Smoking & Oral Health, Noncarious Lesions, Occlusal Trauma, and Dental Hypersensitivity

Flashcards covering Lectures 16 and 17 on smoking and oral health, noncarious dental lesions, periodontal occlusal trauma, and dental hypersensitivity.

Where is nicotine absorbed during smoking, and how quickly does it reach the brain?

Nicotine is absorbed through the lungs and reaches the brain in less than 20 seconds.

When does nicotine reach peak plasma concentration after smoking, and how fast does it decrease?

Peak plasma concentration is reached approximately 10 minutes after the onset of smoking and rapidly decreases over the next 20 to 30 minutes.

How long do residual amounts of nicotine from a single puff of tobacco smoke remain in the body?

Smallest amounts of nicotine from one puff remain in the body for 8 to 12 hours.

What primary carcinogenic agents are present in tobacco products?

Aromatic hydrocarbons, polonium-210, and N-nitrosamines.

What are the two main component categories of tobacco smoke?

Cigarette components (organic matter, nicotinic alkaloids, and additives) and pyrolysis components (CO2, CO, and Tar).

What systemic health conditions are associated with tobacco use?

Cancer (oral cavity, lung), respiratory diseases (such as COPD), cardiovascular diseases (hypertension, stroke), and adverse pregnancy/infant health issues (abortion, preterm labor).

What are examples of oral soft tissue, hard tissue, and esthetic problems caused by tobacco use?

Soft tissue: black hairy tongue; Hard tissue: occlusal and incisal abrasion; Esthetic factors: halitosis and dental stain.

What are examples of oral precancerous lesions and periodontal problems associated with smoking?

Precancerous/cancerous lesions include squamous cell carcinoma and leukoplakia; periodontal problems include localized gingival recession and clinical attachment loss.

What are the diagnostic criteria symptoms for nicotine withdrawal syndrome?

Depressed mood, insomnia, frustration and anger, anxiety, difficulty concentrating, decreased heart rate, increased appetite or weight gain, and cravings for tobacco.

What are the main objectives of pharmaceutical treatments for nicotine addiction?

To make abstaining from tobacco easier through partial replacement, reduce withdrawal symptoms, and sustain tolerance.

How is Nicotine Polacrilex (Gum) delivered, and what precautions should be taken during use?

It is delivered transmucosally during chewing (up to 12 pieces per day). Users must avoid tobacco as well as acidic foods and beverages while using the gum.

What are the administration route and advantages of the nicotine patch?

It provides transdermal delivery through the skin, requires a single application per day, and produces fewer side effects than gum.

What role does sustained-release bupropion play in smoking cessation?

It is a non-nicotine prescription drug that aids smoking cessation (not prescribed as a depression medication in this context) and helps control weight after quitting.

What is dental attrition?

The mechanical wearing away of tooth structure resulting from direct tooth-to-tooth contact during jaw movement.

What are the visual and physical characteristics of dental attrition lesions?

Gradual flattening of the occlusal plane with worn areas that are smooth, shallow, hard, and shiny.

What are the main etiological factors of dental attrition?

Usage (wear of surfaces from coarse food) and bruxism (involuntary tooth grinding caused by psychological stress or tension).

What is dental abrasion?

The mechanical wearing away of tooth substance by external physical forces other than mastication.

What habit shown in this image leads to incisal edge abrasion notches?

Opening bobby pins with the teeth, which causes mechanical wear leaving a small notch on the incisal edge.

What factors cause mechanical abrasion on exposed root surfaces and incisal edges?

Vigorous horizontal toothbrushing with an abrasive agent, biting a pipe held between teeth, or opening bobby pins with teeth.

What is dental erosion?

The loss of tooth substance by a chemical or acidic process without bacterial involvement.

What are the intrinsic and extrinsic causes of dental erosion?

Intrinsic causes: chronic vomiting from pregnancy or eating disorders; Extrinsic causes: industrial exposure to atmospheric acids, and frequent sucking of lemons or citrus fruits.

What is enamel hypoplasia, and what are its two classifications?

A developmental defect caused by disturbance in organic enamel matrix formation. Classifications: Hereditary (enamel partly or wholly missing) and Systemic/Environmental (caused by nutritional deficiency or fluorosis).

What causes tooth fractures, and what directions can fracture lines take?

Causes include falls, vehicle/bicycle/diving accidents, and contact sports without mouthguards. Fracture lines can be horizontal, diagonal, or vertical.

What defines periodontal occlusal trauma?

Injury that develops when occlusal forces exceed the adaptive capacity of the supporting periodontal tissues.

What clinical symptoms are associated with occlusal trauma?

Increased tooth mobility, visible movement of a tooth when subjected to occlusal forces, tooth migration, and dental sensitivity.

How do primary and secondary occlusal trauma differ?

Primary occlusal trauma is excessive force applied to a tooth with normal bone support (e.g., a high new restoration). Secondary occlusal trauma is excessive or normal force applied to a tooth with reduced bone support and alveolar bone loss.

What causes dental hypersensitivity, and what factors contribute to its development?

It occurs when dentin is exposed; contributing factors include loss of gingiva (recession), loss of cementum, and loss of enamel.

What types of stimuli trigger pain in sensitive teeth?

Tactile/mechanical stimuli (e.g., toothbrush bristles), chemical stimuli (e.g., acids in food/drink), and thermal changes (e.g., hot/cold foods or cold air).

What professional in-office procedures help alleviate dental hypersensitivity?

Professional application of fluoride, metallic salts (to occlude dentinal tubules), and varnishes or bonding adhesives/resins (to create physical barriers against external stimuli).