Dental Sciences & Prev Dentistry- Ch 13/14-Test

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Dental Health in the United States

Oral health is essential to overall health

Improvement in preventive care and treatment = significant improvement in oral health

Components of Dental Public Health:

Government

Education

Workforce

Importance of Dental Public Health

Primary function of dental public health specialist:

Oral health assessment

Oral health assurance

Oral health policy development and implementation

Preventing Dental Disease

Most common dental diseases:

• Dental caries

• Periodontal disease

Components of preventive care:

• Patient education

• Nutrition and dietary counseling

• Plaque control

• Fluoride therapy

• Sealants

Types of floss

Floss Picks: Removes plague and food particles between teeth and below the gum line

Satin Tape: Covers more area than standard floss for cleaning wider gaps between teeth

Super Floss: Features varying widths for cleaning between braces, bridges, and around implants

Ribbon Floss: Slides easily in tight spaces for a superior clean at and below the gum line

How to Prevention Dental Issues

Listen carefully

• Each patient will have different needs

Assess the patient’s motivations and needs

• Combine motivating factors with needs

Select the home care aids

• Select a toothbrush, brushing method, interproximal cleaning aids such as dental floss, and a toothpaste

Keep the instruction simple

• Comment positively on the patient’s efforts

Reinforce home care during return visits

Early Preventive Dental Care

Pregnancy and dental care

• The American Academy of Pediatric Dentistry (AAPD) guidelines advise all pregnant women to receive counseling and oral healthcare during pregnancy and that infants undergo oral health assessment by their first birthday

• Many women are not aware of these guidelines, and do not seek dental care during their pregnancy because they believe that they do not have any dental problems

Dental Care: 0 to 5 Years

Even before the baby has teeth, the parent should wipe the gums gently with a clean, wet cloth after each feeding

Visit the dentist by first birthday

As soon as the first tooth appears, the parent can begin brushing the baby’s teeth in the morning and before bedtime

• Toothpaste is not necessary but can be used

• A pea-sized dab of toothpaste until age 6

Oral Health and Aging

Enamel becomes darker in color

Enamel surface develops numerous cracks

Vitality of dentin is greatly decreased

Cementum has compositional changes

Pulpal blood supply decreases

Size of the pulp chamber is reduced

Abrasion and attrition occur in the crowns of the teeth

Age-Related Pathology-Related Conditions

Both coronal and root caries

Alveolar bone becomes more porous

Increase of gingival recession

Systemic disease and medications causing dry mouth

Salivary gland changes causing reduced saliva flow

Older adults frequently have anemia caused by iron deficiencies resulting in red and burning tongue

Fluoride

Has been our primary weapon with which to combat dental caries since the 1950s

Slows demineralization and enhances remineralization of tooth surfaces

Is a mineral that occurs naturally in food and water

Systemic fluoride: ingested by mouth through water, food, beverages, or supplements

Topical fluoride: applied in direct contact with teeth

How Fluoride Works

Preeruptive development

• Before a tooth erupts, systemic fluoride in a fluid-filled sac surrounds it strengthening its enamel

Posteruptive development

• After eruption, fluoride continues to enter the enamel and alters the structure of the enamel crystals

• These fluoride-enriched crystals are less acid soluble than the original structure of the enamel

Safe and Toxic Levels of Fluoride

The fluorides used in the dental office have been proved safe and effective when used as recommended

Chronic overexposure to fluoride, even at low concentrations, can result in dental fluorosis in children younger than 6 years with developing teeth

Acute overdosage of fluoride can result in poisoning or even death

Acute overdosage is very rare

Fluoride Precautions and Needs Assessment

To prevent patients from receiving too much fluoride, evaluate the patient’s current fluoride intake

Fluoride needs assessment

• Saves time by identifying risk factors

• Opens communication between the dental professional and the patient

• Helps “individualize” patient fluoride therapies

• Allows the dentist to more accurately select the appropriate fluoride therapy

Sources of Fluoride

Fluoridated water

Bottled water

Foods and Beverages

Prescribed Dietary Supplements

Topical Fluoride

Plaque Control Program

Plaque can be kept under control with the use of brushing, flossing, interdental cleaning aids, and antimicrobial solutions

A goal of the program is to remove plaque at least once daily

The techniques that are selected must be based on the needs and abilities of the individual patient

Toothbrushes and Toothbrushing

The two basic types of toothbrushes are:

• Manual

• Automatic

Used properly, both types are effective in the removal of dental plaque

Infant Toothbrushes

Very small and soft; should be used as soon as the baby’s first tooth appears in the mouth

Finger brush can also be used

Manual Toothbrushes

Come in many styles of head size, tuft shape, and angle and shape of handle

In general, dental professionals recommend soft-bristled brushes because these bristles are gentler to the soft tissues and to any exposed cementum and dentin

Nylon bristles are preferred

Toothbrushes should be replaced as soon as the bristles show signs of wear or begin to splay outward

Electric Toothbrushes

Have larger handles that contain a rechargeable battery

The larger handle also makes them useful for patients with physical disabilities

Automatic toothbrushes use one of several motions, including back and forth, up and down, or circular

Some models feature pulsating and ultrasonic action

Toothbrushing Methods

Bass method most recommended

The dental professional will recommend the method best suited to the patient’s needs

Teach the patient to clean the mouth and tongue thoroughly using a systematic approach and to understand the importance of controlling plaque and inflammation

Too vigorous brushing can cause wear of tooth structure, gingival recession, exposure of root

Toothbrushing for Unusual Conditions

Acute oral inflammation or a traumatic lesion

After periodontal surgery

After dental extractions

After dental restorations

Dental Floss or Tape

Removes bacterial plaque and thus reduces interproximal bleeding

Dental floss is circular in shape; dental tape is flat

No difference in the effectiveness of waxed and unwaxed floss in removing plaque

Patients should be encouraged to floss before brushing

Interdental Aids

End-tuft brushes

• Soft nylon filaments formed into a narrow cone shape

Bridge threaders

• Used to pass dental floss under the pontic

Automatic flossers

• Have one-use, replaceable, thin rubber filament tips

Perio-Aid

• A handle with holes in the end designed to hold a toothpick

Toothpaste

Toothpaste contains ingredients designed to remove food residue and includes abrasives to remove stains

Highly polished tooth surfaces will stain less readily and remain clean longer

In addition, most brands of toothpaste now contain fluoride

Some toothpastes now contain a compound that reduces calculus formation when they are used regularly after dental prophylaxis

Mouth Rinses

Many patients like the feeling of freshness provided by a mouth rinse

A wide variety of mouth rinses are available today, and some contain fluoride

Recovering alcoholics should select a mouth rinse that does not contain alcohol

Rinsing the mouth with water is recommended after meals and snacks when toothbrushing and interdental cleaning are not possible

Oral Irrigation Devices

Oral irrigators deliver a pulsating stream of water or chemical agent through a nozzle to the teeth and gingiva

Can be applied at home by the patient or in the dental office

Helps keep levels of subgingival bacteria to a minimum

In selected patients, oral irrigation can be used to supplement other oral hygiene techniques

Disclosing Agent

coloring agent used to make plague visible when applied to teeth

Fluoride Varnishing

concentrated form of topical fluoride applied to teeth that are at high risk for developing caries (cavities)

Preventative Dentistry

practice for caring your teeth to keep them healthy; this can include the use of fluorides, application of dental sealants, proper nutrient, and plague control

Systemic Fluoride

fluoride that is ingested, such as in the drinking water

Topical Fluoride

Fluoride applied directly to the tooth surface to aid in remineralization and prevent decay.

Amino Acids

compounds in proteins used by the body to build and repair tissue

antioxidants

substance that protects our body to prevent or slow damage to cells

Anorexia Nervosa

eating disorder caused by an altered self image leading to extreme weight loss and an intense fear of gaining weight.

bulimia

an eating disorder characterized by recurrent episodes of binge eating followed by purging (forcing yourself to throw up), starvation, and/or excessive exercise.

cariogenic

substance causing tooth decay

cholesterol

waxy fat like substance found in all of the cells in the body

fats

also known as lipids; are compounds of carbon, hydrogen, and oxygen and are a major class of energy rich foods

MyPlate

nutrition guide published by the USDA using a visual representation of the five food groups to promote a balanced diet.

nutrients

organic and inorganic food that provides nourishment essential for growth and maintenance of life

organic 

describes food products that have been grown without the use of chemical pesticides, herbicides, or fertilizers

triglycerides

type of fat found in your blood that gives energy to your body

xylitol

is a natural sugar substitute thought to prevent tooth decay

ch 14- slide 5