DHF I (W1) - Categories of Oral Disease

3 categories of oral disease/abnormalities

1) Dental caries & Periodontal disease - both acquired conditions

2) Other acquired oral conditions - other than dental caries/perio disease

• HIV, AIDS, oral cancer

3) Craniofacial disorders - involve cranium & face, include conds ranging from heredity (fr birth like cleft lip/palate) to accidents

diseases of oral cav - caries and perio diseases are caused by?

pathogenic dental plaque on teeth surface (aka plaque disease)

dental caries and perio disease are —— diseases

transmissible

infection disease like caries and perio can only begin when —— (resilient microbes) outnumber manmade and body defenses that repair the bodies capabilities

challenge organisms (bacteria)

Strats to —-, ——, or ——- the impact of plaque disease are? (3)

arrest, prevent, reverse

1) reduce # challenging oral pathogens

2) build tooth resistance & maintain healthy gingiva

3) enhancing ones repair process

earliest visible sign of caries is ——, which is —— followed by ——, and then ——

white spot

demineralization

incipient lesion

cavitation

*incipient = early stages

lesion = damage

for perio disease, earliest sign is?

gingival inflam/bleeding

incipient lesions and gingival inflam are reversable and are considered….

early stages of oral disease

(untreated lead to cavitation / bone loss) **

fyi

The combination of proactive prevention, early detection, and immediate treatment can virtually eliminate the need for tooth extractions by stopping the biological progression of plaque diseases before irreversible damage occurs.

result in near 0 extraction rate

🚀 Halting Disease Progression

• Plaque diseases are progressive. Tooth loss is not an immediate event. It is the final stage of long-term destruction from dental caries (cavities) and periodontal (gum) disease.

• Intervention breaks the cycle. Interventions at the initial stages of disease stop the destruction of tooth structure and supporting bone.

🛡 Primary Prevention (The Shield)

• Fluoride strengthens enamel. Fluoride therapy promotes remineralization. It converts hydroxyapatite into fluorapatite, which resists acid attacks.

• Sealants protect vulnerable surfaces. Dental sealants coat deep pits and fissures. They physically block food and bacteria from settling in hard-to-clean areas.

• The result is lower incidence. These tools prevent the initial formation of cavities on susceptible tooth surfaces.

general strats to prevent oral disease (4)

• less sugar

• chemical plaque control (ex: therapeutic mouthwash)

• mechanical (dental prophylaxis)

• pit and fissure sealants

administrative strats to prevent oral disease (2)

1) education and health promotion

2) access to dental facilities become routine (based on client’s risk factors ex: diagnostic and restorative)

inc access to facilities needed based on assesment like preventative

challenges of prev dental care (4)

• longer life spans = need teeth for longer

• oral bacteria identified in other invasive diseases like diabetes

• public health services getting cut

• high risk grps for dental disease often have other risk issues too

general strats to prevent plaque diseases (multiple)

• control plaque - reduce # responsible pathogens

• build up tooth resistance & maint healthy

gingivae

• Enhance Repair processes

• Fluorides

• Sugar and Diet

• Pit and Fissure Sealants

• Public Dental Health Education

• Access to Comprehensive Dental Care

what’s plaque composed of (3)

salivary proteins

bacteria

end prods of bacterial metabolism

what type of caries do supra/subgingival ones entail? (2)

supra - coronal caries

sub - periodontal problems

whats calculus?

mineralized plaque

when does paque begin to re-form?

immediately after removal

when does gingivitis occur

metabolic end products from periodontal pathogens irritate gingiva tissues

how calculus form?

plaque makes chemical environment for dev of calculus

it harbors masses of periodontopathic plaque

what is fluorides

naturally occuring mineral

• lower concs in frequent intervals yield better results

fluoride and water fluoridation? (controlled proc of applying F)

water fluoridation = controlled adjustment of fluoride lvls in water to prevent tooth decay

• 60-70% dec in caries

• supps usually given in communities with no F in water

key actions of fluoride (3)

1) enters plaque & affects bacteria

• by lowering their acid production rate & reduce possibility of demineralization

2) react w mineral elements on tooth surface

• makes less-soluble environ for acid & end prods of bacterial metabolism

• acid is a plaque byproduct that breaks down minerals in enamel

3) facilitate repair/remineralization of enamel surfs affected by acid end-prods

• saliva has minerals like Ca & F needed to remineralize

most effective agents to combat plaque diseases (2)

1) Fl - prevent demineralization & enhance remineralization

2) Chx - (chlorhexidine) suppress mutans streptococci (cause demin) & other pathogenic bacteria that cause inflam of gingival tissues

whats a carious lesion vs. cavity

carious lesion - area of tooth demineralization caused by decay

• can be non-cavitated (whitespot)

cavity - advanced carious lesion

• structural result of the decay

carious lesions depends on (4)**

1) diet

2) host resistance

3) # of challenging bacteria in plaque

4) time exposure

why are caries a multifactoral disease?

out of the 4 things that cause it if you remove 1 cause it’ll speed up reversibility chances/ it’s formation

caries prevention

• w/o bacteria they won’t develop

• well-balanced meals ensure the harmful amt of met acids released from plaque wont be sufficient in # to cause harm (SUGAR)

• rather than total carb intake, frequency is what matters (+ consistency of sugar-containing foods)

TLDR = reduce total amt sugar, consistency of cariogenic foods, & freq of exposure to cariogenic foods

sugar substitute (3pts for its 3 fxns)

xylitol - reduce amt of plaque + plaque acid

• inhib growth & metabolism of streptococci

• contribute to remineralization

it’s non-cariogenic (doesnt contain fermentable carbs that bacteria turn into acid)

aka doesnt cause cavity (doesnt promote)

& cariostatic (stops/inhibits/slows caries formation)

not in depth on sealants? fissures??

sealants demonstrated —-% retention rate, what this mean?

97% - no bacteria/bacterial acids can affect sealed areas

• easy repair last up to 10 yr

• sealant placement should be followed by topical fluoride treatment

2 types of sealants?

1) Preventative sealants: placed in caries-free tooth to prevent caries

• primary prevention strat

2) Therapeutic sealants: placed in teeth w incipient lesions to arrest decay proc

• secondary prevention strat

what are sealants indicated for? (know 4)

• deep, plaque-retaining pits and fissures on occlusals

• incipient caries (no radiograph evidence of them on prox surfaces)

• xerostomia (dry mouth)

• orthodontis appliances

• infrequent professional prev care

• too much snacking

• high caries experiences

contraindications? (what sealants shouldnt be used on)

• lack of deep pits/fissures

• apparent occlusal decay

• interproximal decay

• insufficient erruption of a tooth

• poor client compliance during treatment

what does sealant retention depend on

its ability to be retained on tooth surface (surface retention)

• could also be clinician inexperience, lack client cooperation, sealant material (resin over glass ionomer)

• fluoride doesn’t interfere w retention rate