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1

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

2

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 (deminremin 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

3

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

4

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

5

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

6

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

7

1-medical conditions & symptoms affecting saliva

-acute/chronic conditions of the glands
-sialolith
-sjogrens
-diabetes
-depression
-radiation therapy
-medications
-eating disorders
-smoking

8

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

9

xerostomia

10

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

11

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

12

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

13

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

14

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)

15

1-sugar free chewing gum
 

1-biotene- laclede
trident w/ recaldent
orbit sugar free- wrigly
xylifresh
koolerz sugarless

16

1- severe decay

2-established decay

3-early decay

4-sound

1-visible dentin
5&6
risk= h/m/l
therapeutic= Preventative & operative 

2-enamel breakdown & shadow
3&4
h/m/l
therapeutic= preventative & operative

3-change in enamel
1&2
h/m/l
therapeutic= preventative

4-sound
0
lesion= 0
h/m/l
therapeutic= preventative