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221 PDS
Take-home examination -1
Briefly answer the following question:
1. What is the definition Health?
A state of complete physical, mental, and social well-being, and not merely the
absence of disease or infirmity
2. Mention the types of prevention, their definitions and give an example for each
type.
*1-Primary Prevention: employs techniques and agents to abort the onset of
disease, to reverse the progression of the initial stages of disease, or to arrest
the disease process before treatment becomes necessary
E.g. remineralization by fluoride
*2-Secondary Prevention: employs routine treatment methods to terminate a
disease process and to restore tissues to as near normal as possible.
E.g. restoration of defected tooth
*3-Tertiary Prevention: employs measures necessary to replace lost tissues
and to rehabilitate patients to the point that function is as near normal as
possible after the failure of secondary prevention
E.g. implantation
3. Mention two advantages of primary prevention over secondary and tertiary
prevention.
Maintenance of original tissue and it is available for everyone due to the low cost it
needs
4. What are the remedies that can be done if primary prevention fails?
Early identification of disease and Immediate treatment of disease
5. What are the categories of oral diseases?
Dental caries
Periodontal disease
Other acquired oral conditions
Hereditary disorders
6. Mention 4 conditions necessary for caries to develop.
Present of bacteria, host, diet, and sufficient time
7. Mention methods used in dentistry to employ primary prevention in dentistry.
-Fluoride
-reducing
-
Sugar
Pit
and
and
diet
consuming
fissure
sealants
- Public education
8. What does the term biofilm mean? And what's role it plays in the disease
process?
Layers of bacteria arranged above each other on the tooth surface
9. What are the factors that may influence the buildup of dental plaque on the
tooth?
Mechanical displacement
Stagnation
Availability of nutrients
Interactions between the microbes and the host’s inflammatory immune
system
10.Give a brief narration on the dental plaque formation from its initial phase to 21
day of formation.
Within 2 hours, initial plaque formation begins as a series of isolated
bacterial colonies, then after 2 days, the plaque double in mass and bacterial
colonies coalesce, then in the first 4-5 days of plaque formation, the number
of bacteria increase significantly, after that by approximately 21 days,
bacterial replication slows so that plaque accumulation becomes relatively
stable, Bacteria in the deeper portion of the developing plaque are either
facultative or obligate anaerobes
11.Explain why mutans Streptocci play a major role in the pathogencity of the
dental plaque.
Due to production of Acids
Intracellular polysaccharides
Extracellular polysaccharides
By consuming sucrose
12.What is the definition of dental caries?
Localized, post-eruptive pathological process involving bacterial acid
demineralization of hard tooth tissue resulting in the formation of a cavity.
13.What are the stages that dental caries go through in the process of
demineralizing tooth structure?
Incipient lesion
Lesion extending to or beyond DE junction
Frank lesion with cavitation
14.What are the factors that may play a role in the progression of dental caries?
Ions concentration
pH
Salivary flow
Buffering action
15.Mention two major bacteria implicated in the initiation and progression of dental
caries.
Mutans streptococci and lactobacilli
16.What are the factors that make Mutans Streptocci highly virulent bacteria with
respect to dental caries?
Ability to adhere to tooth surfaces
Production of abundant insoluble extracellular polysaccharides (glucan)
Production of intracellular polysaccharides
Rapid production of lactic acid
Acid tolerance
17.Mention two risk factors associated with root caries.
Gingival recession and consuming medications known to reduce the salivary
flow and therefore increase the risk of root caries
18.What is the definition of gingivitis?
An inflammation process of the gingiva in which the junctional epithelium,
although altered by the disease, remains attached to the tooth at its original
level
19.What is the definition of periodontitis?
An inflammation condition of the gingival tissues, characterized by loss of
attachment of the periodontal ligament and the bony support of the tooth
20.Mention two theories that aimed to explain the periodontal disease.
Non-specific plaque theory
Specific plaque theory
21.A patient with moderate periodontal disease came to your practice. What are the
methods that you would suggest to him that may prevent future progression of
disease?
Till him to do the following instructions:
1. Mechanical plaque control: such as
- Regular tooth brushing
- Routine use of dental floss
2. Chemical plaque control:
- Use of mouth rinses such as chlorhexidine
- Topical fluoride maybe used to prevent root caries
3. Removal of local factors such as calculus (via scaling) or restorations with
defective margin (i.e. new restorations)
22.What are the functions that a toothbrush serves in the process of toothbrushing?
Carry dentifrice to tooth surfaces
Remove the dental plaque
Clean teeth of food, debris and stain
Massage the gingival tissues
23.What are the factors that may affect abrasiveness of a toothpaste or a
toothbrush?
Abrasiveness depends on the inherent hardness of abrasive, size, and shape of
abrasive particle, also, Brushing technique, the pressure on the toothbrush,
the hardness of the bristles, direction and number of strokes
24.Give examples of abrasives, humectants, binding agents, sweeteners.
Abrasives: Calcium carbonate (chalk) and sodium bicarbonate (baking soda)
are common abrasives used in toothpastes
Recently, silica, silicon oxides, and aluminum oxides are used
Humectants: sorbitol, mannitol, and propylene glycol
Binding agents: gum and then colloids
Sweetener: Saccharin, cyclamate, sorbitol, and mannitol
Glycerin serves as humectants and sweetener
25.Give examples of fluoride formulations used in toothpastes.
0.22% sodium fluoride (NaF) at conc 1,100 ppm
0.76% sodium monoflurophosphate (MFP) at conc 1,000 ppm
0.4% stannous fluoride (SnF2) at conc 1,000 ppm
1,500 ppm SnF2 is 10% more effective than 1,000 ppm SnF2
5,000 ppm is also available as prescription (Colgate Prevident 5,000)
26.Indicate the mechanism by which commercial whiteners make teeth whiter.
1-Mechanical: abrasive
2-Chemical: hydrogen peroxides or carbamide peroxides
27.What is xerostomia and what is its significance to dental public health?
Reduction in the salivary output (dry mouth)
Significance: should be known that it is a caries inducer
28.Mention some of the side effects of Chlorhexidine mouthrinse.
Bad taste, tooth staining, and increased calculus formation