Caries And Aging

Front 1

• Ginigivial recession is normal?
• Due to?

Back 1

o Yes
o Attrition, abrasion, abfraction, restorations, root exposure, normal salivary rate, no bleeding(probing)
o Ginigva stippled, flat , pink

Front 2

Recesiion predisposes teeth to? Due to?

Back 2

Root caries, xerostomia, poor oral hygiene, high carbohydrate diet

Front 3

Causes of Xerostomia: Medications

Back 3

-common: Benadryl,flexaryl,elavil,scopolamine,atropine, HCTZ, Sinemet
Illicit: cocaine, ex, methamepatamines

Front 4

Causes of Xerostomia: radiation cancer therapy causes?

Back 4

-damages cells that produce saliva

Front 5

Sjorgen Syndrome Autoimmune disease develops?

Back 5

-Primary disease: patient develops antibodies to salivary and tear glands

Front 6

MedicationsXerostomia

Back 6

-antihistamine, antidepressants, anorexiants(diet), anticholinergics, sedatives, atniphyschotic, antihypertensive, antiparkinson, diuretics, rec/illicit, prescription drugs for diabetes(sarcoidosis, erythematosis), drug interactions

Front 7

Chemotherapy and radiaton cause? Occur in? Lower risk? Higher risk?

Back 7

-All: radiation of head and neck
-80% hematopoietic stem cell transplant
40% chemotherapy
Lower: minimally myelosuppresive chemotherapy
Higher: stomatoxic chemotherapy(prolonged myelosuppression), head/neck radiation for oral, pharyngeal, laryngeal cancer

Front 8

Treatment for Xerostomia:

Back 8

-water
-artificial saliva
-Mints stimulate salivary glands
-Policarpine(Salagen)

Front 9

Pilocarpine mechanism:

Back 9

-cholinergic, mimics ACH(from nerve cells)
-ACH b/w nerve cells, and organs/nerve cells
-causes salivary glands to make saliva
-lacrimal lands to make tears

Front 10

Xerostomia combined with…?

Back 10

-poor oral hygiene and high refined carbohydrate diet

Front 11

Bacterial Caries in aging:

Back 11

-S.mutans, S. sobrinus, lactobacillus

Front 12

Xerostomia treatment:

Back 12

exam 3-4 months
-rinse mouth with water often
-alchohol free mouthwash
-fluroide tooth brush after each meal and b4 bed time
-floss daily
-sugarless gum,candy,soda
-see dentist if noticed changes/pain/bleeding
-possibly prescription fluoride

Front 13

Testing for S. Mutans procedures and protocol:

Back 13

-Oral health education
-sugar reduction and frequency in eating
-tooth paste that has fluoride and anti-bacterial compound
-provide frequency prophy, fluoride treatment(liquid/varnish), counseling
-advice use of a high-fluoride home treatment(fluoride rinse, tray/sent with pH neutral fluoride gel)

Front 14

What should be used as index for caries risk, why is it better?

Back 14

-S. Mutans index instead of waiting for signs of cavity development
-should be charged as a service

Front 15

What should be done with individuals with high initial count:

Back 15

-chlorhexidine(peridex) .2% daily rinse for 2 weeks, several hrs removed from fluoride rinse
-xylitol chewing gum
-use S. Mutan tests one/week or month after treatment and at recall to restimate risk

Front 16

What is the most effective restoration materail on root, why?

Back 16

-glass-ionomer prevents initial cariogenic challenge with mix species biofilm without therapeutic intervention

Front 17

To prevent caries need to ask?

Back 17

-what keeps demin/remin equilibrium in remin direction
Root caries can lead to?
Apple coringtooth breakage at gingival level

Front 18

Dental caires leads to?

Back 18

-root caries

Front 19

Root caries prevention methods?

Back 19

-good OH, fluoride/antimicrobial rinses, attention to xerostomia
-access to care at home

Front 20

Which type of fluoride treatment is most effective?

Back 20

-frequent topical application of fluoride could be a successful treatment for incipient root carious lesions, irrespective of the type of fluoride treatment used

Front 21

Ozone treatment effect on caries?

Back 21

-reduce bacterial burden of biofilms, maybe in useful in reducing caries on SMOOTH root surfaces and in remineralization of disease

Front 22

Development of Dental Assessments
used to do what?
for?

Back 22

-used to assess the independence or assistance level

-used to assess the quality and outcomes of the intervention

-Types:
Caries, DMF, plaque index, periodontal probing, adoh

Front 23

Caries Annual Activity:

Back 23

Moderate activity: 1-3 caries
High Caries activity: 4 or more new caries
Extremely high caries: atypical patterns, surfaces who caries are exposure are typically low or non-existant

Front 24

Problems Associated with Oral Care Delivery Barriers

Back 24

-patient access
-income
-access:
transportation
dental porviders
physicaian awareness
Oral self-care: self/assistance needed?

Front 25

Measurements taken to asses

Back 25

-fluoride application:open tube of lfuroide, apply to finger then take finger to mouth

-rinsing: measure ability to open a bottle of mouthwash pour the liqudi and take the cup to the mouth

-flossing
pull the flow lout wrap around 2 middle fingers and take to the mouth

Brushing:
open tube of toothpaste, squeeze a small amount on the toothbrush and take it to the mouth

Front 26

ADOH assesment

Back 26

Indp
0-complete indp

Assistance: subject can complete some but not all steps of task w/o assistance
1-subject requires devices to complete task with enhanced performance
2-subject expends 1/2 or more of the ffort in completing the task with or without limited supervision

Dependent: antoher person is requred for either supervision/phyisal assistance in order for the task to be completed

3: subject expends less than 1/2 of the effort in cpmpleting task and requries supervision with or w/o phyiscal contact

4: total asistance is required or the individual can not complete the task
3

Front 27

Results:

Back 27

-each take assesed and added
-0-16, 16 being most dependent
or 0-8 if person is edentulous because flossing and fluoride application is not measured

Front 28

Predictors of caries in old age:

Back 28

Regression analyses and multivariate modeal IDed cares at baseline

-residence in long term facilites, high numbers of lactobacilli, poor oral hygien and frequent sugar consumption as the variable contributing most significant;ly to the risk of caries in old age.

Front 29

Xerostomic medications and oral health: Veterans dental study

Back 29

-oral health data on total surface of coronal caries, root caries index, mean oral mucosa scores, community periodontal index of treatment needed, oral health parameters measured and recorded in dental exams

conclusion: significant deleterious effects of xerostomic medications on oral mucosa.
-xerostomic medications do not appear to increase coronal caries or PI among ambulatory community dwelling particpaints WHO WERE ABLE TO PERFORM ROUTINE PREVENTIVE ORAL CARE

Front 30

Caries incidence and incredments in community-living olderadults with or w/o dementia

Back 30

-coronal/root caries hihger in dementia patients

-dementia patients had higher level of coronal and root caries

-other facotrs: sex, dementia severity, high carer burden, oral hygien care difficulties
-use of neuroleptic medicaiton(high anticholinergic adverse effects)
-preveious experience of carries

Front 31

Minimal Intervention Dentistry

Back 31

-offers dental professionals with realistic, rational, evidence based options for treating disease

-helps with challenges with elderly

Front 32

RFGIs contain

Back 32

-dentinal bond strength
-less expansion/contraction
-fluoride release
-tooth colored
-surface polishability after 24 hrs
-place a layer at time of placement

Front 33

glass ionomer

Back 33

-Temporary glass ionomer

-polyacrylate treated dentin and hybridized layer fomring in an aqueous environment

Front 34

Best predictors of root caries

which teeth showed greatest attack rate

most predictive?

results?

Back 34

-number of teeth remaing
-calculus
-plaque
-medications with xerostomic effects

-mandibular molars/premolars

-medications

-need to provide interceptive dental therapeutics for hi-risk geriatric populations(ex. multple med, poor history of oral care)

Front 35

Root caries in nursing home facilities

Back 35

-increased risk
-DHP/ RDHAP-practice in nursing homes
-OHLs

Front 36

Elderly canadians residing in long-term care hospitals

Back 36

-few remaining teeth, poor OH
-prevention strategies rather than dental interventions alone may be needed

Front 37

How well do restorations reduce effects of biofilm

Back 37

effects of fluoride and aluminum from Ionomeric materials on S.mutans:

-release different proportions of fluoride and aluminum- all released this

-BUT Vitremer release highest Al, most effect in reducing acidogencitiy

-also affected both biofilm formation and composition-->

-aluminum enhance biological effects of fluordie