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15 Cards in this Set
- Front
- Back
What are the purposes of prophylaxis?
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Give patient clean basis to practice home oral hygiene
Help young/anxious patients aclimitised to operating procedures Remove extrinsic stains for aesthetic reasons Remove plaque and debris from teeth Localised: eg to prepare a treatment site for fissure seal placement |
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What is extrinsic staining and it's causes? (specific examples)
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Extrinsic staining occurs from pigmentation of the normally colourless saliva pellicle that coats the teeth from various substances or bacteria.
Variety is the strength of attachment and degree of colour. Found more where there is low salivary flow, eg cervial, interproximal regions Causes: Black line - gram positive bacteria in pellicle - tenacious Green stain - fluorescent microorganisms in pellicle. Max incisors Dietary: wine, tea, coffee (tannins) Tabacco: tar combustion products and tabacco juices Chlorhexidine: 2%, brown, yellowish stains Betal quid: brown/red Metallic: iron containing medicines All removal except green stains can permanently stain demineralised enamel |
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What tools are used in prophylaxis?
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Rubber cup or brush on special prophy head of slow speed handpiece
Prophy pastes Abrasive particles Water Humectants (humidifier/moisture retainer eg glycerine) Binder (stop seperation/splatter) Sweetener Fluoride |
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What are some clinical tips in carrying out prophylaxis?
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Scaling can be used first to remove calculus
Avoid gingival margin, especially with brush (risk of trauma) Keep paste moist to minimise frictional heat Dentine exposed areas may be particulary sensitive |
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Why disclose plaque?
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Tooth brushing is an automatic process for most people and people have different levels of awarenss during brushing. Therefore they may not realise they are missing places, or even know plaque is there (whitish, see through). Showing the patient it's prescence can show them areas they are missing and provide extra motivation
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What is disclosing solution?
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Dye that is selective for soft debris, pellicle and bacteria on teeth.
Non-selective staining of gingival tissue and lips is a barrier to compliance of home disclosing Examples are organic erythrosin dye, synthetic fluorescent dye, two tone (old and new plaque), tartrazine yellow, |
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What is plaque/biofilm?
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Accumulation of bacterial collonies on the tooth surface, usually encased in a polysaccharide gel/ slime matrix
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What is the procedure of disclosing?
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Isolate area with cotton rolls, slow speed suction
Dry area with triplex Apply disclosing solution using small cotton pellet in microbrush/tweezers for 30 seconds Remove cotton rolls, rinse Use mouth mirror to visualise areas with disclosed plaque, record on blue perio form Show patient with face mirror Discuss |
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What is prophylaxis?
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The checking and correcting of restorations/prothesis overhangs/problems and the removal of supra/subgingival plaque, stains and calculus via scaling and polishing as a preventative measure to control irritants that can lead to conditions such as ginigvitis and caries
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What is the gag reflex?
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One of the noraml reflexes that protects the respiratory tract. Normally activated by contact with posterior third of tongue, fauces and pharynx, mediated by activation of the glossopharyngeal nerve
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What are the consequences of an abnoraml gag reflex?
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Social embarrassment
Poor oral hygiene Difficulty receiving dental treatment Avoidance of dental treatment Difficulty retaining dentures ...leading to: Increased oral disease Increased extraction |
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How is a gagger treated?
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Comprehensive history (triggers, first time, oral hygiene, patients treatment attempts, do they gag at just the thought or examination, what the patient wants...)
Examine the gag reflex Do they gag on suggestion of oral exam? Can they show you where they are sensitive? Map the reflex:(Cheeks, lower before upper, buccal/labial before palatal/lingual, anteriors before posteriors, tongue last) |
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What is a possible theory of the gag reflex?
Is there any consious control |
Conditioning of gag reflex to the stimulation of certain branches of the Trigeminal nerve (normally Glossopharyngeal)
ie Conditioned Autonomic reflex Conditioned response after only one reinforcment may be a survival instinct (rapid learning of what is dangerous increases survival) However consious control is demonstrated by a decrease in the reflex when the patient is distractred, or an increase if they are concentrating |
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What is the criteria for sucess in desensitising an abnormal gag reflex?
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Reducing the gag reflex in all areas except the posterior of the tongue and fauces as this is a natural protective mechanism
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What are the 12 steps in desentising the gag reflex?
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1. Check they can breathe through nose when lying on back
2. Brushing (labial to buccal surfaces, man first) 3. Brushing (anterior to posterior, first lingual/man, then palatal/max) 4. Suckling (until reaches soft palate) 5. Tongue thrusting (far out then rapidly) 6. Mouth opening (widely, then rapidly, then with a prop) 7. Tongue touching (gently pull out) 8. Tongue retraction to side 9. Tongue brushing (while holding, anterior 2/3's) 10. Cotton Rolls (string and pin, 1 to 4) 11. Gargling 12. Chewing gum If gagging occurs, go back a previous step |