AAPD Prevention and Anticipatory Guidance Questions with correct Answers
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AAPD Prevention and Anticipatory Guidance Questions with correct Answers
when should the first dental visit be?
within 6 months of first tooth eruption or by 1 year
when do you transition from a "smear" sized to a "pea" sized amount? Why? How much fluoride (in mg) in in each amount?
1) Sm...
AAPD Prevention and Anticipatory
Guidance Questions with correct
Answers
when should the first dental visit be? - answer within 6 months of first tooth eruption
or by 1 year
when do you transition from a "smear" sized to a "pea" sized amount? Why? How much
fluoride (in mg) in in each amount? - answer 1) Smear-sized: 0-3 years (0.12 mg
fluoride)
2) Pea-sized: 3-6 years (0.25 mg fluoride)
3) Smear sized until they are able to expectorate toothpaste and NOT swallow
For chronically ill patients/SHCN, what might you additionally include/consider in your
Caries Risk Assessment? - answer 1) High-Sucrose Medications (frequent
medications with sugar enhanced flavoring)
2) Xerostomia
what are the three Caries Classification systems? - answer 1) DMFS (Decayed,
Missing, Filled-Surfaces): most traditional, doesnt account for incipient lesions
2) ICDAS (international Caries Detection and Assessment System)
3) the ADA Caries Classification System (CCS): more practical for clinical use
For classification purposes, what is considered a "sound Surface"? - answer 1)
Healthy, normal color and translucency
2) adequate restoration or sealant
3) no radiolucent lesion evident
For classification purposes, what is considered an "initial caries lesion"? - answer 1)
demineralization of surface
2) NON-cavitated
3) Brown pit and fissures (withOUT shadowing)
4) radiolucent area extending to DEJ or outer 1/3 of dentin
For classification purposes, what is considered a "Moderate Caries Lesion"? - answer
1) Deeper demineralization with visible loss of enamel
2) Dark Gray shadow under pits and fissures
3) Radiolucent area extending to middle 3rd of dentin
For classification purposes, what is considered a "Advanced Caries Lesion"? - answer
1) Full cavitation of enamel
2) exposed Dentin
,3) radiolucency extending to inner 3rd of dentin
what is the purpose of a Caries Classification system? - answer 1) facilitates
effective monitoring of disease process
2) Helps with planning treatment
3) gives measurable outcomes to treatment
What is the BEST indicator of caries risk in children? - answer 1) Presence of visible
plaque!
When eating/snacking, how long does it take for pH to drop? How long does it take to
return to baseline? What implications does this have? - answer 1) pH drops
INSTANTLY upon eating
2) 20-30 minutes for pH to return to baseline
3) Frequent snacking never allows pH to return to baseline and demineralization
initiates
Which foods have the longest lasting effect on pH? - answer 1) STICKY FOODS!
take longer to clear and remain for prolonged bacterial conversion to acid
If snacking every _______minutes, pH will NEVER return to baseline. - answer 1) 30
Minutes (snacking every 30 minutes prevents return to pH baseline)
which 2 bacteria predominate at pH < 5.5? - answer 1) Strep Mutans and Lactobacilli
(they are weakly competitive at physiologic pH, but predominate at lower pH)
What measurement (specifically) in primary dentition is the BEST predictor of eventual
caries on permanent teeth? - answer 1) Multi-surface caries on primary molars was
the BEST predictor of caries on permanent teeth.
What are the 3 Major hypothesis regarding caries and which theory is most commonly
held to be true? - answer 1) Specific plaque hypothesis (CERTAIN bacteria cause
caries)
2) Non-specific plaque hypothesis (ALL bacteria cause cavities)
3) Ecological Plaque Hypothesis (shifts in the pH of biofilm cause shift in favor of
cariogenic bacteria
***Ecological plaque hypothesis is the most widely accepted theory
what are examples of salivary proteins that are beneficial to the mouth and what is their
mode of action? - answer 1) Mode of action: Control microbial overgrowth by
inhibiting adherence and slowing bact. metabolism
2) examples of proteins:
a) Agglutinins
b) immunoglobulins
c) Beta Defensin
d) Non-immunoglobulin proteins
, What is Critical pH and how does fluoride alter that? - answer 1) Critical pH is the pH
level required for the demineralization of enamel
What is the critical pH for fluorapatite? Hydroxyapetite? - answer 1) Critical pH (pH
necessary for demineralization):
a) Fluorapatite: 4.5 pH
b) Hydroxyapatite: 5.5 pH
deficiency in 1) which two ions alters ability to remineralize and 2) can raise the critical
pH to _______. - answer 1) Calcium and Phosphorus
2) Raises critical pH to 7.0
what is the difference between 1) risk factors and disease indicators (in caries risk
assessment) and 2) why are they important to document/record? - answer 1) Risk
Factors either cause or promote disease
a) ie: cariogenic bacteria, diet, hyposalivation
2) Disease indicators are clinical signs of disease
a) white spot lesions, cavities, previous restorations
3) They are important for EDUCATION and DOCUMENTATION
T or F: fluoride is rendered (essentially) useless in the absence of calcium and
phosphorus. - answer TRUE; saliva (rich in calcium and phosphorus) is 1) a carrier
for fluoride and 2) necessary for actual remineralization of enamel to take place
T or F: it is necessary to dry teeth before varnish application - answer TRUE (ish);
because varnish SETS ON CONTACT with saliva, drying the tooth enhances its effect
for adhesion to tooth structure and prolong fluoride exposure
T or F: Due to high calcium and phosphate content, MI paste is just as effective as
fluoride toothpaste at remineralization. - answer FALSE; although MI paste is better
than fluoride-free control groups (at promoting mineralization), it was not significantly
better than fluoridated toothpaste
T or F: xylitol is metabolized by cariogenic bacteria? - answer FALSE, it si a 5 carbon
sugar alcohol that CANNOT be metabolized
T or F: Xylitol is inherently bacteriostatic - answer FALSE, if chewed in LARGE
quantities, it has been shown to contribute to reduction in caries risk (but likely due to
increased salivation, therefore leading to increased buffer capacity, clearance, and
reduction in desire for sugar containing foods.)
38% SDF is commercially available in the US, what is the percent breakdown (in % w/v)
for silver? for Fluoride? - answer 1) 38% SDF contains:
a) 24-28% silver
b) 5-6% Fluoride (44,800 ppm)
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