Cario Elderly.txt

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Cario Elderly.txt
2012-05-11 00:28:48
Cariology Elderly

Cariology Elderly
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  1. ´╗┐What compounds caries risk from recession?
    • Xerostomia
    • Poor Oral Hygeine
    • High Carbohydrates
  2. What are the causes of xerostomia?
    • medication: common, illicit (over 500 and interactions)
    • Radiation Therapy (all HN malignancys, 80% hematopoeitic, 40% of chemo) low risk: myelosuppressive, high risk stomatotoxic (prolonged myelosuppresion)
    • Sjogrens Syndroe: Autoimmune: Ab against salivary and tear
  3. What are the signs and diagnostics of Sjogren's syndrome?
    • Dry, Sticky, cavities, thick/no saliva, swollen glands, smooth tongue, dry/cracked lips, sores corners
    • biopsy of salivary gland lip: presence of lymphocytes in particular pattern
  4. What biomarkers are found in saliva?
    Dr Wong: IgA, amylase, proteins and mRNA
  5. How do you treat xerostomia?
    water, artificial saliva, mints, pilocarpine(salagen) Ach cholinergic agonist
  6. How do root caries progress?
    • Spreads laterally to infect side branches of dentin tubules
    • not necessarily cavitated
    • varies (no surface->pulp infection)
    • critical pH for root is higher than enamel
  7. What is ICDAS?
    • International Caries Detection and Assessment System: standard measurement to identify enamel and dentin caries.
    • Root surface visible?
    • Dry color Change?
    • Cavitiation Visible?
  8. How are root caries clinically diagnosed?
    • Surface loss, tactily
    • NOT color
    • in vitro/no histological eval
  9. How should a xerostomic patient be treated?
    • more frequent exams
    • rinse mouth (alcohol-free)
    • Floride(prescribed)
    • floss
    • sugar-free
  10. What are S. mutans risk classifications?
    • Low < 100K
    • Medim 100K-500K
    • high >500K: Rx: chlorhexidine (peridex), xylitol, recall
  11. Which restorative material was superior?
    Glass-ionomer conferred preventive effect on root surfaces
  12. What is the role of floride in arresting root caries?
    frequent topical application of F irrespective of type is successful for incipient RCLs
  13. What is a drawback of Dr Shi lollipops?
    Reduced presence of S. Mutans in saliva only.
  14. Ozone is effective in reducing bacterial load.
  15. What are some results of untreated root caries?
    • fistulas
    • chronic periradicular periodontitis
    • opportunistic infection
  16. What are things you want to assess in health history?
    • Independence or assistance level
    • Quality and outcomes of intervention
    • Assessment types: (caries, DMF, plaque index, perio probe, ADOH, CAMBRA)
  17. What are the classes of caries activity?
    • moderate (1-3 new)
    • high (>=4 new)
    • extremely high (atypical surfaces)
  18. What is ADOH?
    • Activities of Daily Oral Hygeine
    • Helps assess one's oral hygeine ability
    • Observer Fluoride application, rinsing, flossing, brushing
    • 0=independent, 4=complete dependency
    • 16 is most dependent
    • 8 is most dependent for edentulous
    • Claifies what assistance is needed, may need to assess caregiver's willingness too
  19. What are the problems associated with oral care delivery?
    Access, income, transportaion, providers, physician awareness , self-efficacy
  20. Why does oral microflora change with advancing age?
    • possibly due to impaired immune function and colonization of nonoral species (Staph, entero, yeast)
    • also consider medication, xerostomia, dentures
  21. What are some of the caries risk factors for elderly?
    • residence in long term care facilities
    • high Lactobacilli
    • poor OH
    • frequent sugar consumption
  22. What did the Veterans dental study conclude?
    • deleterious effects of xerostomic meds on oral mucosa
    • xerostomic meds did NOT appear to increase coronal caries, or periodontal indext amoung people who were able to perform ROUNTINE PREVENTIVE ORAL CARE
  23. How does dementia affect oral health?
    • higher incidence of coronal and root caires
    • oral hygeine difficulties, neuroleptic meds, high anticholinergic effects
  24. Which bacteria are specifically present with root caries in elderly?
    • Lactobacilli
    • Actinomyces
    • S. Mutans
    • high variability
    • maybe Atopobium, Olsenella, Pseudoramibacter,Propionibacterium, Selenomonas
  25. What does Geriatric Minimal Intervention Dentistry do?
    stop caries->stop possible domino effect, use EBD to find effective solutions.
  26. What is CAMBRA?
    • Caries Management By Risk Assessment
    • asessing caries and making dental treatment recommendations based on patients risk
  27. What are the predictors of root caries in elderly?
    • OHI and RCI:
    • # of teeth
    • calculus
    • plaque
    • xerostomic meds (maxillary root caries)
    • mand molars/premolars greatest risk
    • interceptive dental therapeutics needed for high risk geriatric
  28. Can prevention alone rather than intervention control oral diseases in elderly?
    Yes according to canadians.
  29. Which ionomeric materials had greatest effect on acidogenicity of S Mutans?
    • Vitremer: highest release of Al
    • Aluminum may enhance F effectiveness