Download Answers quiz 4 th sem block 6

Preventive Dentistry/ Questioner 4 th sem Block 6
D Caroline Mohamed
Answers
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1. Dental caries is a multifactorial microbial disease of the calcified tissues
of the teeth, characterized by demineralization of the inorganic portion
and destruction of the organic substance of the tooth, which often leads
to cavitations.
2. Streptococcus mutans and Lactobacillus.
3. Lactic acid
4. 5.5
5. White spot
6. Educational level, socio economical level, knowledge, behavior, Host
defense, microbiota, saliva, fluoride, diet.
7. Prevalence is the number or proportion of persons in a population
affected by a condition at a given point of time and Incidence is the rate
of new cases of condition over a given point of time.
8. Age-Three peaks
4-8yrs/ 11-18yrs/ 55-65yrs
9. Are high risk:
10. Interproximal surfaces of primary molars. And occlusal surfaces of first
permanent molars.
11. Pits & fissures / Irregularities in arch form/ Crowding/ Overlapping.
12. Regularity of snaks, more than 3 times a day, snacking between meals,
this increases the acid challenge to the teeth for a high level / Nocturnal
bottle usage- additive/ On pacifier during sleep/ Drinking sweet
beverage/Brushing by mother
13. The deep in folding of enamel makes oral hygiene along the surfaces
difficult, allowing dental caries to develop more commonly in these areas.
14. Within the dentin, the decay follows a triangle pattern that points to the
tooth's pulp. This pattern of decay is typically described as two triangles
(one triangle in enamel, and another in dentin) with their bases conjoined
to each other at the DEJ.
15. This base-to-base pattern is typical of pit and fissure caries, unlike
smooth-surface caries (where base and apex of the two triangles join).
16. It is an inverted V with a narrow entrance and a progressively wider area
of involvement closer to the DEJ.
17. Smooth surface caries occurs on the gingival third of the buccal, lingual
& proximal surfaces. On proximal surface, caries begins below the
contact area & in early stage this appear as a faint white opacity of
enamel without loss of continuity of surface. As caries progresses, it
appears bluish white in later stage. Caries in cervical area are in the
form of crescent shaped cavities. It appear as a slightly roughened,
chalky area which gradually becomes deeper.
18. Bitewings
19. Lesion have a broad area of origin and a conical, or pointed extension
towards DEJ.
20. V shape with apex directed towards DEJ.
21. Caries originating on the root is alarming because:
1. It has a comparatively rapid progression
2. it is often asymptomatic
3. it is closer to the pulp
4. it is more difficult to restore
22. Root caries lesions have less well-defined margins, tend to be U-shaped
in cross sections, and progress more rapidly because of the lack of
protection from and enamel covering.
23. The root surface is more vulnerable to the demineralization process than
enamel because cementum begins to demineralize at 6.7 pH, which is
higher than enamel's critical pH.
24. it is easier to arrest the progression of root caries than enamel caries
because roots have a greater reuptake of fluoride than enamel.
Dental
Progressio Consistency
Colour
Severity
Teeth/
caries
n
(caseous/
(light,
(possibilit surface
lesions
(Slow/
smooth/
darker)
y of pulp involved
fast)
leathered/
exposure
Hard)
/ high or
low)
Acute
fast
caseous
light
high
many
coloredbrown/
grey
Chronic slow
leathery
brown
low
few
Nursing fast
smooth
Light
high
upper
brown
anterior
teeth
Rampan fast
smooth
light
high
mandibul
t
coloredar incisors
brown/
also
grey
Radiatio fast
smooth/leathere brown
high
manyn
d
smooth
caries/
cervical
area
Arrested slow
hard
marked
low
occlusal
brownsurface
eburnatio
n
of
dentin
25. A primary caries is one in which the lesion constitutes the initial attack on
the tooth surface. This type of caries is observed around the edges and
under restorations.
26. Remineralised by fluoride application
Initial caries- demineralization
Superficial caries- enamel
Moderate caries- dentin caries
Deep caries – dentin close to the pulp
Deep complicated caries – pulp involvement
27. Low salivation/ low buffering/ less salivary clearance/ more plaque
accumulation/ more dental caries
28. Sharp tips physically damage small lesions with intact surfaces.
29. Probing can cause fracture & cavitation of incipient lesion. It may
spread the organism in the mouth.
30. a.I
31.
b. II
c. III
Social History
Medical History
Dietary Habits
d. IV
e. V
f. VI
High Risk
Socially deprived
High caries in siblings
Low
knowledge
of
caries
Medically compromised
Xerostomia
Long-term
cariogenic
medicine
Sugar intake: frequent
Low risk
Middle class
Low caries in sibling
High dental aspirations
No such problem
Infrequent
Use of fluoride
Non-fluoridated area
Fluoridated area
No fluoride supplements Fluoride supplements
used
Plaque control
Poor
oral
maintenanc
Saliva
Low flow rate& buffering
capacity

S.mutans
&
lactobacillus counts
Normal
flow
rate&
buffering capacity

S.mutans
&
lactobacillus counts
Clinical evidence
New lesions
Premature extractions
Anterior
caries
restorations
Multiple/repeated
restorations
No fissure sealants
Multi-band orthodontics
No new lesions
No extraction for caries
Sound anterior teeth
No/few restorations
Fissure sealed
No appliances
hygiene Good
oral
maintenance
hygiene
32. Support, masticatory load, sensory, nutritive, mantainence, adaptive role,
shock absorber.
33. Gingiva, alveolar mucosa, periodontal ligament, alveolar bone and
cementum.
34. Erytema- redness, edema- swelling, absence of stippling, bleeding on
probing
Definition of dental plaque
Dental
plaque
is
the
soft,
nonmineralized bacterial deposit
which forms on teeth and dental
protheses that are not adequately
cleaned. LÖe 1965
Definition of Pellicle
It is the initial phase of plaque
formation.
Contents:
salivary
components,
crevicular
fluid,
bacterial products, tissue cell
products and debris
Definition of dental calculus
Hard deposits that forms
mineralization of dental plaque
Definition of material alba
Bacterial aggregations, leucocytes
and desquamatd oral epithelial cells
accumulating at the surface of
plaque and teeth but lacking the
regular internal structure observed in
dental plaque.
by
Major sites for plaque accumulation
Fissures of molar teeth
Supragingival: on the tooth surface
above the gingiva
Subgingival: in the area bounded by
the margin of the gum and the tooth
Interproximal: between adjacent
teeth
Most important bacteria related to Streptococos ( mutans and sanguis)
dental caries/ the dominant and the and lactobacillus
more aggressive
Phase I characteristics
Bacteria adhere, multiply and
24 – 48 hours after plaque increase in mass and thickness and
accumulation
form mini – colonies in layers upon
the pellicle .
Phase II characteristics
3 and 4 days
Phase III characteristics
4 to 7 days
There is a dramatic increase in
plaque thickness. The outer surface
of the plaque is covered by grampositive tall rods.
Plaque
begins
to
migrate
subgingivally, and bacteria and their
Phase IV characteristics
7 to11 days
products permeate and circulate in
the pocket.
The plaque becomes more gram
negative and anaerobic in the
deeper layers, the gums become
slightly inflamed.
Types of bacteria of phase I
rod and cocci
Types of bacteria of phase II
Types of bacteria of phase III
Types of bacteria of phase IV
35. Normal dental plaque: coccis, filaments, epithelial cell, little motility,
Gingivitis plaque: spirochetes and great motility
36. The diseased periodontal pocket harbors both attached subgingival
plaque biofilms and nonattaching, motile subgingival microflora
(spirochetes, vibrios, and straight rods with flagella).
37. In humans, when bacteria are allowed to accumulate in plaque on the
tooth surfaces, enamel caries and gingivitis develop within …2 to 3
weeks
In relation to gingival index …0……..means normal
…1………means slight change in color and
mild edema with slight change in texture
……2…… bleeding on probing/pressure
……3…... spontaneous bleeding
38. In humans, when bacteria are allowed to accumulate in plaque on the
tooth surfaces, enamel caries and gingivitis develop within …2 weeks..(
how many days or weeks or months or years)
39. Inadequate dental procedures that contribute to the deterioration of the
periodontal tissues are referred as iatrogenic factors.
40. Overhanging margins of dental restoration contribute to the development
of periodontal disease: Over contoured crowns and restoration, Not
replaced missing teeth
41. Ortho. Therapy may affect the periodontium by favoring the plaque
retention or by directly injuring the gingiva as a result of overextended
bands and by creating excessive force on tooth and supporting
structures. Ortho. Appliances can modify the gingival ecosystem.
42. Toothbrush trauma/ Chemical irritation/ Mouth breathing/ Tongue
thrusting/Tobacco use
43. Abrasion of the gingiva as well as alterations in tooth structure may result
from aggressive brushing in a horizontal or rotary fashion.
44. Scuffing of epithelial surface, denudation of underlying connective tissue
– gingival ulcer gingival recession.
45. Smoking
46. Tongue thrusting is often associated with an anterior open bite.
47. Proximal contact relation//Cervical enamel projections and enamel
pearls/ Intermediate bifurcation ridge/ Root anatomy/Cemental
tears/Accessory canals/ Root proximity/Adjacent teeth
48. 16… right maxillary permanent first molar…or upper right maxillary
permanent first molar
25… left maxillary second pre molar…or upper left second molar
11… right maxillary central incisor or upper right permanent central
incisor…
24… left maxillary second pre molar or left upper permanent first
premolar.
33… left mandibular permanent canine or lower left permanent canine.
38… left mandibular permanent third molar or lower left permanent
premolar
42… right mandibular permanent lateral incisor or lower mandibular
permanent lateral incisor
44… right mandibular permanent second premolar
47… right lower permanent second molar
52….right maxillar permanent lateral incisor
51… right upper deciduous central incisor
62… left maxillar deciduous lateral incisor
71…left lower deciduous central incisor
84…right lower deciduous first molar
49. D + M + F = DMFT
50. a)14
51. Its mainly recommended for :
Individual lacking motor skills ( Aged persons, arthritic patients)
Hospitalized patients whose teeth are cleaned by the caregivers.
Special needs patient ( physical and mental disability)
Patient with orthodontic applied
Whosoever wants to use
52.
53.Charter´s method.
54.Plastics hands on the toothbrush. velcro strap with a pocket on the palm
side into which the toothbrush can be inserted, The handle of some brushes
can be modified by immersion in hot water.
55. Remove plaque and debris
that adhere to the teeth; restorations, orthodontic appliances, fixed
prostheses and pontics, gingiva in the interproximal embrasures; and around
implants.
Polish the surfaces as it removes the debris.
Massage the interdental papillae
Aids in identifying the presence of subgingival calculus deposits, over –
hanging restorations, or interproximal carious lesions.
Reduces gingival bleeding and control of halitoses.
May be used as a vehicle for the application of polishing
chemotherapeutic agents to interproximal and subgingival areas.
or
56. Type II and Type III embrasures,
-Diastemas,
-Exposed root furcations,
-Orthodontic and fixed appliances,
-Application of fluoride,
antimicrobial or desensitizing agents.
57. Mechanical. Chemical plaque control should always be regarded as a
needs-related supplement to, and not a substitute for, mechanical plaque
control.The choice of agent and frequency of use for self-care and
professional care should be related to the individual patient’s predicted risk
for oral disease.
58. Arrest enamel (incipient) caries, convert active root caries to inactive,
and heal inflamed periodontal tissue as soon as possible and thereby
reduce the Plaque Formation Rate Index (PFRI)
59. disrupt the natural balance of the oral microflora, lead to colonization by
exogenous organisms, or lead to the development of microbial resistance.
60. Substantivity is defined as the ability of an agent to bind to tissue
surfaces and be released over time, delivering an adequate dose of the
active principle ingredient in the agent. Thus the agent delivers sustained
activity necessary to confront bacteria attempting to colonize the tooth
surfaces.
61. Penetrability refers to the efficiency of an agent in penetrating deeply
into the formed plaque matrix.
62. The concept of selectivity implies that the agent has the ability to affect
specific bacteria in a mixed population.
63. It is the chemical property that an antiplaque agent must have to easily
and rapidly solubilize in its delivery vehicle allowing its fast release into the
oral environment.
64. It is the property of reaching the site of action and the manteinence at the
site long enough to have a sustained effect.
65. It is the chemic property related to the ability of not changing and not
losing it effect as an effect of chemical breakdown or modification that an
antiplaque agent may have.
66. Plaque formation may be prevented by chemical agents by one or more
of the following principles;
inhibition of bacterial colonization,
inhibition of bacterial growth and metabolism,
disruption of mature plaque and
modification of plaque biochemistry and ecology.
67. Toothpaste, Mouthrinses-Spray- Irrigators-Chewing gum-Varnishes68. Toothpaste
69. Inhibit the development of plaque, calculus and gingivitis. Most positive
antibacterial results, Pronounced antiseptic properties, Reduce plaque by
55% and gingivitis by 45%. Chx is used in all kinds of delivery systems for 2
to 3 weeks.
Disadvantage:
70. A disadvantage is brown staining of the teeth and the tongue after some
weeks’ use particularly from mouthrinses.
71. Cetylpyridium presents less substantivity comparing with CHX, it is just
3 to 5 hours.
72. Indications: acute ulcerative gingivitis. Contra indications: 3% hydrogen
peroxide increases the degree of the injury to damage tissue, thus delaying
wound healing. Carcinogenisis, tissue damage, hyperkeratosis, oral
ulceration and hyperplasia.
73.Fluoride varnish/ CHX varnish
74. This device is very helpful in reducing dental decay where compliance is
impaired such as in patients with special needs.