Transcript CARIES

STATISTICS
•42% adults 65 and older visit a dentist annually
•68% of teenagers have experienced tooth decay
•average adult has 21.5 decayed or filled tooth surfaces
•50% of all Americans need dental treatment
•80% of all Americans have some degree of periodontal disease
•44% of all Americans 75 years and up have lost all natural teeth
CARIES
(a.k.a. – cavities)
WHAT CAUSES CARIES?
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orthodontic appliances
xerostomia (dry mouth)
gum tissue recession
radiation therapy
smokeless tobacco
excessive alcohol consumption (xerostomia)
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Patients with poor oral hygiene
Bacteria
=
BACTERIA!
acid = elevated pH = demineralization
= cavities
HOW DO YOU PREVENT CARIES?
DIET:
cariogenic foods
- >15% sugar (sucrose, fructose, lactose)
- clings
less cariogenic foods
- high water content
- stimulate saliva
- high in protein
PLAQUE REMOVAL/PREVENTION:
- mechanical methods
- brush and floss (twice daily)
-chemical methods
- disrupts components of plaque to aid in mechanical
removal
- specialty aids
- Stim-U-Dent
- rubber stimulator tips
- miniature bottle brushes
- denture brushes….etc…
- oral irrigating devices
- high pressure stream to tooth surface
- contraindicated in patients predisposed to bacterial
endocarditis
- removal by dentist
DENTRIFICES:
abrasive ingredients
- essential for removing stains from teeth
- baking soda (not shown to be effective)
- high abrasive formulations not for long- term use
whitening agents
- titanium dioxide = temporary brightening
- not a tooth bleaching agent
chemotherapeutic ingredients
- fluoride (preventing/treating caries)
- potassium nitrate (hypersensitive dentin)
- triclosan (antibacterial/antigingivitis)
- stannous fluoride (antigingivitis/anticaries)
- >2-3 months = temporary staining
- zinc chloride & citrate (prevent/retard calculus)
- soluble pyrophosphates (inhibit crystal growth)
- can cause contact dermatitis
OTHER ANTIPLAQUE PRODUCTS:
Mouthrinses and Gels:
- adjunct to proper flossing and toothbrushing
Cosmetic Mouthrinses
- alcohol (antibacterial & cleansing action)
- surfactants (aid in removal of debris)
- fluoride
- astringents
- demulcents
Therapeutic Mouthrinses:
- aromatic oils (antibacterial & anesthetic activity)
- thymol
- eucalyptol
- menthol
- methyl salicylate
- agents with antimicrobial activity
- cetylpyridinium chloride
- domiphen bromide
- phenol = anesthetic, antiseptic & bacteriocidal agent
Gum and Lozenges:
- increases saliva flow = buffer effect against acids
- baking soda chewing gum (plaque reduction)
- lozenge by Aquafresh (increase saliva flow)
(chew or suck after eating…)
Discontinue
use if
irritation
occurs and
persists.
Caution
parents of
use in
children
when alcohol
is an
ingredient.
NOTE: IF ORAL ODOR PERSISTS AFTER BRUSHING AND
FLOSSING DO NOT RECOMMEND MOUTHWASH/RINSE TO MASK
SMELL. REFER PATIENT TO DENTIST.
FLUORIDE:
- believed to help prevent cavities
- facilitates remineralization of
early carious lesions
- may interfere with plaque
adherence
- may inhibit glycolysis (sugar to
acid)
- found in water of 50% of
communities in US
(web: seattle public utilities)
Rinses and Gels:
- used daily = significant
reduction in caries
Who benefits from use?
- orthodontic appliances
- decreased salivary flow
- at risk for developing root
caries
- poor oral hygiene
Fluorosis resulting from too
much systemic fluoride.
HALITOSIS
…OFFENSIVE ODOR EMANATING FROM THE ORAL CAVITY…
…MAY BY
SYMPTOMATIC
OF ORAL
PATHOLOGY…
What causes halitosis?
- poor oral hygiene
- cancer
- odiferous decaying food particles
- hepatic failure
- cellular & nutritional debris
- plaque coated tongue
Tobacco, smoked
- caries
and smokeless, can
- bleeding gums
cause halitosis.
- periodontal disease
- xerostoma
- postsurgical states
- purulent infections
PREVENTION OF HALITOSIS:
- removal of plaque
- improperly cleaned dentures
- prevention of calculus
- pulmonary disease
formation
- renal failure
- brushing and flossing
regularly
- 8 ounces of water each day