Midterm

List facts about:

• AAPD (American Academy of Pediatric Dentistry)

  • Definition: advocates policies, guidelines, and oral health care for children

  • 1st dental visit BEFORE 12 months

  • early morning/after nap

  • Recall every 4–6 months or as needed

• ADA (American Dental Association)

  • Recommend soft bristles

  • recommends a minimum of 2x daily

  • List of approved products on the website

• AAPD / ADA  Age Classification

  • Infant: Under 1 year

  • Toddler: 1–3 years

  • Preschooler: 3–5 years

  • School-age: 6–11 years

  • Adolescent: 12–17 years

• ADA Seal of Approval (1931)

  • Evaluate OTC products for safety and effectiveness

  • voluntary

  • awarded after full review of effectiveness/safety

  • acceptance is for 5 years

  • use must have an ADA approval statement

  • lack of seal does not mean unsafe or ineffective

• ADHA (American Dental Hygienist Association)

• CDC (Centers for Disease Control and Prevention)

• FDA

  • Cosmetic: Cleans or improves appearance only (whitening, fresh breath).

  • Therapeutic: Prevents or treats disease (caries prevention, gingivitis reduction).

CAMBRA

• What does CAMBRA stand for?

  • Caries management by risk assessment

• What is the purpose of CAMBRA?

  • assessment data to determine caries risk level for children under 6 or adults (over 6+)

  • classify child’s risk levels

Early Childhood Caries (ECC)

• List factors/microbes that contribute to ECC

  • high level of S. mutans in biofilm → risk factor

  • transfer by saliva-sharing behaviors (AVOID)

  • Lactobacilli and Candida contribute

  • Predisposing factors: bottle in bed, prolonged breastfeeding

  • Pattern: maxillary anteriors → primary molars

• List facts about ECC

  • Also known as: Nursing bottle caries, baby bottle caries, or rampant caries.

  • presence of 1 or more decayed, missing, or filled tooth surfaces in any primary tooth in a child under 6

  • S-ECC → child under 3 with any smooth-surface caries

  • Adolescence: One of the highest caries-risk periods, particularly for males

• List the consequences of thumb sucking

  • narrow maxillary arch

  • anterior open bite

  • posterior crossbite

  • increased overjet

  • decrease overbite

• List facts about biofilm-induced gingivitis in adolescents

  • Severity may increase during puberty

  • clinical and hormonal changes related to increased biofilm

  • exaggerated response to biofilm

fluoride supplement chart:

Home Care:

List considerations when choosing oral health aids for patients:

• anatomy

• ability to perform self-care

• product they use

• time dedicated to oral health

• barriers to self-care

Finance and Usage Factors:

• affordability of the product

• product upkeep (battery)

• current product usage (suggest to the appointment)

Anatomy and Access:

• Position of teeth

• Embrasure type:

  • type I: gingiva fills interproximal area

  • Type II: missing/reduced papilla

  • Type III: extensive recession; may be lost

Biofilm and compliance factors:

• extent and location of biofilm with BFI

Recommendations for home care

• Research shows ____power_____ manual toothbrushes are more effective at biofilm removal by 10-20%

• the ADA recommended ____2_____ manual toothbrushes

  • AM/PM

• What toothbrushes are best for patients in orthodontics?

  • Interdental brushes

• Which teeth are more likely to suffer from toothbrush abrasion?

  • canine, 1st premolar, bucco/linguoverted teeth

• List methods to disinfect toothbrushes and intraoral aids.

  • 3% hydrogen peroxide

  • CPC/CHX

  • essential oil rinse

  • microwave or UV light

• When can children start using mouth-rinse?

  • over 6 years

• Under 3 years: Smear (rice-sized amount)

• Ages 3–6 years: Pea-sized amount

List defining properties of each toothbrushing method:

Modified Bass	45° to sulcus, light pressure, vibrate ×10, roll to crown	+ Gingival stimulation− Limited subgingival biofilm removal
Modified Stillman	Filaments partly on gingiva, blanch, vibrate, roll	+ Gingival stimulation− Slippage may cause lacerations
Charters	45° toward occlusal, rotary strokes	+ Marginal gingiva stimulation− No subgingival removal
Fones	Teeth edge-to-edge, circular motion	+ Easy for children− Lower biofilm removal
Leonard	Teeth edge-to-edge, vertical strokes	+ Easy for children− Minimal interproximal/sulcular cleaning
Horizontal Scrub	90° to tooth, back-and-forth	Only for children <7− Cervical abrasion

Special Areas: Anterior linguals: Brush vertically, overlapping strokes

Occlusals: Handle parallel; overlapping strokes and vibration into pits/fissures

List the best interdental aids for:

• Orthodontics

  • floss threader

  • interdental brushes

  • toothpick holder

  • water-piks

• Bridges   

  • superfloss

  • interdental brushes

  • rubber tips

• Implants

  • superfloss

  • floss threader

  • interdental brushes

  • soft-piks

  • rubber tips

  • water-piks

• Teeth next to edentulous areas

  • gauze strips

• Type I embrasures

  • dental floss

• Type II embrasures

  • interdental brushes

• Type III embrasures

  • Stim-U-Dent

For mouthrinses, describe the function of:

• Surfactant (detergent)

  • foam and cleanse

  • lower surface tension

  • penetrate/loosen surface deposits

  • suspension of debris

  • emulsify/disperse flavor oil

  • contribute to foaming action

• Humectant

  • moisture stabilizer

  • retain moisture

  • prevent hardening when exposed to air

• Preservatives

  • prevent bacterial growth

  • prolong shelf life

• Dyes

  • adds color

• Flavor/sweetener

  • add pleasantness/freshness

  • contributes to overall flavor perception

• Alcohol

  • enhances flavor impact

  • contributes to cleaning

  • acts as perservative

• Water

  • major vehicle to carry ingredients

Process of Removable Appliances in Clinic

• Place wet paper towels in denture cup.

• Give patient tissue and instruct them to remove appliance.

  • If tight, apply even vertical pressure — avoid pulling on clasp.

• Inspect appliance for defects.

• Place appliance in denture cup to transport for sterilization

• Double-bag:

  • Write patient’s name on outer bag.

  • Put cleaning solution in inner bag with appliance.

• Seal bag and place in ultrasonic cleaner for 10 minutes

• Remove bag and discard.

• Rinse appliance under warm water.

• Clean with denture brush to remove debris.

• Place wet paper towel in denture cup and set appliances on top.

• Allow patient to inspect and reinsert appliance.

• Return empty denture cup and brush to care bag

• After removing ortho brackets, fluoride can remineralize up to:

  • 38-44%

Define: Oral Concerns

• Angular cheilitis

  • inflammation of the corners of the mouth

  • nutrient deficiency, fungal or yeast infection, loss of vertical dimension

• Denture stomatitis

  • inflammation of the oral mucosa under a prosthesis

• Tissue hyperplasia

  • excessive growth of tissue in response to inflammation or trauma

• Traumatic ulceration

  • isolated, red, inflamed area surrounding ulcerated lesions

Fixed/Removable Appliances:

• List the purposes for replacing missing teeth

  • preserves alveolar bone

  • enhances oral functions

  • improved psychological impact

• Which teeth are usually not replaced?

  • third molars

  • extractions for ortho

Examples (fixed):

• fixed partial prosthesis

• implanted-supported overdentures

• fixed ortho appliances

• perio splint

• space maintainer

Examples (removable):

• removable partial dentures

• complete dentures

• root-supported overdentures

• obturatory

• removable ortho appliances

  

• List the best methods to clean around fixed appliances

  • soft toothbrush

  • mouth rinse

  • gum stimulator

  • superfloss

  • waterpik

  • soft pik

  • non-abrasive dentifrice

    

Describe:

• Abutment

  • natural tooth or implant supporting pontic

• Pontic

  • false (floating) teeth

• Bridge

  • fixed partial prosthesis

• Implant

  • prosthetic device placed in the jaw to which a tooth or denture may be anchored

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