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DW- Chapter 18- Exam 2
Terms in this set (56)
An estimation of the likelihood that an event will occur in the future.
CAMBRA stands for:
Caries Management by Risk Assessment
A transmissible bacterial infection that is preventable and in some cases even reversible.
Dental caries is caused by mutans streptococci and lactobacilli that live in ______________ biofilm that attach to teeth.
These bacteria metabolize dietary fermentable carbohydrates to produce ____________.
A rest the typical pH of plaque biofilm is:
When acids diffuse into the tooth to dissolve the calcium and phosphate materials.
After ingestion of fermentable carbohydrates stops, the pH gradually returns to neutral in 30 to 60 minutes provided adequate __________.
Plays a key role that it neutralizes acids and provides minerals and proteins that protect the teeth.
Saliva's beneficial actions
-Provides calcium and phosphate for remineralization
-Carries topical fluoride around the mouth for remineralization
-Neutralizes organic acids produced in plaque biofilm
-Discourages the growth of bacteria, inhibiting infection
-Recycles ingested fluoride into the mouth
-Protects hard and soft tissues from drying
-Facilitates chewing and swallowing
-Speeds oral clearance of food
The deposition of minerals into demineralized areas of tooth structure.
Plays a very important role in the remineralization repair process and the overall prevention of carious lesions.
A demineralized area of enamel that usually has an intact surface remaining over the body of the demineralized early carious lesions.
white spot lesion
The enamel surface of a white spot typically remains intact, but the demineralized area appears white owing to the loss of mineral in the _________________ zone of the enamel.
The white spot lesion is a __________ to intervene to avoid the development of a frank carious lesion.
Dental caries involves an interaction among ____________ and __________ factors.
pathologic and protective
Pathologic factors include:
-Frequent eating and/or drinking of fermentable carbohydrates
-Subnormal salivary flow and function
Protective factors include:
fluoride in the saliva
normal salivary flow
antibacterial agents if needed
The goal of caries management is to restore and maintain balance, known as the ______________________, between protective and pathologic factors to remineralize early carious lesions and prevent future caries.
_________________________________ is the first step in CAMBRA.
caries risk assessment
Four clinical observations from the clinical examination that indicate past caries history and activity.
caries disease indicators
Four caries disease indicators for caries risk assessment:
1. Teeth with frank cavitations or lesions that radiographically show penetration into dentin
2. Approximal radiographic lesions confined to enamel only
3. Visual white spots on smooth surfaces
4. Any restorations placed in the last three years
Presence of any one of these four indicators automatically places the client at ________________________ unless therapeutic interventions are already in place and disease progress has been arrested.
high caries risk
The presence of any one of these caries disease indicators in the presence of inadequate salivary flow automatically indicates _________________________.
extreme caries risk
Biologic factors that contribute to the level of risk for developing new carious lesions in the future or having the existing lesions progress.
caries risk factors
Caries risk factors:
-Medium or high S. mutans and lactobacilli counts
-Visible heavy plaque biofilm on teeth
-Frequent snacking between meals
-Deep pits and fissures
-Recreational drug use
-Inadequate salivary flow
Biologic or therapeutic factors that collectively can offset the challenge presented by the caries risk factors.
caries protective factors
Caries protective factors:
-Lives, works, and attends school in fluoridated community
-Uses fluoride toothpaste at least once daily
-Uses fluoride toothpaste at least twice daily
-Uses fluoride mouth rinse daily
-Uses 5000 ppm fluoride toothpaste daily
-Had fluoride varnish applied in the last 6 months
-Had an office fluoride topical application in the last 6 months
-Used prescribed chlorhexidine daily for 1 week during each of the last 6 months
-Used xylitol gum or lozenges four to five times daily for the last 6 months
-Used calcium and phosphate supplement paste during last 6 months
-Has adequate salivary flow
This test should be conducted if inadequate salivary flow is noticed or if the client reports having a dry mouth.
Salivary flow rate test
The reason for any low salivary flow rate
needs to be determined to plan for ___________ management.
If any one of the four disease indicators is present, a bacterial culture should be taken.
Caries bacteria testing
Results can be used to _________ client compliance with recommended antibacterial regimens
An infectious disease that affects children from birth to 2 years of age and rapidly destroys newly erupted teeth.
Early childhood caries (ECC)
Initially ECC appears as bands of demineralized areas usually first seen on the primary maxillary _____________________.
These areas of demineralization quickly turn yellow or brown cavitated areas.
The American Dental Association, the American Academy of Pediatric Dentistry, and the American Association of Public Health Dentistry recommend all children have their first preventative dental visit by _______________ months of age.
A ______________ interview is conducted before the child is examined to identify caries risk factors, disease indicators, and protective factors already in place.
If the mother has active ___________, then that automatically puts the child at high risk owing to the likelihood of bacterial transmission from parent to child.
Once the risk factor sheet has been checked, the provider summarizes the risk factors and assigns a _______________.
caries risk level (Low, moderate, or high)
Strategies to modify the maternal or caregiver transmission of cariogenic bacteria to infants through the potential use of:
chlorhexidine rinse, fluoride varnish, and xylitol-based products.
Caries management involves:
-Suppressing the bacteria that cause the infection
-Remineralizing early noncavitated carious lesions (increasing salivary flow, fluoride, and use of calcium and phosphate paste products)
-Protecting tooth surfaces with the use of sealants and fluorides
-Decreasing the frequency of sugar intake
-Surgically removing carious lesions and restoring
A naturally occurring element present in many minerals, water supplies, and foods.
Fluoride delivered to the _________ surface and the plaque biofilm can have a dramatic caries preventative and reparative affect if delivered at the right concentrations.
Fluoride present on the the tooth surface and in plaque fluid inhibits acid ________________________ by reducing the solubility of the tooth mineral.
Fluoride accelerates the remineralization process by absorbing to mineral _________________ within the tooth and attracting calcium ions.
Other than the fluoride consumed in drinking water, _______________ are most widely used fluoride preparations.
Brushing twice a say with a fluoride containing dentifrice is one of the most effective ways to control dental ________.
Self-applied in the form of nonprescription (OTC) products:
Dentifrices, mouthrinses, gels
Self-applied in form of prescription products:
Dentifrices, mouthrinses, gels
Professionally applied in the form of prescription product:
Gels with the use of a tray technique, varnishes
A concentrated topical fluoride with a resin or synthetic base that is painted on the teeth to prolong fluoride exposure.
A broad-spectrum antibacterial agent that works by opening up the cell membranes of the bacteria. Administered by prescription in the U.S.
chlorhexidine gluconate (0.12%):
-Regimen: Rinse for 1 minute daily for 1 week each
-Must be used in conjunction with fluoride
-Adverse reactions: Affects taste, compliance is
poor, staining of teeth
A sweetener that looks and tastes like sucrose. It inhibits attachment and transmission of bacteria and can be delivered through chewing gum or lozenges as an effective anti caries therapeutic message.
Neutralizes acids produced by acidogenic bacteria and has antibacterial properties. Can be delivered by gum or toothpaste.
Sodium bicarbonate (baking soda)
How many fluoride parts per million (ppm) do most of the OTC toothpastes contain?
Fluoride varnish applications:
-take less time
-create less client discomfort
-achieve greater client acceptability than does fluoride gel
-contains small quantity of fluoride compared with fluoride gel
THIS SET IS OFTEN IN FOLDERS WITH...
DW- Chapter 23- Exam 2
DW- Chapter 19- Exam 2
Wilkins- Chapter 24- Exam 1
Preventive Test 2
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