Health Promotion Caries N Stuff

Front 1

What percent of oral cancers are attributed to tobacco and heavy alcohol use?

Back 1

75%

Front 2

What percent of Americans visit a dentist each year?

Back 2

60%

Front 3

What percent of Americans visit a physician each year?

Back 3

40%

Front 4

What are some of the major "pre diseases"?

Back 4

• Prediabetes ----> Diabetes
• Prehypertension ------> Hypertension
• Overweight -------> Obesity

Front 5

what is primary intervention?

Back 5

Preventing the occurrence of the disease

Front 6

what is secondary prevention?

Back 6

Limiting the extent of the disease,once it has occurred (treatment)

Front 7

What is tertiary prevention?

Back 7

Rehabilitation after extensive disease has left functional disabilities

Front 8

Which study monitored health status and looked for commonalities among those suffering from heart attacks?

Back 8

The Framingham Study

Front 9

What decade was the Framingham Study conducted?

Back 9

1950s

Front 10

What was the conclusion of the Framingham Study?

Back 10

The major causes of heart disease are:
1) Smoking
2) Cholesterol
3) Hypertension

Front 11

Significance of th Framingham Study?

Back 11

1) Causes of chronic diseases differed from the causes of infectious diseases—they could not be controlled through the same technologies

2) They did not share the same necessary and sufficient causal relationship found between microbes and infectious disease

3) The agents of chronic diseases were redefined as risk factors

4)The study results led to a growing recognition of the crucial role human behaviors play in the etiology of chronic disease

Front 12

When was the Surgeon General’s Report on Smoking & Health released?

Back 12

1964

Front 13

What was the goal of the Surgeon General's Report on Oral Health?

Back 13

1) To define, describe and evaluate the interactions between oral health and general health and well- being (quality of life), through the life span, in the context of changes in society

2) To review determinants of health, highlight emerging technologies and project what factors may affect the future of America’s oral health

Front 14

When was the Surgeon General's Report on Oral Health released?

Back 14

May 2000

Front 15

Major findings of the Surgeon General's Report on Oral Health?

Back 15

1) Oral diseases and disorders affect health and well-being throughout life

2) The mouth mirrors general health and well- being

3) Oral diseases and conditions are associated with other health problems

4) Lifestyle behaviors that affect general health, such as tobacco use, excessive alcohol use, and poor dietary choices, affect oral and craniofacial health as well

5) There are safe and effective measures to prevent the most common dental diseases- caries & periodontal diseases

6) There are profound and consequential oral health disparities within the American population

7) More information is needed to improve American oral health

8) Scientific research is the key to further reduction in the burden of diseases and disorders that affect the face, mouth and teeth

Front 16

What is the 2010 oral health objective for ages 2-15?

Back 16

Reduce dental caries experience in children

Front 17

What is the 2010 oral health objective for ages 65-75?

Back 17

Reduce complete edentulism

Front 18

What is the 2010 oral health objective for ages 35-44?

Back 18

1) reduce gingivitis
2) reduce peril disease

Front 19

What is the 2010 oral health objective for all ages?

Back 19

1) Increase detection Stage I oral cancer lesions
2) Increase persons on public H2O receiving fluoridated H2O
3) Increase use of dental services for LTC facilities

Front 20

What is the 2010 oral health objective for ages 40+?

Back 20

Increase # of oral cancer exams

Front 21

What is the 2010 oral health objective for ages 8-14?

Back 21

increase sealants in:

8yr----1st molars
14yrs - 1st and 2nd molars

Front 22

What is the 2010 oral health objective for ages 2+?

Back 22

Increase utilization of oral health system

Front 23

What is the 2010 oral health objective for ages 0-18?

Back 23

Increase preventive dental services for poor children

Front 24

The INNER CIRCLE includes what?

Back 24

Oral diseases and conditions:

1) Dental Caries
2) Periodontal Diseases
3) Oral Cancer
4) Facial Trauma/Injuries

Front 25

The MIDDLE CIRCLE includes what?

Back 25

Systemic diseases or conditions that:
1) Have direct impact on oral health and disease management
2) Are risk factors, risk indicators or risk markers for oral diseases

• Diabetes
• Substance Abuse
• Osteoporosis
• Eating Disorders
• HIV & AIDS
• Stress & Anxiety • Depression
• Polypharmacy

Front 26

The OUTER CIRCLE includes what?

Back 26

Lifestyle diseases/conditions

1) Obesity
2) CV Diseases
3) Hyperlipidemia
4) Cancers
5) Hypertension

Front 27

What is The “Common Risk Factor Approach” to Practicing HP?

Back 27

It recognizes that chronic conditions share a set of common risks
- promotes interdisciplinary working or and teaming up

Front 28

What is The Biopsychosocial approach to care?

Back 28

Consider the patient as a whole entity

Front 29

is the rate of dental caries increasing?

Back 29

yes

Front 30

What % of the population has what % of the decay?

Back 30

20% of the Popula)on Has
60% of the Decay

Front 31

What % of the population receives what % of the restorations?

Back 31

10% OF THE POPULATION RECEIVE 65% OF RESTORATIONS

Front 32

What factors promote remineralization of tooth enamel?

Back 32

Increased alkalinity or ca+ conc.

Front 33

What are the effects of fluoride incorporation in enamel?

Back 33

makes smaller crystals, less soluble in acids

Front 34

What are the effects of carbonate incorporation in enamel?

Back 34

makes a less organized more soluble crystal in acids

Front 35

What are the effects of magnesium incorporation in enamel?

Back 35

increased solubility in acids

Front 36

very basic structure of dentin?

Back 36

-70% Inorganic/ 30% Protein (collagen)
-Tubular structure

Front 37

very basic structure of enamel?

Back 37

-97% Inorganic
-Organized crystal

Front 38

does enamel communicate with the pulp?

Back 38

no

Front 39

does dentin communicate with the pulp?

Back 39

yes, directly

Front 40

random dentin characteristics?

Back 40

Dentinal fluid flow
Smear layer

Front 41

is saliva a buffer

Back 41

yes

Front 42

how many medications serve as cholinergic antagonists?

Back 42

1000 common

Front 43

What are the pathological factors for caries formation?

Back 43

1) Acid-producing bacteria
2) Frequent eating/drinking of fermentable carbohydrates
3) Sub-normal saliva flow and function

Front 44

What are the protective factors for caries formation?

Back 44

1) Saliva flow and components
2) Fluoride - remineralization!
3) Antibacterials (chlorhexidine, xylitol, new?)

Front 45

what effect did switching from sucrose to high-fructose corn syrup have on dental caries and WHYY?

Back 45

caries increased b/c HFCS is a simple sugar

Front 46

what do we remove from brown flour during its refinement?

Back 46

phytate

Front 47

Refinement of carbohydrate results in:

Back 47

increased caries

Front 48

List 3 very important IN VIVO studies that define causes of caries.

Back 48

1) 1992 - Refined sugar increase the rates of caries

2) 1983 - fluoride reduced rates of decay in overall American pop, despite increased sugar consumption.

3) caries relate more to freq. of sugar consumption, than quant. 3x more carries w/ snacking.

4) in kids, regular brushing w/ fluoride toothpaste better than restricting access to sugary foods.

Front 49

Foods in Low Cariogenic Index

Back 49

by least to worst,

1) Bologna
2) Corn Chips
3) Yogurt
4) gelatin

peanuts too?

Front 50

Foods in Moderate Cariogenic Index

Back 50

by least to worst,

1) Pretzels
2) Potato Chips
3) Saltines

Front 51

Foods in High Cariogenic Index

Back 51

by least to worst,

1) Milk Chocolate
2) Cupcakes
3) Bread, Sucrose
4) Granola Cereal
5) Bananas
6) Raisins

Front 52

What is Caries Risk Assessment and what is it not?

Back 52

IS:

1) patient-centered w/ long-term health

2) use of best practices confirmed by “real” research

3A) Applying the indicated diagnostic tools for:
3B) specific treatment plans

4A) EDUCATING the patient about their condition for:
4B) treatment choices


NOT: a practice management strategy to “do more” and improve the bottom line

Front 53

What are some disease indicators?

Back 53

• Cavities/dentin!
• Enamel lesions! • White spots!
• Restorations<3 yrs

Front 54

What does the "OLD" Caries Balance Theory exclude?

Back 54

disease indicators

Front 55

The NEW Caries Balance Theories includes?

Back 55

1) Risk/Disease Indicators,
2) Risk/Disease Factors
3) Protective protocol

Front 56

What compounds increase alkalinity/base production?

Back 56

Arginine, urea, and peptides

Front 57

Mechanisms of fluoride function?

Back 57

1) Produces fluoride-apatite crystals-reducing solubility, balancing remin/demin.

2) Subtle anti-microbial effects, decreasing the ability of S. Mutans to respond to low pH (HF uptake into the cell) denying growth preventing development of low pH

3) In high concentration F may effect the enolase in S. Mutans and inhibit growth

Front 58

When was the specific fluoride-caries relationship established?

Back 58

1942

Front 59

What % of schoolchildren in the U.S. have dental sealants on the molar teeth?

Back 59

less than 25%

Front 60

When should a patient be clinically re-evaluated?

Back 60

Low risk - 6 months
Med risk - 4 months
High risk - 3 months

Front 61

When should a patient have radiographic re-evaluation?

Back 61

Low risk - 24 months
Med risk - 12 months
High risk - 6 months

Front 62

What are the office initial recall protocols?

Back 62

1) Evaluate for caries
2) Review risk factors
3) Review oral hygiene

4) Possible in-office tests - salivary flow and diagnoses

Front 63

Mechanisms of fluoride function

Back 63

1)Topical
----Inhibits demineralization
----Promotes remineralization
2) Systemic
----Improves enamel crystalinity (?)
----Reduces acid solubility (?)
----Improves tooth morphology (?)
3) Antibacterial
----Concentrates in plaque
----Disrupts enzyme system

Front 64

What is the fluoride we use?

Back 64

CaF

Front 65

Where is most fluoride in tooth?

Back 65

outer 5-10 microns

Front 66

What is the most effective dose and frequency of fluoride?

Back 66

low doses at regular intervals on a daily basis

0.08ppm is optimal

Front 67

What year did we start fluoridating water supplies?

Back 67

1945

Front 68

"four horsemen" of public health?

Back 68

Chlorination
Pasteurization
Immunization
Fluoridation

Front 69

what percent of the US pop is accessing fluoridated water supplies?

Back 69

73.9% - 204.3 million people

Front 70

by what percent does fluoride reduce pop. caries in PRIMARY dentition?

Back 70

40-50%

Front 71

by what percent does fluoride reduce pop. caries in PERMANENT dentition?

Back 71

50-60

Front 72

why are some studies showing lower community effectiveness of fluoridated water supplies??

Back 72

"halo effect" - b/c foods and other stuff are being made with fluoride already so it appears as if fluoridating our water supply has less of an effect.

Front 73

% caries reduction with toothpastes?

Back 73

30%

Front 74

problem with fluoride toothpastes?

Back 74

ingestion causes fluorosis

Front 75

how much fluoride is in toothpaste?

Back 75

1000ppm or 0.1% F-ion

Front 76

what % effectiveness of fluoride rinses?

Back 76

20-25% over 4 years (50% inter proximal reduction)

Front 77

what are the advantages of fluoride varnishes over other forms of fluoride delivery?

Back 77

1) Easy to apply
2) Can eat & drink after
3) Ingestion minimal
4) Teeth do not need a professional prophylaxis

Front 78

toxic dose of fluoride?

Back 78

5mg/kg

Front 79

fatal dose of fluoride?

Back 79

15-71 mg/kg

Front 80

what surfaces are fluorides most effective? and why

Back 80

-smooth surfaces.

Front 81

what is more effective in reducing surface carries of occlusal surfaces...varnish or sealants?

Back 81

sealants

Front 82

chemical comp of sealants?

Back 82

Bisphenol A-glycidyl methylacrylate

Front 83

primary different between sealents?

Back 83

the method of polymerization

Front 84

describe the types of sealant polymerization?

Back 84

1) Light-Cured Sealants
2) Self-Cured Sealants

Front 85

what % of caries in children occur in pits & fissures?
�

Back 85

90%

Front 86

are sealants effective in reducing bacteria in NON-CAVITATED CARIOUS LESIONS?

Back 86

yes

Front 87

four-handed delivery of autopolymerized sealants was associated with increased sealant retention of_____%?
�

Back 87

9%

Front 88

T/F - sealants also are an effective secondary preventive approach when placed on early NON-CAVITATED carious lesions

Back 88

true

Front 89

predictors of the need for sealant:

Back 89

The best predictors:
1) Prior caries experience of the patient
2) Tooth morphology (fissure anatomy)
3) Home care, plaque load

Front 90

T/F - sealant delivery to auxiliaries is less effective?

Back 90

false. more effective

Front 91

how long is the recall after applying sealant to determine retention?

Back 91

3 months

Front 92

The 4 commandments for successful sealant placement:
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Back 92

the tooth must:
1) Have a maximum surface area
2) Have deep, irregular pits and fissures
3) Be clean
4) For most sealant materials, be absolutely dry and uncontaminated with saliva residue