categories of oral disease
1. dental caries and periodontal disease
- acquired
2. other acquired oral conditions
(opportunistic infections)
3. craniofacial disorders
- involve the cranium and face
- includes heredity, accidents
caries and periodontal disease are caused by
- pathogenic dental plaque (known as plaque diseases)
- considered transmissible diseases
- any infectious disease can only bein if the challenge organisms are in sufficient
numbers to overwhelm the combined manmade and body defenses and repair
capabilities
strategies to arrest, prevent or reverse plaque disease
- reducing # of challenging oral pathogens
- building up the tooth resistance and maintaining healthy gingiva
- enhancing the individuals repair processes
can dental caries be reversed
yes if discovered at its early stages
earliest visible sign of caries is usually a
white spot
- demineralized followed by incipient lesion (white) and then cavitation
earliest sign of perio disease
gingival inflammation/bleeding
caries and perio __ be reversed
can be reversed
,- not all white spots go on to become caries
- not do all inflammation become perio disease
- if both untreated, leads to cavity or bone lsoeeq
general strategies to prevent oral disease
- mechanical
- chemical plaque control
- sugar discipline
- pit and fissure sealants
administrative strategies to prevent oral disease
1. education and health promotion
2. access to dental facilities becomes routine based on clients risk factors
(diagnostic, restorative, preventive services)
- increased access to comprehensive oral health care, including preventive
practiced based on assessment of risk for oral disease
challenges of preventive dental care
- increased life span requires teeth longer
- oral bacteria have been identified in other invasive diseases - heart, lungs,
diabetes
- many public health services have been cut
- high risk groups for dental disease often have other risk issues
strategies to prevent plaque diseases
- plaque control- reduce # of responsible pathogens
- build up tooth resistance and maintain healthy gingiva
- enhance repair processes
- fluorides
- sugar and diet
- pit and fissure sealants
- public dental health education
- access to comprehensive dental care
plaque control
composed of salivary proteins + bacteria and end-products of bacterial
metabolism
- supragingival - coronal caries
- subgingival - periodontal problems
,plaque formation
- plaque immediately begins to reform after removal
- gingivitis occurs when metabolic end-products of the periodontal-
pathogens irritate gingival tissues
calculus formation
- Produces chemical environment for development of calculus
- Calculus harbors masses of periodontopathic plaque
Apposition of new layers of biofilm
-10 days- rapid calculus formers
-20 days- slow calculus formers
-From 10-20 days undisrupted oral biofilm changes to mineralized calculus,
although mineralization can occur within 24-48 hrs.
Influenced by: roughness of tooth, personal biofilm control
Source of Minerals:
- Supragingival Calculus: saliva
- Subgingival: the gingival sulcus fluid and the inflammatory exudates.
Heavy calculus formers have higher salivary levels of calcium and
phosphorous than do light calculus formers.
Light calculus formers have higher levels of parotid pyrophosphate, which is an
inhibitor of calcification and is used in anti-calculus toothpastes.
fluorides
a mineral - can be naturally found
- lower concentrations applied more often yields better results
fluoride and water fluroidation
- water fluoridation results in approx 60-70% reduction in caries
- in communities where there is no added or naturally occuring FL in the water,
often supplements are given
key actions of fluoride
, 1. It enters the plaque and affects the bacteria by depressing their production of
acid to reduce the possibility of demineralization
2. It reacts with mineral elements on the tooth surface, creating a less-soluble
environment for the acid end-products of bacterial metabolism
3. It facilitates the repair (remineralization) of enamel surfaces that have been
affected by acid end-products
saliva contains minerals such as *
calcium, phosphate and fluoride needed for remineralization*
To combat plaque diseases, the most effective agents are:
- Fl prevents demineralization and enhances remineralization
- Chx (Chlorhexidine) suppresses mutans streptococci that cause
demineralization and other pathogenic bacteria that causes inflammation of the
gingival tissues
carious lesions depend on
- diet
- host resistance
- # of challenging bacteria in plaque
- time exposure
caries prevention
Without bacteria, caries will not develop
- Well-balanced meals will ensure that the harmful amount of metabolic acids
released from plaque, will not be in sufficient amounts to cause harm
- More important than the total intake of refined carbohydrates is
the frequency of intake and the consistency of the sugar- containing foods
- To reduce the incidence of caries, one needs to reduce the total amount of
sugar, consistency of cariogenic foods and frequency of exposure to cariogenic
foods
xylitol
reduces amount of plaque & plaque acid
- inhibit growth and metabolism of streptococci
- reduce decay in animal studies
1. dental caries and periodontal disease
- acquired
2. other acquired oral conditions
(opportunistic infections)
3. craniofacial disorders
- involve the cranium and face
- includes heredity, accidents
caries and periodontal disease are caused by
- pathogenic dental plaque (known as plaque diseases)
- considered transmissible diseases
- any infectious disease can only bein if the challenge organisms are in sufficient
numbers to overwhelm the combined manmade and body defenses and repair
capabilities
strategies to arrest, prevent or reverse plaque disease
- reducing # of challenging oral pathogens
- building up the tooth resistance and maintaining healthy gingiva
- enhancing the individuals repair processes
can dental caries be reversed
yes if discovered at its early stages
earliest visible sign of caries is usually a
white spot
- demineralized followed by incipient lesion (white) and then cavitation
earliest sign of perio disease
gingival inflammation/bleeding
caries and perio __ be reversed
can be reversed
,- not all white spots go on to become caries
- not do all inflammation become perio disease
- if both untreated, leads to cavity or bone lsoeeq
general strategies to prevent oral disease
- mechanical
- chemical plaque control
- sugar discipline
- pit and fissure sealants
administrative strategies to prevent oral disease
1. education and health promotion
2. access to dental facilities becomes routine based on clients risk factors
(diagnostic, restorative, preventive services)
- increased access to comprehensive oral health care, including preventive
practiced based on assessment of risk for oral disease
challenges of preventive dental care
- increased life span requires teeth longer
- oral bacteria have been identified in other invasive diseases - heart, lungs,
diabetes
- many public health services have been cut
- high risk groups for dental disease often have other risk issues
strategies to prevent plaque diseases
- plaque control- reduce # of responsible pathogens
- build up tooth resistance and maintain healthy gingiva
- enhance repair processes
- fluorides
- sugar and diet
- pit and fissure sealants
- public dental health education
- access to comprehensive dental care
plaque control
composed of salivary proteins + bacteria and end-products of bacterial
metabolism
- supragingival - coronal caries
- subgingival - periodontal problems
,plaque formation
- plaque immediately begins to reform after removal
- gingivitis occurs when metabolic end-products of the periodontal-
pathogens irritate gingival tissues
calculus formation
- Produces chemical environment for development of calculus
- Calculus harbors masses of periodontopathic plaque
Apposition of new layers of biofilm
-10 days- rapid calculus formers
-20 days- slow calculus formers
-From 10-20 days undisrupted oral biofilm changes to mineralized calculus,
although mineralization can occur within 24-48 hrs.
Influenced by: roughness of tooth, personal biofilm control
Source of Minerals:
- Supragingival Calculus: saliva
- Subgingival: the gingival sulcus fluid and the inflammatory exudates.
Heavy calculus formers have higher salivary levels of calcium and
phosphorous than do light calculus formers.
Light calculus formers have higher levels of parotid pyrophosphate, which is an
inhibitor of calcification and is used in anti-calculus toothpastes.
fluorides
a mineral - can be naturally found
- lower concentrations applied more often yields better results
fluoride and water fluroidation
- water fluoridation results in approx 60-70% reduction in caries
- in communities where there is no added or naturally occuring FL in the water,
often supplements are given
key actions of fluoride
, 1. It enters the plaque and affects the bacteria by depressing their production of
acid to reduce the possibility of demineralization
2. It reacts with mineral elements on the tooth surface, creating a less-soluble
environment for the acid end-products of bacterial metabolism
3. It facilitates the repair (remineralization) of enamel surfaces that have been
affected by acid end-products
saliva contains minerals such as *
calcium, phosphate and fluoride needed for remineralization*
To combat plaque diseases, the most effective agents are:
- Fl prevents demineralization and enhances remineralization
- Chx (Chlorhexidine) suppresses mutans streptococci that cause
demineralization and other pathogenic bacteria that causes inflammation of the
gingival tissues
carious lesions depend on
- diet
- host resistance
- # of challenging bacteria in plaque
- time exposure
caries prevention
Without bacteria, caries will not develop
- Well-balanced meals will ensure that the harmful amount of metabolic acids
released from plaque, will not be in sufficient amounts to cause harm
- More important than the total intake of refined carbohydrates is
the frequency of intake and the consistency of the sugar- containing foods
- To reduce the incidence of caries, one needs to reduce the total amount of
sugar, consistency of cariogenic foods and frequency of exposure to cariogenic
foods
xylitol
reduces amount of plaque & plaque acid
- inhibit growth and metabolism of streptococci
- reduce decay in animal studies
