Term
| what are the 4 compounds that desensitize by protein precipitation |
|
Definition
silver nitrate
zinc chloride
strontium chloride
formaldehyde |
|
|
Term
| What are 7 compounds that desensitize by occluding tubules? |
|
Definition
calcium hydroxide
potassium nitrate
amorphous Ca-phosphate
fluorides
sodium citrate
iontophoresis with 2% NaF
K oxalate |
|
|
Term
| what are 5 compounds that desensitize by physically sealing tubules? |
|
Definition
composites
resins
glass ionomers
varnish
sealants |
|
|
Term
| what area is the most likely to exhibit sensitivity? |
|
Definition
|
|
Term
| what are some questions to ask your patients about sensitivity? |
|
Definition
do you avoid certain foods or beverages because of pain?
do you have sensitivity from cold, hot, sweet, or sour food?
have you recently whitened your teeth? |
|
|
Term
| Is dentinal hypersensitivity undiagnosed and misdiagnosed? |
|
Definition
|
|
Term
| Dentinal hypersensitivity affects approximately how many people? |
|
Definition
|
|
Term
| What age range is usually affected by hypersensitivity? |
|
Definition
|
|
Term
| are women or men more likely to have dental hypersensitivity? |
|
Definition
|
|
Term
| what teeth are most affected by hypersensitivity? |
|
Definition
| premolars, canines, and molars |
|
|
Term
| what type of pain is felt for dental hypersensitivty? |
|
Definition
| short, sharp but transient |
|
|
Term
| what are the 5 types of hypersensitivity stimuli? |
|
Definition
thermal
tactile/mechanical
chemical
osmotic
evaporative |
|
|
Term
| what are osmotic stimuli? |
|
Definition
|
|
Term
| what is evaporative stimuli? |
|
Definition
|
|
Term
| what is tactile/mechanical stimuli |
|
Definition
toothbrush
fingernail
scaler |
|
|
Term
| does dentinal hypersensitivity increase or decrease with age |
|
Definition
|
|
Term
| how thick is the cervical cementum? |
|
Definition
|
|
Term
| what percentage of teeth have cementum that does not overlap enamel |
|
Definition
|
|
Term
| what are the two ways that dentinal tubules become exposed? |
|
Definition
gingival recession
enamel loss |
|
|
Term
| how does enamel loss cause exposed dentin? |
|
Definition
| restorative procedures on the crown |
|
|
Term
| what are 4 factors that contribute to loss of tooth structure? |
|
Definition
abrasion
abfraction
erosion
attrition |
|
|
Term
| what are two causes of tooth abrasion? |
|
Definition
toothbrushing technique
abrasive toothpaste |
|
|
Term
|
Definition
|
|
Term
| what are two causes of erosion? |
|
Definition
acid (soda, juice)
bulimia |
|
|
Term
| what are 2 causes of attrition? |
|
Definition
occlusal tooth wear
bruxism |
|
|
Term
| what are the 6 steps of the hydronamic theory of dentin hypersensitivity? |
|
Definition
stimulus
disturbance of fluid in dentinal tubules
fluid movement
nerve stimulation
depolarization of nerve
pain sensation |
|
|
Term
| what are 3 forms of natural dentinal desensitization |
|
Definition
sclerotic dentin formation
secondary dentin formation
tertiary/reparative dentin formation |
|
|
Term
| what is it caused when mineralized deposits develop within dentin tubules which creates mineralized peritubular dentin which decreases the diameter of tubules and restricts fluid movement? |
|
Definition
| sclerotic dentin formation |
|
|
Term
| what type of natural desensitization is caused by traumatic stimuli such as attrition and decay |
|
Definition
| sclerotic dentin formation |
|
|
Term
| what type of natural desensitization occurs throughout the life of the tooth on the floor of the roof and floor of the pulp chamber which decreases the pulp tissue size and insulation the pulp from fluid disturbances? |
|
Definition
| secondary dentin formation |
|
|
Term
| what type of natural desensitization occurs in areas of exposed dentin and insulates the pulp from fluid disturbances? |
|
Definition
| tertiary/reparative dentin formation |
|
|
Term
|
Definition
| microcrystals of cementum, dentin, tissue debris, and biofilm |
|
|
Term
| what causes formation of a smear layer? |
|
Definition
SRP
burnishing with TB
toothpick |
|
|
Term
| what can cause removal of the smear layer? |
|
Definition
|
|
Term
| does calculus prevent or exaggerate dentinal hypersensitivity? |
|
Definition
|
|
Term
| what are the 3 goals of dentin hypersensitivity? |
|
Definition
relieve pain
modify or eliminate contributing factors |
|
|
Term
| what are 3 treatment options for dentin hypersensitivtiy? |
|
Definition
avoid stimulation
self-cure treatment
professional interventions |
|
|
Term
| what are 3 1st line approaches to hypersensitivity |
|
Definition
plaque control, habit modification, diet modification
anti-hypersensitivity toothpaste
Rx fluoride gel |
|
|
Term
| what are some professional interventions |
|
Definition
in office topical agents
glass ionomer cements
resin restorations |
|
|
Term
| what are 3 methods of reducing the number of exposed dentin tubules? |
|
Definition
covering open tubules and sealing surface
applying agents to produce insoluble occluding precipitates
stimulate secondary dentin formation |
|
|
Term
| what is the first line of defense for dentinal sensitivity? |
|
Definition
|
|
Term
| what is the active ingredient for most desensitizing toothpastes? |
|
Definition
|
|
Term
| what is the mechanism of action for potassium nitrate? |
|
Definition
| disrupts pain transmission by depolarizing nerves at dentin-pulp interface |
|
|
Term
| what is the term for the dentin-pulp interface? |
|
Definition
|
|
Term
| what ion prevents repolarization of the dentin nerve fibers? |
|
Definition
|
|
Term
| what 2 desenitizing toothpaste ingredients other than K nitrate which occlude dentin tubules? |
|
Definition
10% strontium chloride
sodium citrate |
|
|
Term
| what are two desensitizing products which use 0.4 % stannous fluoride |
|
Definition
|
|
Term
| what are two desensitizing products which use 1.1% NaF? |
|
Definition
Prevident 5000- Rx
Neutracare- Rx |
|
|
Term
| when is it best to use fluoride rinses, gels, and pastes? |
|
Definition
| at bedtime - no food/drink for 30 minutes |
|
|
Term
| how long does it take to notice relief from sensitivity toothpaste? |
|
Definition
| 2x/ day for at least 2 weeks |
|
|
Term
| Do whitening and tartar control toothpastes impact sensitivity? |
|
Definition
|
|
Term
| What is the active ingredient for NovaMin |
|
Definition
| calcium sodium phosphosilicate |
|
|
Term
|
Definition
| releases calcium and phosphate ions which precipitate and form protective mineral barrier of hydroxycarbonate apatite |
|
|
Term
| NovaMin's active process was tested during what other medical process? |
|
Definition
| 15 year tech for hip implant bone regeneration |
|
|
Term
| what forms is NovaMin available in? |
|
Definition
toothpaste
prophy paste
syringe delivery |
|
|
Term
| what is the main ingredient in MI paste? |
|
Definition
| casein phosphopetide (CPP) |
|
|
Term
| What minerals precipitate from MI paste and under what conditions does this happen? |
|
Definition
| Ca and P under acidic conditions |
|
|
Term
| what are some examples of chemical desensitizers? |
|
Definition
5% gluteraldehyde
HEMA
40% formalin
silver nitrate
calcium hydroxide |
|
|
Term
| how do chemical desensitizers work? |
|
Definition
| precipitates plasma proteins the close lumen of tubule |
|
|
Term
| What are 2 disadvantages of chemical desensitizers? |
|
Definition
may irritate soft tissue
may discolor teeth |
|
|
Term
| how do surface sealers/self-etch primers work? |
|
Definition
| hydrophilic resin primers penetrate and seal tubules. light cured after acid etching |
|
|
Term
| what are two forms of concentrated fluoride used for desensitization? |
|
Definition
0.4% stannous fluoride
1.1% sodium fluoride |
|
|
Term
| what precipitate from stannous fluoride causes tooth staining? |
|
Definition
|
|
Term
| what is the precipitate formed from NaF that occludes tubules |
|
Definition
|
|
Term
| what form of fluoride requires daily application |
|
Definition
|
|
Term
| what product is used for rapid temporary relief (whitening or loss of temporary crown)? |
|
Definition
|
|
Term
| what are 3 contraindications for use of Gel-Kam |
|
Definition
-young children
-pregnancy and lactation
-porcelain/ceramic restorations or veneers |
|
|
Term
| what are 2 forms of oxalate solutions used for desensitization |
|
Definition
ferric oxalate
potassium oxalate |
|
|
Term
| what is the mechanism of action for oxalates? |
|
Definition
| calcium oxalate crystals occlude tubules |
|
|
Term
| how do you apply oxalates> |
|
Definition
isolate the area
dry
apply (don't need to burnish)
evacuate |
|
|
Term
| what is a desensitizing treatment that uses electrical current from a 9volt battery to impregnate the tooth with Fluoride ions and results in secondary dentin formation? |
|
Definition
|
|
Term
| how long does iontophoresis need to be used? |
|
Definition
|
|
Term
| how do you do iontophoresis |
|
Definition
| patient holds + pole, RDH holds - charged brush dipped in NaF |
|
|
Term
| Is there any discomfort with iontophoresis? |
|
Definition
|
|
Term
| Is Laser desensitization FDA approved? |
|
Definition
|
|
Term
| lasers are used with what compound to reduce hypersensitivity? |
|
Definition
|
|
Term
| what is the downside of laser hypersensitivity treatment? |
|
Definition
|
|
Term
| what are 3 forms of physically blocking tubules for dentinal hypersensitivity? |
|
Definition
composite/glass ionomer restorations
crowns
soft tissue grafts |
|
|
Term
| what are the chemical agents in whitening products? |
|
Definition
hydrogen peroxide
carbamide
(3:1 ratio) |
|
|
Term
| how do you manage hypersensitivity in patients whitening their teeth? |
|
Definition
| 5% potassium nitrate toothpaste 2x day for 2 weeks prior to bleeching and 2 weeks during bleeching |
|
|
Term
| when was NaF varnish developed? |
|
Definition
|
|
Term
| what is the FDA approved use for NaF varnish? |
|
Definition
cavity liner
treatment of hypersensitivity
(Not caries reduction) |
|
|
Term
| How does NaF varnish treat hypersensitivity? |
|
Definition
| precipitates CaF to occlude tubules |
|
|
Term
| how long does fluoride work and how fast is the relief? |
|
Definition
| immediate long lasting relief |
|
|
Term
| Do you need to dry teeth prior to applying varnish? |
|
Definition
| no, sets in presence of moisture |
|
|
Term
| what is a single unit dose of fluoride varnish |
|
Definition
|
|
Term
| how do you remove varnish from mirrors and instruments? |
|
Definition
|
|
Term
| how often can fluoride varnish be applied? |
|
Definition
|
|
Term
| what are post-op instructions for fluoride varnish |
|
Definition
avoid drinking/eating for 30 minutes
avoid hot liquids/abrasive foods
dont brush for at least 4 hours |
|
|
Term
| what are 3 brands of fluoride varnish |
|
Definition
duraphat
duraflor
control Rx |
|
|
Term
| what is the caries reduction rate for fluoride varnish on primary teeth? |
|
Definition
|
|
Term
| what are two forms of nonsurgical periodontal therapy |
|
Definition
periodontal debridement
root planing |
|
|
Term
| what is the point of periodontal debridement? |
|
Definition
| allow comprehensive periodontal evaluation and diagnosis |
|
|
Term
| how many mm's below the CEJ do you find the crest of alveolar bone? |
|
Definition
|
|
Term
| what is instrumentation of the crown and root surfaces to remove plaque, calculus, and strains? |
|
Definition
|
|
Term
| what is removal of cementum or surface dentin that is rough, impregnated with calculus or contaminated with toxins and microorganisms? |
|
Definition
|
|
Term
| what is removal or disruption of bacterial plaque. it's byproducts. and plaque retentive calculus deposits from the coronal surfaces, root surfaces, and within pocket space and tissue wall to the extent needed to reestablish periodontal health and restore a balance between the bacterial flora and the host's immune response |
|
Definition
|
|
Term
| what is the goal of periodontal debridement? |
|
Definition
|
|
Term
| what insruments are used for periodontal debridement? |
|
Definition
|
|
Term
| T/F- SRP is contraindicated in pockets of less than 3mm and has been shown to cause loss of attachment |
|
Definition
|
|
Term
| what is the order of instrumentation for SRP? |
|
Definition
explore
scale
explore
root plane
explore |
|
|
Term
| light lateral pressure during the feeling stroke is used to detect what? |
|
Definition
calculus
surface irregularities |
|
|
Term
| short powerful overlapping strokes with firm lateral pressure are common for what type of instrumentation stroke? |
|
Definition
|
|
Term
| what amount of pressure is used for root planing? |
|
Definition
|
|
Term
| are root planing strokes longer or shorter than scaling strokes? |
|
Definition
|
|
Term
| what stroke directions are used for root planing? |
|
Definition
| horizontal, vertical, oblique |
|
|
Term
| why are multidirectional strokes used for root planing? |
|
Definition
| greater possibility that an area of burnished or smooth calculus will be detected |
|
|
Term
| why is a pushing insertion stroke with working pressure not recommended for SRP? |
|
Definition
client discomfort
rupture JE and cause periodontal abcess |
|
|
Term
| what are 5 clinical factors that favor bacterial accumulation? |
|
Definition
root surface irregularities
calculus deposits
overhanging margins
open contacts
mouth breathing |
|
|
Term
| what is the difference between periodontal debridement and SRP in terms of endotoxin attachment? |
|
Definition
SRP- deeply embedded endotoxins
debridement- loosely attached |
|
|
Term
| what is curettage accomplished unintentionally during SRP? |
|
Definition
|
|
Term
| what is deliberate debridement of junctional and pocket epithelium and disease CT with a curet or other instrument? |
|
Definition
| gingival curettage (soft tissue curettage) |
|
|
Term
| what are 3 post-procedural complications of root planing |
|
Definition
hypersensitivity
gum soreness
excessive post-procedural bleeding |
|
|
Term
| how should you treat gum soreness from SRP? |
|
Definition
| ibuprofen or other anti-inflammatory |
|
|
Term
| what causes excessive post-procedural bleeding? |
|
Definition
| inadvertent STC and blood thinning medications |
|
|
Term
| what areas should you SRP first? |
|
Definition
| most involved areas first- more monitoring of OHI and improvement |
|
|
Term
| what are 3 factors which complicate root planing? |
|
Definition
multiple appointments needed
cost of treatment
home care practices |
|
|
Term
| what is an instrument that uses a small optic camera to see subgingivaly? |
|
Definition
|
|
Term
| where can the gracey 1/2 and 3/4 be used? |
|
Definition
| anterior teeth- all surfaces |
|
|
Term
| where can the gracey 5/6 be used |
|
Definition
| anterior and premolars- all surfaces |
|
|
Term
| where can the gracey 7/8 and 9/10 be used |
|
Definition
posterior teeth- facial and lingual
(add- anterior and premolar all surfaces) |
|
|
Term
| where can the gracey 11/12 be used? |
|
Definition
posterior mesials
(add- anterior M & D, posterior facial, lingual, mesial) |
|
|
Term
| where can the gracey 13/14 be used? |
|
Definition
posterior distals
(add- anterior M & D) |
|
|
Term
| where can the gracey 15/16 be used? |
|
Definition
| posterior facial lingual and mesials |
|
|
Term
| where can the gracey 17/18 be used? |
|
Definition
|
|
Term
| what graceys can be used on anterior teeth all surfaces? |
|
Definition
| 1/2, 3/4, 5/6, 7/8/, 9/10 |
|
|
Term
| what graceys can be used on anterior mesials and distals |
|
Definition
|
|
Term
| what graceys can be used on posterior facial, lingual and mesials? |
|
Definition
|
|
Term
| what gracets can be used on posterior distals? |
|
Definition
|
|
Term
| what graceys can be used on premolars? |
|
Definition
|
|
