Card Set Information
What compounds caries risk from recession?
Poor Oral Hygeine
What are the causes of xerostomia?
: common, illicit (over 500 and interactions)
Radiation Therapy (all HN malignancys, 80% hematopoeitic, 40% of chemo) low risk
: myelosuppressive, high risk stomatotoxic (prolonged myelosuppresion)
: Autoimmune: Ab against salivary and tear
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
What biomarkers are found in saliva?
Dr Wong: IgA, amylase, proteins and mRNA
How do you treat xerostomia?
water, artificial saliva, mints, pilocarpine(salagen) Ach cholinergic agonist
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
What is ICDAS?
International Caries Detection and Assessment System
: standard measurement to identify enamel and dentin caries.
Root surface visible?
Dry color Change?
How are root caries clinically diagnosed?
Surface loss, tactily
in vitro/no histological eval
How should a xerostomic patient be treated?
more frequent exams
rinse mouth (alcohol-free)
What are S. mutans risk classifications?
Low < 100K
: Rx: chlorhexidine (peridex), xylitol, recall
Which restorative material was superior?
Glass-ionomer conferred preventive effect on root surfaces
What is the role of floride in arresting root caries?
frequent topical application of F irrespective of type is successful for incipient RCLs
What is a drawback of Dr Shi lollipops?
Reduced presence of S. Mutans in saliva only.
Ozone is effective in reducing bacterial load.
What are some results of untreated root caries?
chronic periradicular periodontitis
What are things you want to assess in health history?
Independence or assistance level
Quality and outcomes of intervention
: (caries, DMF, plaque index, perio probe, ADOH, CAMBRA)
What are the classes of caries activity?
moderate (1-3 new)
high (>=4 new)
extremely high (atypical surfaces)
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
What are the problems associated with oral care delivery?
Access, income, transportaion, providers, physician awareness , self-efficacy
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
What are some of the caries risk factors for elderly?
residence in long term care facilities
frequent sugar consumption
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
How does dementia affect oral health?
higher incidence of coronal and root caires
oral hygeine difficulties, neuroleptic meds, high anticholinergic effects
Which bacteria are specifically present with root caries in elderly?
maybe Atopobium, Olsenella, Pseudoramibacter,Propionibacterium, Selenomonas
What does Geriatric Minimal Intervention Dentistry do?
stop caries->stop possible domino effect, use EBD to find effective solutions.
What is CAMBRA?
Caries Management By Risk Assessment
asessing caries and making dental treatment recommendations based on patients risk
What are the predictors of root caries in elderly?
OHI and RCI:
# of teeth
xerostomic meds (maxillary root caries)
mand molars/premolars greatest risk
interceptive dental therapeutics needed for high risk geriatric
Can prevention alone rather than intervention control oral diseases in elderly?
Yes according to canadians.
Which ionomeric materials had greatest effect on acidogenicity of S Mutans?
: highest release of Al
Aluminum may enhance F effectiveness