamel demineralization to occur is between: | 4.5 and 5.5
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| The major pathogenic bacterial species involved in caries initiation are: | Streptococcus Mutans and Sorbinus
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| Of the following, which has the greatest influence on exacerbating caries formation: | frequency of carbohydrate ingested
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| A well-established case of gingivitis is clearly clinically evident by: | 14-21 days
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| A carious lesion that forms on intact enamel other than pits and fissures is referred to as: | smooth surface caries
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| When caries occurs on the tooth surrounding a restoration: | reccurent caries
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| A patient’s salivary function can be reduced by: | illness medications and radiation therapy
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| Accompanying inflammation is a definite order of arriving defense cells. The first cells to arrive are: | A. Polymorphonuclear leukocytes
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| The U.S. Public Health Service established an optimal standard for fluoride in the drinking water in the U.S. based upon the annual average of maximum daily air temperature. As a result, the optimum level is actually a range of: | 0.7-1.0 ppm
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| Topical fluoride is applied directly to the tooth through use of a toothbrush, mouthrinse and applications of gels, foams, and varnishes AND topical fluoride is acceptable to swallow. | First part of statement is correct; second part is incorrect
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| The following are all examples of systemic fluoride EXCEPT: | toothpastes and mouth rinses
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| Community water fluoridation is ideal primary health prevention because: | inexpensive
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| The dentists determine if a dental assistant can perform professional topical fluoride application to a patient not the state laws. | false
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| All of the following regarding bacterial biofilm is correct EXCEPT: | D. The best method currently available to control biofilms is chemical means.
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| The following is associated with gingivitis: | redness, enlarged gingiva, irreversible
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| All of the following are TRUE in regards to calculus formation EXCEPT: | B. Calculus inhibitors only work on subgingival calculus
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| What is the term for the dissolution of calcium and phosphate from the tooth? | demineralization
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| What is the term for the rapid and extensive formation of caries? | rampant carries
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| Which of the following characteristics is typical of bacteria in a biofilm? | A. Bacteria communicate with each other by sending out chemical signals.
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| The relationship between periodontal disease and heart disease may be from: | Oral bacteria affects the heart when it enters bloodstream, attaches to fat plaques in arteries & causes clots. CHD is a thickening of the walls of the CA due to fats. Blood clots obstruct normal blood flow, less oxygen & nutrients get to heart
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| Before prescribing supplements, the dentist considers the following: | childs age and fluoride level in drinking water
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| What is the goal of a patient education program? | teach the patients how to take care of their teeth and develop sound dental habits
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| What is the initial step in a patient education progam? | listening to the patients
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| What technique is used in a dental office to provide fluoride treatment? | topical
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| What is the name of the process by which fluoride protects the teeth from decay? | remineralization
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| What dental condition is the result of too much fluoride? | flurosis
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| Fluoride varnish is used with which group of patients? | patients of any age
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| How do sugar-free sodas relate to dental caries? | increase acidity
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| WHAT IS CAMBRA? | caries management by risk assesment
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| WHAT IS ppm? | parts per million
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| WHAT IS FLUORIDE VARNISH? | Fluoride Varnish is a temporarily adhesive form of fluoride applied to the tooth surface by a health care professional as a type of topical fluoride therapy
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| WHAT IS DENTAL FLUOROSIS? | development disturbance of dental enamel caused by the consumption of excess fluoride
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| WHAT IS RECURRENT DECAY? | decay within the immediate vicinity of a restoration and it begins by failing at the margin of the restoration
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| WHAT IS ACUTE FLUORIDE TOXICITY? | rapid intake of an excess dose over a short period of time
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| WHAT IS CHRONIC FLUORIDE TOXICITY? | long term ingestion of fluoride above the therapeutic recommended level
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| WHAT IS PERIODONTITIS? | is a serious gum infection that damages the soft tissue and destroys the bone that supports your teeth it can cause tooth loss or worse, an increased risk of heart attack or stroke and other serious health problems.
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| WHAT IS ECC? | early childhood caries
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| NAME THE FOUR GENERAL AREAS OF THE TOOTH FOR CARIOUS LESIONS: | pits and fissures
root caries
reccurrent caries
smooth surface caries
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| magine that you are holding an “interview” of bacteria living in an oral biofilm. How might the bacteria respond to your question about advantages of living in a biofilm? List three MAJOR advantages | they're protected by an extracellular slime layer that's resistant to antibiotics, antimicrobial agents& the bodes immune response, this aids in long term survival of the bacteria. They're not easily destroyed, in this biofilm they are able to communicate
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| LIST the Factors involved in the Formation of a Carious Lesion (cavity)… | Fermentable carbohydrates + Bacteria + Host (tooth)= over time- DECAY
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| How does saliva protect the teeth from dental caries? | it neutralizes ph in the vicinity of the tooth surface
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| What precautions are necessary for children using fluoridated toothpaste? | seek advice from a dentist or healthcare professional before introducing a fluoridated toothpaste
supervise child while brushing to discourage swallowing
only a small pea sized amount of fluoride tooth paste on brush
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| As a dental assistant, you have been asked to speak to a group of pregnant women regarding their dental health. Why is it important for these pregnant women to have excellent dental health before their babies are born? | have dental care during pregnancy to prevent transmission of caries from mother to baby. I would also suggest they rinse with baking soda if they experience morning sickness as this will help prevent erosion, use fluoride to prevent caries in child
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| twins are in your dental office mom informs you that they both eat the same amount of sweets. However, Christie eats her sweets all at once, but Callie divides her sweets throughout the day. Which of the twins is most likely to have tooth decay? Why? | callie because the teeth are not allowed to demineralize and remineralize like they are when christie eats her sweets all at once
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| new patient in. His medical history indicates that he is taking medications for his Type I diabetes mellitus. On the basis of this information, do you think you might see any unusual conditions in his oral tissues? If so, what and why? BE SPECIFIC. | ask if how they maintain diabetes, and what they last ate. slow healing of wounds harder to fight infections xerostomia aand high blood sugar levels can contribute to periodontal disease in diabetic patients
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| new patient in. He indicates that he smokes 1/pk a day of cigarettes, takes no medications, and “notices his front teeth are loose”. What is the relationship between smoking and periodontal disease? BE SPECIFIC. | observe oral cavity first. look for inflamed gums bleeding & open sores. smoking is the leading cause of periodontal disease. It restricts the blood vessels making blood hard to get to the area to fight off bacterias. healing is harder for smokers
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| A 10 year boy does not think he should give up eating sweets all day long? How would you present patient ed? | inform the patient of remineralization and demineralization. when you constantly snack you cause demineralization which = caries. so if you snack all day you get caries and with caries comes restoratives.
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| A mother is afraid to have fluoride treatment on her children because she heard fluoride is a poison. How will you address this situation? | inform the pt that fluoride is not a poison when administered correctly. Fluoride treatments done at the office are safe as long as the patient does not swallow, prevent swallowing with lowvol w/ tray treatment & varnish drie fast. low doses not harmful
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