Preventive Final Flashcards by A G

Q

1 ppm = ____ mg/L

A

1

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Pea-sized amount of toothpaste contains ____mg/L of fluoride

A

0.25

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Sodium fluoride toothpaste has _____% fluoride ion

A

0.22

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Sodium monofluorophosphate toothpaste (MFP) has _____% fluoride ion

A

0.76

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Stannous fluoride toothpaste has ____% fluoride ion

A

0.4

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

T/F: Sodium fluoride, sodium monofluorophosphate, and stannous fluoride toothpaste all have 1000 ppm of fluoride

A

True

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Which toothpaste?

Fluoride salt
Highly reactive fluoride ion
Only silica abrasives are compatible
More stable than stannous fluoride

A

Sodium fluoride

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Which toothpaste?

Not an ionic fluoride salt
Compatible w/ wide variety of abrasives
Not suitable for use in pts with xerostomia

A

Sodium monofluorophosphate

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Which toothpaste?

Covalently bound fluoridated compound that requires enzymatic activation by a salivary enzyme to release bioavailable fluoride

A

Sodium monofluorophosphate

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Which toothpaste?

Tin fluoride - chemical compound w/ formula SnF2
Fluoride is highly reactive
Abrasive calcium pyrophosphate
Adheres to surface of tooth enamel and forms protective layer, shields tooth from erosion

A

Stannous fluoride

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Which toothpaste?

Challenge to find abrasive system that has low reactivity w/ fluoride to maintain bioavailability

A

Stannous fluoride

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

What are the 2 ways to acquire fluoride?

A

Topical
Systemic

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Which way of acquiring fluoride?

Bathe tooth surface after eruption

A

Topical

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Which way of acquiring fluoride?

Fluoride bathes erupted teeth and is deposited into enamel (concentration in surface enamel could be as high as 3000 ppm)

A

Topical

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Which way of acquiring fluoride?

Benefits occur throughout life of tooth once erupted

A

Topical

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Which way of acquiring fluoride?

Very rapid uptake by tooth immediately after eruption and in demineralized areas

A

Topical

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Which way of acquiring fluoride?

Inhibits demineralization and enhances remineralization

A

Topical

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Which way of acquiring fluoride?

Excessive intake does not result in fluorosis

A

Topical

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Which way of acquiring fluoride?

Swallowing fluoride in water or prescribed dietary supplements while teeth are developing/before eruption

A

Systemic

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Which way of acquiring fluoride?

Uptake depends upon amount of fluoride ingested and length of time of exposure

A

Systemic

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Which way of acquiring fluoride?

Benefit ends after teeth have erupted

A

Systemic

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Which tooth development stage related to systemic fluoride?

Fluoride is deposited during formation of enamel after enamel matrix has been laid down by ameloblasts

A

Mineralization

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Which tooth development stage related to systemic fluoride?

Fluoride is incorporated as fluorapatite

A

Mineralization

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

What is a form of hydroxyapatite in which fluoride ions have replaced some of the hydroxyl ions?

A

Fluorapatite

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Which tooth development stage related to systemic fluoride? Fluoride is circulated to developing tooth by way of blood plasma to tissues surrounding tooth buds

Mineralization

Which tooth development stage related to systemic fluoride? Fluoride incorporated in enamel beginning at dentinoenamel (DEJ) junction

Mineralization

Which tooth development stage related to systemic fluoride? Fluorosis can occur during this stage

Mineralization

Form of enamel hypomineralization due to excessive ingestion of fluoride during mineralization; ranges from small white spots to severe brown staining with pitting

Fluorosis

Which tooth development stage related to systemic fluoride? Excess fluoride inhibits normal activity of ameloblasts forming defective enamel matrix

Mineralization

Which tooth development stage related to systemic fluoride? Fluoride continues to be deposited in surface of enamel

After mineralization, before eruption

Which tooth development stage related to systemic fluoride? More fluoride acquired by outer surface than underlying layers

After mineralization, before eruption

Which tooth development stage related to systemic fluoride? Can benefit from this mechanism if exposed to fluoride within 2 years of eruption

After mineralization, before eruption

What consists primarily of a calcium-phosphate-based crystalline mineral called hydroxyapatite (HAP)?

Enamel

The ___________ crystals are packed tightly together to form millions of microscopic prisms and lattices

hydroxyapatite (HAP)

Fluoride is incorporated into the solid hydroxyapatite crystal lattice by iso-ionic exchange to form what?

Fluorohydroxyapatite (FAP)

What form of enamel is harder than the naturally occurring HAP and more resistant to decay?

Fluorohydroxyapatite (FAP)

When the outer surface of the enamel is exposed to fluoride (>50ppm), what can be formed?

Calcium fluoride (CaF2)

What can be precipitated on the enamel surface and act as a source of fluoride ions, and may also act as a barrier to demineralization?

Calcium fluoride (CaF2)

The CaF2 -derived fluoride ions are released in _________ conditions and either diffuse rapidly into the underlying enamel, resulting in formation of FAP and subsequent enamel hardening, or increase fluoride levels in the saliva

acidic

What 2 things affect the extent and rate of benefit associated with fluoride by altering the degree of saturation of FAP?

Concentration of fluoride ions pH of the saliva

T/F: Even at very low concentrations in saliva, fluoride drives the thermodynamic equilibrium for remineralization by calcium and phosphate from saliva

True

T/F: There is an on-going battle between demineralization and remineralization

True

When fluoride is applied to teeth, calcium fluoride precipitates out to provide free fluoride ions. Fluoride in saliva stays at higher level for 1 to 2 hours; Fluoride also imbedded in ______

plaque

There is a constant exchange of fluoride in mouth to __________ areas of tooth

demineralized

T/F: Remineralized enamel is more resistant to decay due to larger crystals and has higher concentration of fluoride in enamel

True

Which areas have the greatest uptake of topical fluoride?

Demineralized areas

What is key to remineralization?

Frequent applications of low concentration of fluoride

Benefits of remineralization are from _________ applications of fluoride

topical

Remineralization reduces ability of plaque organisms to form acid and inhibits a step in ________, which slows down plaque metabolism

glycolysis

What seals dentinal tubules to alleviate pain from hypersensitivity?

Fluoride

What is the ingredient in toothpaste that helps reduce tooth sensitivity?

Potassium nitrate

What is the ppm of fluoride in tap water?

0.7 ppm (0.7 mg/L)

What is the way to write a prescription for Prevident?

Rx: prevident 5000 booster paste Disp: 1 bottle Sig: use pea sized amount to brush teeth 1-2 times daily. Spit but do not rinse. Refill: 3 Refills

Which fluoride product? Sodium fluoride 5% (22,600 ppm)

Varnish

Which fluoride product? FDA has approved for use in U.S. for cavity liner and root desensitizer, but not as anti-caries agent

Varnish

Which fluoride product? Can be used for caries prevention, but cannot be marketed as such

Varnish

Which fluoride product? Teeth are dried and thin layer of varnish is painted on surfaces; can be used site specific or on full mouth

Varnish

Which fluoride product? Sets rapidly in presence of saliva

Varnish

Which fluoride product? Does not require full prophy prior to application, but best applied following brushing and flossing

Varnish

Which fluoride product? Forms non-water soluble layer, which provides slow release of fluoride into tooth

Varnish

Which fluoride product? Should not rinse, drink, eat, brush, or floss for at least 2 hours

Varnish

Which fluoride product? Sodium fluoride - Rx 0.2% (990 ppm)

Rinse

Which fluoride product? Sodium fluoride - OTC 0.05% (225 ppm)

Rinse

Which fluoride product? Example: ACT - 10 mL rinse or apply to teeth and spit daily after brushing

Sodium fluoride OTC rinse

Which fluoride product? Example: PreviDent - Once weekly, rinse 10 mL vigorously around and between teeth for 1 minute, then spit

Sodium fluoride Rx rinse

Which fluoride product? Acidulated phosphate fluoride - OTC 0.044% (440 ppm)

Rinse

Which fluoride product? Stannous fluoride - Rx 0.1% (250 ppm)

Rinse

Which fluoride product? Shows 30 – 40% decrease in caries

Rinse

Which fluoride product? Good modality for high risk patients, but question cost-effectiveness as a universal population-wide strategy

Rinse

Which fluoride product? Rx strength preferably applied at bedtime, after brushing and flossing first

Rx toothpaste

Which fluoride product? Sodium fluoride 1.1% (5,000 ppm)

Rx toothpaste

Which toothpaste? pH = 7.0

Sodium fluoride 1.1% (5,000 ppm) (Rx)

Which toothpaste? Requires a prescription (Rx) Recommended for high risk caries patients Can be applied in tray or by brushing Comes in gel or paste

Sodium fluoride 1.1% (5,000 ppm) (Rx)

Which toothpaste? Product of choice for patients with composite, resin or porcelain restorations and titanium implants and those who cannot tolerate acidic fluorides

Sodium fluoride 1.1% (5,000 ppm) (Rx)

Which fluoride product? Acidulated phosphate fluoride 0.5% (5,000 ppm)

Rx toothpaste

Which toothpaste? Requires prescription (Rx) Can microetch some restorative materials

Acidulated phosphate fluoride 0.5% (5,000 ppm) (Rx)

Which fluoride product? Stannous fluoride 0.4% (1,000 ppm)

Toothpaste

Which toothpaste? pH = 3.5

Stannous fluoride 0.4% (1,000 ppm)

Which toothpaste? Does not require prescription but some brands are labeled as Rx

Stannous fluoride 0.4% (1,000 ppm)

Which toothpaste? Adverse effects of 8.0% rinse not generally noted at 0.4% strength but some patients may experience mild staining

Stannous fluoride 0.4% (1,000 ppm)

Which fluoride product? 25 to 35% decrease in decay; use preformed or custom trays

Topical foam/gel

Which fluoride product? Prophy prior to application is not required unless calculus is present because fluoride diffuses through plaque and pellicle

Topical foam/gel

Which fluoride product? Better for pts with high gag reflex

Topical foam

Which fluoride product? More easily evacuated via suction than gels

Topical foam

Which fluoride product? Allow for increased interproximal tooth coverage without overflow into oral cavity

Topical foam

Which fluoride product? Results in less excess being left in the mouth after treatment

Topical foam

Which topical foam/gel? pH = 7

Sodium fluoride 2% (9,040 ppm)

Which topical foam/gel? Recommended regimen was four weekly applications (ages 3, 7, 11, and 13) but commonly used as alternative to APF

Sodium fluoride 2% (9,040 ppm)

Which topical foam/gel? Recommended for: -Patients with extensive porcelain and composite restorations -Patients who cannot tolerate acidic fluorides (bulimic) -Patients with reduced salivary flow

Sodium fluoride 2% (9,040 ppm)

Which topical foam/gel? Most commonly professionally applied topical fluoride; agent of choice for most caries prone patients

Acidulated phosphate fluoride 1.23% (12,300 ppm)

Which topical foam/gel? Has pH of 3.0 to 4.0 resulting in rapid uptake of high levels of fluoride, especially in first minute of treatment

Acidulated phosphate fluoride 1.23% (12,300 ppm)

Which topical foam/gel? pH of 3.5 is ideal for rapid uptake and acceptable taste

Acidulated phosphate fluoride 1.23% (12,300 ppm)

Which topical foam/gel? Applied for 1 to 4 minutes on semi-annual basis (some directions say 4 minutes, but uptake very rapid in first minute)

Acidulated phosphate fluoride 1.23% (12,300 ppm)

Which topical foam/gel? Contraindications: -Etches or dulls porcelain and composite restorations and titanium implants -Patients who cannot tolerate an acidic environment

Acidulated phosphate fluoride 1.23% (12,300 ppm)

Which topical foam/gel? Approved for semi-annual professional applications

Stannous fluoride 8% (19,360 ppm)

Which topical foam/gel? Adverse effects: -Staining of demineralized enamel, grooves, and margins of restorations -Bitter taste

Stannous fluoride 8% (19,360 ppm)

Which topical foam/gel? Rarely used today because effective alternatives are available

Stannous fluoride 8% (19,360 ppm)

Found in parotid and submandibular glands

Serous fluid

Contains the enzyme amylase which acts in the digestion of carbohydrates

Serous fluid

The parotid gland produces purely ______ saliva; the other major salivary glands produce mixed (serous and mucus) saliva

serous

Found in sublingual and submandibular glands

Mucous

Mucous is a saccharide glycoprotein called _______. With water, it makes the slippery lubricant used in many parts of the body, where it lines the moving parts, surfaces and tubes

mucin

Has antiseptic qualities: it contains lysozyme and immunoglobulins

Mucous

Traps fungia, bacteria, viruses, and prevents infection

Mucous

Which gland? 25% total saliva when unstimulated

Parotid

Which gland? Produce serous secretions (dominant in stimulated saliva)

Parotid

Which gland? Produce a mixed serous and mucous secretion (dominant in unstimulated saliva)

Submandibular

Which gland? 70% total saliva when unstimulated

Submandibular

Which gland? Produce mucous secretions

Sublingual

Which gland? 5% total saliva when unstimulated

Sublingual

What is the normal mean of unstimulated saliva?

0.5 mL/min

What is the normal range of unstimulated saliva?

0.4-0.6 mL/min

What is the abnormal rate for unstimulated saliva?

≤ 0.2 mL/min

What is the % of glands involved for unstimulated saliva?

70% submandibular 25% parotid 5% sublingual

What is the normal mean of stimulated saliva?

1.5 mL/min

What is the normal range of stimulated saliva?

1.0 - 2.0 mL/min

What is the abnormal rate for stimulated saliva?

≤ 0.5mL/min

What is the % of glands involved for stimulated saliva?

90% parotid 10% other

Major buffer in unstimulated saliva

Phosphate buffer system

Mechanism is due to the ability of the secondary phosphate ion, HPO42-, to bind a hydrogen ion and form a primary phosphate ion H2PO4-

Phosphate buffer system

Major buffer in stimulated saliva

Carbonic anhydrase buffer system

Acts mainly to neutralize acids produced by bacteria when they digest sugars in the mouth or acids from the stomach

Bicarbonate

The concentration of the bicarbonate ion depends largely on what?

Salivary flow rate

What determines saliva pH?

Bicarbonate

Saliva pH is directly dependent on bicarbonate concentration; the higher the bicarbonate concentration, the higher the saliva pH

Henderson Hasselbalch equation

A high bicarbonate concentration linked to a high flow rate in stimulated saliva would keep saliva pH above 6.3 so that the risk of erosion of tooth structure is _____

low

Supersaturation of calcium phosphates in saliva help maintain enamel ________

integrity

Prevent precipitation/crystallization of supersaturated calcium phosphate thus keeping it readily available to be used for remineralization

Statherins Proline-rich peptides

Traps and aggregates microorganisms (bacteria and viruses), preventing them from attaching to the surface of the mouth

Mucins

They help the clearance of these pathogens by facilitating their removal through swallowing

Mucins

Interact with antimicrobial proteins in saliva and enhances their effectiveness

Mucins

Inhibit bacterial adhesion because they present in the early enamel pellicle and in mature pellicles (plaque); pellicle acts as a diffusion barrier, slowing both attacks by bacterial acids and loss of calcium phosphate ions

Proline-rich peptides

Strong promoters of bacterial adhesion

Proline-rich peptides

Forms part of the acquired enamel pellicle; protects from acid attack by acting as a diffusion barrier

Proline-rich peptides

An iron-binding glycoprotein secreted by the serous cells of the major and minor salivary glands

Lactoferrin

Plays a role in iron sequestration

Lactoferrin

Binds free iron in the saliva, effectively starving bacteria of the iron they need for growth

Lactoferrin

Many harmful microorganisms rely on iron to survive and proliferate, and by limiting its availability, this component can reduce their ability to thrive in the oral cavity

Lactoferrin

Lactoferrin binds to the surfaces of bacteria, preventing them from adhering to tissues, such as tooth enamel and mucosal surfaces This bacteriostatic effect is lost if the lactoferrin molecule is saturated with ______, a factor that should be taken into account in areas where the drinking water is rich in iron

iron

Break down cell walls of bacteria, particularly those of gram-positive bacteria, by hydrolyzing the peptidoglycan layer that provides structural support to bacterial cells; this weakens the bacteria, causing them to rupture and die

Lysozymes

2 major biologic functions: (1) antimicrobial activity (2) protection of host proteins and cells from hydrogen peroxide toxicity.

Salivary peroxidase

Produced in the acinar cells of the parotid and submandibular glands, but not in the minor salivary glands

Salivary peroxidase

Aggregate bacteria, making them easy to remove via swallowing

Secretory immunoglobulins (S-IgA)

They target & attack specific bacterial components: -bacterial adhesins -bacterial glucosyl transferase

Secretory immunoglobulins (S-IgA)

The saliva also contains ______ and ______ from serum and local production in the gingival tissues

IgG; IgM

Begins the breakdown of complex carbohydrates; cleaves the alpha 1-4-glycosidic bonds in starch and glycogen converts to maltose

Salivary amylase

The enzymatic breakdown in the oral cavity reduces the workload on pancreatic amylase in the small intestine, enhancing overall digestion efficiency

Salivary amylase

Initiates the breakdown of dietary fats (triglycerides) into simpler molecules, such as free fatty acids and diglycerides

Lipases

Important in digestion of milk fat in new-born as they have immature pancreatic function

Lipases

It identifies, measures and assesses the patient’s saliva condition, which helps determine risk of caries

Saliva-Check BUFFER

Tests for hydration, salivary consistency, resting saliva pH, stimulated saliva flow, stimulated saliva pH and saliva buffering capacity

Saliva-Check BUFFER

Step 1: resting flow rate Step 2: assess salivary consistency Step 3: resting saliva pH Step 4: stimulated saliva flow rate Step 5: stimulated saliva pH Step 6: buffering ability of stimulated saliva

Saliva-Check BUFFER

What is the critical pH of dentin?

6.5

What is the critical pH of enamel?

5.5

Frequency of eating fermentable ______ has strong association with dental caries

carbs

___________ sugars (starches) are less cariogenic than simple sugars (sucrose, glucose, fructose)

Complex

What remains the main driver of the dental caries process?

Diet

Which sugar is the most cariogenic due to the production of extracellular glucans?

Sucrose

What are not readily soluble in oral fluids, have low diffusion into plaque fluid and must be broken down into maltose (via amylase) for use by bacterial plaque?

Starches

Freely diffusible in dental plaque; readily metabolized by oral bacteria

Sucrose metabolism

What does sucrose metabolism yield?

Organic acids

Used by glucosyltransferase to form extracellular polysaccharides (glucan), which is sticky

Sucrose substrate

What facilitates the accumulation of S. Mutans in dental plaque?

Sucrose substrate

It is only under frequent __________ of dental plaque that microorganisms become pathogenic

acidification

Selective protein rich film covering enamel surface

Acquired enamel pellicle

When does the acquired enamel pellicle form?

Immediately after the tooth is cleaned (30 mins - 1 hr)

Protects the enamel against acid dissolution; prevents continuous deposition of calcium and phosphate

Acquired enamel pellicle

Base attachment for oral bacteria adherence

Acquired enamel pellicle

What are the 3 stages of biofilm formation?

Attachment Growth Dispersal

Organized/Non-random symbiotic bacterial colonization of the pellicle layer

Early biofilm formation

In early biofilm formation, the first bacteria to attach to these pellicle glycoproteins are ______________ from the Mutans Streptococci family

gram + aerobic cocci

In early biofilm formation, gram + aerobic cocci from the Mutans Streptococci family are able to replicate in the oxygen rich environment of the oral cavity and form micro-colonies within _________ after attachment

minutes

In early biofilm formation, what do gram + aerobic cocci from the Mutans Streptococci family produce?

Glucosyltransferase

Converts sucrose into a sticky extracellular polysaccharide called Glucan

Glucosyltransferase

Creates a sticky environment that allows other early colonizing bacteria to attach to the initial colonies and protect them from acidic environments

Glucan

When does early biofilm formation form?

12 - 24 hrs after tooth brushing

As the plaque begins to develop and expand, oxygen can no longer diffuse into the colonies

Maturing biofilm formation

In maturing biofilm formation, after a few days, _____________ begin to colonize the plaque

gram - anaerobic cocci, rods, and filaments

When does maturing biofilm formation with gram - anaerobic cocci, rods, and filaments beginning to colonize the plaque form?

1 - 3 days after tooth brushing; full growth after 1 week

In maturing biofilm formation, after several weeks, the bacteria (cocci, rods, and filaments) grow together forming colonies known as _____________

corncobs

When does maturing biofilm formation with gram - anaerobic cocci, rods, and filaments growing together to make corncobs form?

3 weeks after tooth brushing

In maturing biofilm formation, the anaerobic environment causes facultative anaerobes such as __________ and ___________ to break down sucrose through fermentation pathways

S. mutans and Lactobacilli

What do S. mutans and Lactobacilli produce as their metabolic byproduct?

Lactic acid

Where do significant amounts of maturing biofilm accumulate?

Margin between tooth and gum (gingival crevice) Fissures in occlusal surfaces of molars Interproximally

What are the following associated with? Number and type of bacteria present in oral cavity Character of tooth surface Affinity of bacteria for pellicle or plaque Quality and quantity of saliva Mechanical removal of plaque by muscular action Personal hygiene habits

Factors in plaque formation

Which treatment for high CFU? Combination of eucalyptol, menthol, methyl salicylate, and thymol are active antimicrobials

OTC antimicrobial rinse

Which treatment for high CFU? Brushing and flossing help disrupt and remove biofilm, but sometimes may miss hard to reach areas; Antiseptic rapidly penetrates the biofilm to kill these said microorganisms

OTC antimicrobial rinse

Which treatment for high CFU? 12% Chlorohexadine Gluconate

Rx antimicrobial rinse

Which treatment for high CFU? Broad spectrum antimicrobial with activity against gram-positive and gram-negative organisms, yeast, and other fungal organisms

Rx antimicrobial rinse

Which treatment for high CFU? Binds to oral surfaces and has minimal gastrointestinal absorption, thereby limiting adverse systemic effects

Rx antimicrobial rinse

What is the following tx associated with? Topical must be used for at least 2 days after elimination of signs/symptoms; rinses, lozenges, troches, pastilles, cream, ointment, powder

Fungal infection

The personal practice of keeping the mouth clean in order to prevent cavities (dental caries), gingivitis, periodontitis, bad breath (halitosis), and other dental disorders

Oral hygiene

Requires the continual removal of dental biofilm through mechanical disruption

Oral hygiene

Consists of personal and professional care

Oral hygiene

It is the professional (dentist/hygienist) responsibility in educating the patients on how to keep the mouth clean to prevent caries, gingivitis/periodontitis, and halitosis

OHI

Patient specific and must be tailored to their clinical deficiencies; each pt must get a specific set of instructions and preventive tx plan

OHI

A naturally occurring, low calorie sugar substitute with anti-cariogenic properties

Xylitol

Short-term consumption is associated with decreased Streptococcus mutans levels in saliva and plaque

Xylitol

Decrease the transmission of S. mutans from mothers to children

Xylitol

Bacteria are unable to produce acid in the presence of this and as a result the plaque pH does not decrease

Xylitol

The stable pH prevents demineralization, and hardens the lining of the cavities making untreated cavities less sensitive

Xylitol

Naturally cooling and sweet tastes also increase salivary flow, which optimizes the pH level in the mouth further promoting dental health

Xylitol

T/F: Incipient white spot lesions can have both demineralization and remineralization occurring simultaneously

True

An advancing subsurface lesion with a remineralizing surface lesion

Incipient white spot lesion

If the outer enamel stays intact, the lesion will remain stable/ arrested

Incipient white spot lesion

T/F: An arrested incipient white spot lesion is considered more resistant to demineralization due to maturation and fluoride

True

Use a _____ explorer and light pressure to help detect caries; too sharp and/or too much pressure can create iatrogenic damage

dull

What are the ways to treat white spot lesions?

Remineralization Minimally invasive tx (ICON) Composite bonding Veneers/crowns

Which method of treating white spot lesions? Fluoride treatment/varnish OHI and nutritional counseling

Remineralization

Which method of treating white spot lesions? A thin resin material is applied to the lesion to fill in porosities and blend the color with surrounding enamel

Minimally invasive tx (ICON)

D0601

Low caries risk

D0602

Moderate caries risk

D0603

High caries risk

When is the re-eval for low caries risk?

12-18 months

When is the re-eval for moderate caries risk?

6-12 months

When is the re-eval for high caries risk?

3-6 months

What do the following refer to? Current active demineralization

Disease indicators

What do the following refer to? Poor OH, limited fluoride exposure, low salivary flow, poor salivary composition, cariogenic/acidic diet, history head/neck radiation, limited access to care, high drug usage, crucial systemic disease, etc

Risk factors

What do the following refer to? Good OH, adequate fluoride exposure, normal salivary flow, good salivary composition, good diet, no history head/neck radiation, good access to care, no drug usage, no systemic disease, etc

Protective factors

What do the following refer to? Recent restorations and exts due to demineralization process

Disease indicators

Write the rx for Pilocarpine

Rx: Pilocarpine (5mg) Salagen Disp:100 tablets Sig: Take 1 tablet t.i.d for dry mouth RF- three (3)

Prevent carious lesions in newly erupted teeth on high risk patients

Sealants

Arrest incipient carious lesions that have not cavitated yet (white spot lesions)

Sealants

Prevent cariogenic bacterial growth in sealed fissures

Sealants

Prevent source of infection in other areas of the mouth

Sealants

When are sealants ideally placed since they haven't undergone post-eruptive maturation and loss of carbonate ions yet?

After eruption of 6 year and 12 year permanent molars

Who should receive sealants?

High risk pts regardless of groove depth Pts w/ deep, retentive, unrestored pits and fissures

What material is used for sealants?

GI

Main controller of saliva production

Parasympathetic nervous system

Mild effect on saliva flow

Sympathetic nervous system

__________ in mouth stimulates salivatory nuclei in medulla and increases saliva secretion, stimulation of acinar cells, and contraction of myoepithelial cells

Pressure

T/F: Saliva production also stimulated by sight, smell, taste, sound

True

Why do we get dry mouth when sleeping?

Nothing is stimulating saliva

Stimulates mucus secretion, decreasing serous secretion, leads to viscous saliva

Sympathetic nervous system

What is the final saliva product by ductal cells?

Hypotonic

Tonicity and ion concentrations depend on rate of _________ flow -> ion channels have a maximum rate of transport

salivary

If salivary flow is increased, final saliva concentration would increase and decrease in which ions?

Increase in Na+, Cl-, HCO3- Decrease in K+

Posterior to mandibular ramus in front of mastoid process of temporal bone

Parotid gland

Opening is in the mucosa of the cheek via Stenson’s duct

Parotid gland

Beneath the lower jaw, superior to digastric muscles

Submandibular gland

Opening is in the sublingual caruncle via Wharton’s duct

Submandibular gland

Beneath the tongue anterior to the submandibular gland

Sublingual gland

Opening is the sublingual fold via excretory ducts

Sublingual gland

Make serous fluid for mastication

Serous cells

Make mucus rich secretion for protection

Mucous cells

Functional unit of salivary gland

Salivon

The salivon has a single layer of cells arranged in a grape-like structure called what?

Acinus

What are the 2 cell types in the acinus?

Serous Mucous

The acinus is surrounded by contractile cells called what that can aid in expulsion of the freshly secreted saliva?

Myoepithelial cells

After the acinus produces the original salivary product, it is modified by which cells?

Ductal cells