Preventive, 10/27/11

Front 1

dmf index

Back 1

decayed, missing and filled surfaces or teeth in the primary dentition
cumulative exposure of children under age 6 to dental disease

Front 2

Prevalence of oral leukoplakia is a risk factor or risk indicator?

Back 2

risk indicator - no longitudinal component.

Front 3

Risk factor? risk indicator vs. risk marker

Back 3

Risk factor: attribute or exposure that increases the probability of disease occurrence
dose-response
biologically plausible
strong causal role
longitudinal analysis

Risk indicator - cross sectional association, theoretical causal role

Risk marker - attribute or exposure associate with increased probability of disease
-not considered part of causal chain

Front 4

Oral cancer incidence..

Back 4

Incidence-
30,000 new cases per year (ACS)
~ 9,000 cancer deaths/year in U.S.
50% five-year survival rate
survival rates vary by extent of disease and race

Front 5

How does the incidence rate of oral and pharyngeal cancer change with age?
Incident rates by location, race, education, and death rates

Back 5

Increases with age and plateaus around age 80. men have greater incidence of cancer than female.

-greatest amt in larynx + mouth, less in pharynx, lip, and tongue.
Regional is more common than localized. Blacks more likely to have regional cancer than white.
Oral cancer deaths are higher in non hispanic blacks, higher in those less educated

Front 6

Prevention of oral CA: primary, secondary, and tertiary factors

Back 6

Primary - reduce risk factors, ?dietary?
Secondary - early detection and treatment, i.e., of
susceptible people via molecular epidemiology
localized disease
removal of risk factors at dx
Tertiary - excellent care to ameliorate...

Front 7

Incisor trauma

Back 7

varies by age
6-50 y.o. -25%
6-20 y.o. - 18.4% and 21-50 y.o. 28.1
and tooth type
mandibular - 6.3%, maxillary - 22.6%

Front 8

Kvittem study - high school athletes

Back 8

In high school athletes, in one year
At least one orofacial injury occurred -
27.6 % in soccer
55.4% in basketball
72.3% in wrestling
6% of the athletes used mouthguards
none were injured
fixed ortho-->greater risk

Front 9

Prevention of injuries - primary, secondary, tertiary

Back 9

Primary - seat belts, mouthguards, helmets
Secondary - early detection but no reversal
Tertiary- early and expert tx of injury to ameliorate the negative effects of the injury (tooth loss through failed endo for example)

Front 10

Describe the data available on malocclusion + prevention

Back 10

Variable measurements (Burt and Eklund, 1999)
no good epidemiologic data
most recent national data show that (Brunelle et al, 1996)
among 8-50 year olds-
11% had 6mm+ maxillary incisor crowding
15% had 6mm+ mandibular incisor crowding
9% had posterior crossbite

Front 11

Main reason why people got extractions?

Back 11

Caries was main reason why most got extractions.

Front 12

Caries incidence in children and adults

Back 12

1 carious tooth surface / person / year
Griffin et al., 2005
Incidence in older adults = 1.44: i.e., .87 coronal + .57 root surfaces per person per year - Hand et al., 1988
Primary reason for extractions in users of VA care - Jones et al., 2003

Front 13

Predictors of high root caries incidence ?

Back 13

age
ADL dependent
functional decline
unemployed
retired
smoking
low salivary flow

high % root plaque
high S. mutans
loss of attachment
gingival recession
root tips
partial dentures
extensive fixed pros

Front 14

Low risk caries in adults - what factors constitute this?

Back 14

No carious lesions within the last 3 years
Good salivary flow
Evidence of good daily oral care (e.g., DRM Plaque Index score of 0-1, or <20% of root surfaces with plaque)
Regular dental visits (at least 1x/year)

Front 15

Moderate caries risk - what constitutes this?

Back 15

1-2 new carious lesions within the last 3 years
Evidence of moderate daily oral care
High carbohydrate or sugar intake
Inadequate fluoride exposure (brushing less than 2x/day and no other fluoride source)

Front 16

Reported xerostomia and salivary dysfunction

Back 16

in this case, xerostomia is subjective.
-# of medications taken - as this increases, the xerostomia increases as well.

Front 17

High risk caries

Back 17

3 or more carious lesions within the last 3 years
Reduced salivary flow
Evidence of poor daily oral care (heavy plaque)
High S.mutans counts
Medical conditions that contribute to caries susceptibility (e.g.: head and neck radiation, psychiatric conditions, drug abuse and others)