Ch7- Preventative/Desensitizing (DM3)

Medicament trays

poly eether sheets, same thickness as whitening tray, but not scalloped

Sealants

virgin teeth only or teeth with incipient (in sip ee ent) caries in enamel, bonding agent to improve retention

Steps for sealants

pumice, isolate, dry, etch 30 secs, rinse 15 secs, dry until chalky/frosty, apply sealant, light cure, check occlusion, attempt to remove w/ explorer, (10 sec re etch if needed), floss

0.7mg ppm

Optimum ppm for fluoride in water

Fluoride and demineralization

replaces minerals and forms surface on tooth that contains fluorapetite (floor appetite), which is resistant to acids from cariogenic bacteria and drops demineralization pH from 5.5 to 4.5

Fluoride and acid

offers some protection against erosion from acids, but repeated acid will win

Fluoride and bacteria

joins Hydrogen ions to become hydro-floor-ick acid in order to cross cell wall, detached from hydrogen, and disrupt cell function leading to cell death

Fl2 supplements

not recommended if drinking water is above .6 ppm of fl2

Lethal dose for 20lb child

approximately 700 to 1500 mg of sodium fluoride

Tx for fl2 overdose

milk of magnesia to bind to fl2 ions, cow milk to slow absorption, send to ER

Desensitizating agents

plug open tubules or desensitize nerve endings

Remineralization

Main ingredient is amorphous calcium phosphate (ACP) or calcium sodium phospho-silicate (MI paste), another option is resin infiltration

SDF

only FDA approved for dentinal hypersensitivity, used off label for arresting caries by strengthening and remineralizing tooth, plus silver has antimicrobial properties. 90% of lesions when applied 2x/year

SDF is used on

mostly used on children or for posterior teeth because teeth turn brown/black