Intro & Caries - PD
|Head Start (1965)|| Program provides dental services to preschoolers with F. need|
Allows kids to enter school on equal health basis.
|Medicaid||65+ to those with F. need. Insurance protection.|
|Forms of Dntl Health service (3)|| 1. by Dr. & Dntl Pros|
2. non-govt Dr. & Dntl Pros, partly funded by gov't
3. Dr & Dntl Pros employed by govt (Ex: Military)
|Each stage of prevention has examples of (3):|| Professional|
|3 Levels of Preventative Dentistry|| Primary (prevents)-Motivate individual!|
Secondary (prevents progress)
Tertiary (replacement; prevent loss of function)
|1ary prevention community|| fluorinated H2O supply|
Fluo. supplement/mouthrinse programs
|1ary prev. Professional|| sealants|
apply topical fluoride
plaque cntrl programs
dental caries activity test
|1ary prev. individual|| Make Dr. Appt|
self applied topical Fluo. products
|2ary prev. Pro||perio scaling|
|3ary prev. Pro||prosthetics|
|Educational Process|| 1. Know Pt. Needs|
2. Get Pt. to express needs
3. Provide Pt. Motivation
4. Help Pt. set goals!
5. Activate goals
6. Repeat! -demo, -(Q)s, -different words
|dental plaque|| sticky layer of microorganisms/bacteria embedded in matrix.|
Begin @ cervical area & interproximally.
May cause disease after 24 hrs.
|Detersive foods||apples, toast=Deter Plaque!|
|Which Arch collects more plaque?|| Mandibular!|
(think of salivary glands, plus gravity lets food rest on bottom)
|How to detect plaque:|| direct vision|
|Why does lease amount of plaque collect on Lingual Maxillary teeth?||Occlusal & Incisal 3rds also retain less plaque!|
|1ary etiological factor in dental disease?||dental plaque|
|Acid removes what in tooth tissue?||minerals|
|Sugars + Cariogenic Plaque =||ACID formula|
|Acid + tooth surface =||CARIES formula|
|Fermentable Carbs(Carcinogenic):|| plaque>|
|Contributing factors to caries production:|| 1. time starts immediately|
2. pH of plaque
3. frequency of carb intake
4. tooth morphology (alignment)
5. saliva content
7. systemic factors
8. family habits
|Is it better to have an Airhead or a Lollipop?|| airhead-chew & get it out!|
pH level drops with every lick of a pop-no homeostasis
|pH decreases after...||sucrose is in contact! 6.2-7.0 avg pH range|
|pH decreases in caries susceptible pt.s to what pH & will increase in how many hours?||pH 5.0; 2-3 hours|
|pH enamel demineralizes...||@ pH 5.0|
|incipient caries||lil white spots-demineralized. Fluoride Tx will pause progress|
|protein helps to ...||neutralize acid environment|
|Health Triangle|| Physical|
|fat protective oily film|| inhibits acid from getting to tooth structure|
(cariostatic; this is How protein helps)
|Plaque mineralization||change from soft plaque to hard calculus deposit. Occurs quickly after plaque matures.|
|Avg Calculus formation=||10-20 days|
|Mineralized plaque/Calculus:|| 1. acquired pellicle formation (very 1st layer in plaque)|
2. plaque formation
3. plaque mineralized/calculus
|Which areas of which teeth are more apt to calculus? (b/c salivary glands 1st hit these areas)|| Buccal of 1st molars,|
Lingual of Mandibular anteriors
|gingivitis||inflamed gums disease|
|ANUG aka "trench mouth" (WWI)|| Acute Necrotizing Ulcerative Gingivitis- too much bacteria @ interdental papilla.|
Quick onset, eats away @ gums, causes ulcers (that harbor plaque & food debris), swelling & dead oral tissues. Pseudomembrane!
|Pseudomembrane||A false membrane that sometimes develops during infections-looks like real tissue but is usually mucus, fibrin, bacteria or immune system cells.|
|Systemic Diseases:|| hormone imbalances|
Ascorpic acid deficiency (lack of Vit. C-scurvy)
Acute herpetic gingivostomatitis
|Gingival Hyperplasia||Overgrowth of the Gum tissue, often in pt.s treated with Dylantin (controls epileptic seizures).|
|Acute herpetic gingivostomatitis||=gingivitis + stomatitis. Inflammed gingiva & oral mucosa.|
|Saliva=||source of minerals in SUPRAgingival calculus.|
|Gingival sulcus fluid=||source of minerals in SUBgingival calculus.|
|Calculus attaches to exposed Cementum (3):|| 1. acquired pellicle|
3. direct contact
|Traits of inflamed gums:|| change in color, form, position|
surface of healthy gingiva="rete-peg!"
|when plaque produces toxins...||they irritate sulcar epithelium (lining mucosa) which causes gingivitis!|
|alveolar crest-||most coronal part of alveolar bone-interproximal.|
|apposition-||formation new layer of tissue/structure|
|resorption-||destruction; loss of tissue/structure.|
|Cortical bone-|| aka Compact bone!|
Dense; on Facial, Lingual surfaces of mandible & Maxilla.
On Xrays appear very white! Outer Layer of Bone, where needed for strength!
|Cancellous bone-|| Most Interior of Max & Mand.|
Lightweight, spongey bone.
On Xrays appear Web-Like! "Trabeculae"
|Periodontium Unit=||gingiva, periodontal ligaments, cementum, alveolar bone.|
|5 periodontal ligaments|| Alveolar Crest|
|White Lamina Dura-||healthy (on xray) Lines alveolus|
|material alba||lots of plaque (becomes mature)|
|periodontal ligament||specialized CT surrounds root & connects it to Alveolar Bone.|
|Plaque begins where?||@ Cervical areas & proximal surfaces|
|Distribution considerations-plaque formation||crowding, hygiene, prosthetics, supragingival, subgingival|
|Dry Socket|| AKA Alveolitis!|
inflammation & Infection associated w/disturbance of blood clot after EXT!
Clot is important b/c protects wound & is later replaced by granulation tissue, then bone!
|Curettage||removing bacteria from pocket/lining of tooth! (soft tissue)|
|Root Planning||remove bacteria on cementum of tooth! (hard tissue)|
|Plaque:|| 1.Acquired Pellicle|
|rete pegs:|| fibers from bone to tissue. When healthy it is taunt, tight and stippled.|
Loss of rete pegs="loss of stippling"=1st step of gingivitis.
|bulbous/swollen tissue area indicates|| advanced gingivitis!|
shiny, smooth, red, bulbous tissue means Bacteria is underneath gingiva! No rete pegs, just smooth!
|Pseudopocket|| pocket of swollen tissue (measurement appears larger because of swelling)|
Pseudopocketing means swollen, not bone loss!
|It's only a true pocket if ...||if bone is lost!|