the last lectures Flashcards
1-risk
2-risk factor
3-risk assessment
1-probability that a event will occur: sucrose
2-environmental, behavioral, or biological factor which if present will increase probability of disease occuring= sucrose (high sugar intake) while disease indicator= white spot lesions, cavitation, or rstorations
3-quantitative/qualitative estimation of adverse effects that may result from exposure of adverse effect that may result from exposure to specific hazards or absence of biologic influences
1-Caries Risk
2-risk assesment
3-caries disease
1-probabiltiy individual develops lesions
or
-specific number of existing lesions will progress over a specific period of time
2-everyday phenomenon or why parents insurance goes up when teenager is added to car insurance
3-local environ at surface and then natural dynamics (demin<–>remin process)—exchange of mineras across interface between surface & saliva/biofilm
so when demin overrules= caries= lesion
oral environment: inc of plaque/biofilm, lots of sufar, reduced bufferingfrom saliva, and theres no fluoride
1-Disease Indicators: WREC
2-Risk Factors: BAD
3-Protective Factors: SAFER
1-W= White Spots R= Restorations\< 3 yrs E= Enamel Lesions C= Cavities/Dentin
2-B= Bad Bacteria
A= Absence of Saliva
D=Destructive Lifestyle Habits
3-S- Saliva & Sealants
A-Antibacterials
F- Fluoride/Ca/PO4
E-Effective Lifestyle Habits
R-RIsk Based Reassessment
1-risk assessment
2-flow of caries
3-disease indicators
4-active lesion
5-inactive lesion
1-individualizes treatment plans= predictability, diagnosis, prognosis, & treatment plan
high risk= diabetes & cancer
target therapy/ multidisciplinary approach
2- caries detection & assessment–>diagnosis–> Risk assessment–> Caries Management
3-location, severity, activity (plaque accum, gingival redness, loss of luster, caries risk, + radiograph)
4-prgoressing towards cavitiation (demin)
4-not progressing or is remineralizing
1- caries activity
2-caries risk
3-risk factors
1-satus of caries process (demin/remin) on tooth surface
2-status of whole patient= liklihood of patient getting a new cavitation
3-direct casuality of disease= high sugar
- strongest predictor= past/present caries
- plaque, lactobacilli, s.mutans, hyposalivation
- no fluoride
1-relationship between risk/disease
2-contribute to low pH
3-saliva
1-more factors present= higher likelihood of disease
more serious risk factors= higher liklihood of disease
2-diet (significant contribution), hygiene (plaque level), saliva (quant & quality)
—strep mutans are the most important bacteria, and use sucrose as sugar for an energy source that will generate acid at critical pH 5.5 for demin = inc s.mutans
3-buffer= 6-7.5 pH. bicarb= flow rate, inc metabolic rate, bicarb conc increases= inc pH
1-medical conditions & symptoms affecting saliva
- acute/chronic conditions of the glands
- sialolith
- sjogrens
- diabetes
- depression
- radiation therapy
- medications
- eating disorders
- smoking
1-influencing shape of stephens curve
1-comp of plaque
- fermentable substance nature
- rate of diffusion of metabolites
- salivary comp
- salivary access
- salivary flow rate
- shape of curve critical to pH
xerostomia
1-saliva check kit
2-psycho/social/cultural/familial patters
3-environmental risk factors
4-caries diagnosis
1-caries risk assessment= chairside testing of saliva quantity & quality
salivary pH, salivary buffering, & viscosity
for s.mutans= white on blue
for lactobacilli= white on green
2-active caries w/in mother, children w/ special health care needs, low level caregiver
3-fluoride exposure, access to care, & socioeconomic
4-caries active, caries balanced, caries undetermined
1-traditional surgical model
2-after risk assessment
3-CAMBRA
1-band aid= surgically invasive= but there is no medical management
2-relate to origin, establish treatment, frequency of applications
3- C=CAries
M= Management
B=By
R=RIsk
A=Assessment
-modification of oral flora to favor health
-patient education
-remin of non cavitated of enamel & dentin/cementum
1-prevention
2-caries control- home care
3-challenge
1-education (diet/tobacco counseling)
- fluoride
- sealants
- remin
- bacterial testing
- saliva flow rates
- recall
2-patient education–> patient awareness/understanding–>behavior modification & adherence
3-identify & treat underlying cause
- treat symptom (lesion)
- prevent recurrence
1-alternatives to sucrose
2-xylitol
3-pH
4-chemotherapeutics
1-xylitol & sorbitol w/ CCP/ACP
calcium casein peptide/ amorphous calcium phosphate
2-plaque reducing
attract + starve bacteria
remineralizing effect
3->5= saliva can buffer
<5 = enamel demin
<6= dentin demin
Ca, P, F= remin
4-fluoride varnish
fluoride paste
MI paste
xylitol
chlorhexidine
1-effective use of fluoride or chlorhexidine
2-fluoride
3-fluoride resistance
4-chlorhexidine
5- xerostomia manaement
1-treat primary reservoirs (mothers)
treat at time of tooth eruption—infants 1-2, kids 6-7, teens 12-14
2-penetrates white spot lesions, inhibits enolase of S.mutans
3-s.mutans develop resistance to effects of fluoride but the ones that are resistant are less cariogenic
4-surface= substantive, s.mutans decrease
50% caries reduction so it helps reduce bacteria during colonization
5-saliva substitutes= moist plus as a rinse
stimulants= sugarless gum, sugarless mints,prescription meds (pilocarpine & cevimeline)
1-sugar free chewing gum
1-biotene- laclede
trident w/ recaldent
orbit sugar free- wrigly
xylifresh
koolerz sugarless
