Head Start (1965)
Program provides dental services to preschoolers with F. need
Allows kids to enter school on equal health basis.
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):
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
apply topical fluoride
plaque cntrl programs
dental caries activity test
1ary prev. individual
Make Dr. Appt
self applied topical Fluo. products
2ary prev. Pro
3ary prev. Pro
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
sticky layer of microorganisms/bacteria embedded in matrix.
Begin @ cervical area & interproximally.
May cause disease after 24 hrs.
apples, toast=Deter Plaque!
Which Arch collects more plaque?
(think of salivary glands, plus gravity lets food rest on bottom)
How to detect plaque:
Why does lease amount of plaque collect on Lingual Maxillary teeth?
Occlusal & Incisal 3rds also retain less plaque!
1ary etiological factor in dental disease?
Acid removes what in tooth tissue?
Sugars + Cariogenic Plaque =
Acid + tooth surface =
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
lil white spots-demineralized. Fluoride Tx will pause progress
protein helps to ...
neutralize acid environment
fat protective oily film
inhibits acid from getting to tooth structure
(cariostatic; this is How protein helps)
change from soft plaque to hard calculus deposit. Occurs quickly after plaque matures.
Avg Calculus formation=
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
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!
A false membrane that sometimes develops during infections-looks like real tissue but is usually mucus, fibrin, bacteria or immune system cells.
Ascorpic acid deficiency (lack of Vit. C-scurvy)
Acute herpetic gingivostomatitis
Overgrowth of the Gum tissue, often in pt.s treated with Dylantin (controls epileptic seizures).
Acute herpetic gingivostomatitis
=gingivitis + stomatitis. Inflammed gingiva & oral mucosa.
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!
most coronal part of alveolar bone-interproximal.
formation new layer of tissue/structure
destruction; loss of tissue/structure.
aka Compact bone!
Dense; on Facial, Lingual surfaces of mandible & Maxilla.
On Xrays appear very white! Outer Layer of Bone, where needed for strength!
Most Interior of Max & Mand.
Lightweight, spongey bone.
On Xrays appear Web-Like! "Trabeculae"
gingiva, periodontal ligaments, cementum, alveolar bone.
5 periodontal ligaments
White Lamina Dura-
healthy (on xray) Lines alveolus
lots of plaque (becomes mature)
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
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!
removing bacteria from pocket/lining of tooth! (soft tissue)
remove bacteria on cementum of tooth! (hard tissue)
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
shiny, smooth, red, bulbous tissue means Bacteria is underneath gingiva! No rete pegs, just smooth!
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!