What is considered biohazard waste?
- sharps
- items saturated w/ blood and/ or saliva
- hard or soft tissues removed from pt
what is MSDS
-Material safety data sheet: contains info about each product used
what is considered biohazard waste
- sharps
- items saturated w/ blood and/ or saliva
- hard or soft tissues removed from pt
what is PPE used for
- reduce direct contact
- reduce indirect transmission
- minimize spatter
-minimize aerosole
FOMITE
- inanimate object thats contaminated w/ infectious organisms, can transmit organism to another source
SPATTER
- VISIBLE droplets of blood or saliva
AEROSOL
- INVISIBLE droplets of airborne particles created by breathing, coughing, sneezing, air driving hand pieces like ultrasonic scaler
Ultrasonic Cleaner
- minimizes risk of puncture wounds when cleaning instruments, clean dentures
DISINFECTION
- kills MOST microorganisms
STERILIZATION
- kills ALL microorganisms including spores using heat or chemicals
qualities of idea disinfection
- broad spectrum
- fast
- non toxic
- compatible w/ diff surfaces
- easy
- residual effect
- odorless
HIGH level of surface disinfection
- common in surgical areas, ex: 3% glutaraldehyde
INTERMEDIATE level of surface disinfection
- commonly used in dental offices
- kills Mycobacterium tuberculosis
ex: chlorine compounds, iodophors,
Complex phenols
LOW level of surface disinfection
- unacceptable in dental offices
- kills HIV and hep B
ex: simple phenols
how long and at what temp should steam autoclave be used?
20- 30 min at 250�F
details on steam autoclave
- cycles depend on packaged or loose instruments and type of packaging material
- dont use closed containers
- corrosion of non- stainless steal may occur
what spore test is used for steam autoclave and unsaturated chemical vapor?
- **
Geobacillus stearothermophilus
** AKA bacillus
how long and at what temp should unsaturated chemical vapor be used?
20 minutes at 270�F
details on unsaturated chemical vapor
- dont use on closed containers
- may damage plastic and rubber items
- provide adequate ventilation for vapor
- CANNOT sterilize liquid
how long and at what temp should DRY HEAT (static air) be used?
60- 120 minutes at 320�F
details on DRY HEAT (static air)
- cannot sterilize liquids
- may damage plastic and rubber
- dont use paper products in chamber
- recommended for metal
- bacillus atrophaeus- spore test
how long and at what temp should FORCED AIR (convection) be used?
12 min at 375�F
details on FORCED AIR
(convection)
- may damage plastic and rubber
- dry items thoroughly before processing
- may not be appropriate for handpieces
- bacillus atrophaeus- spore test
What is used to determine if sterilization method is reaching proper temp, pressure, and amount of time to kill all microorganisms?
spore tests! only way to truly know if instruments are sterilized
indicator tape changes color once temp is reached, but does not do what?
does not determine sterility of instruments
Class III caries
proximals of anterior teeth, not including line angle
Class I caries
pits and fissures of anterior and posterior teeth
class II caries
proximals of posterior teeth, commonly involving occlusal surfaces
Class IV caries
proximals of anterior teeth including line angles
class VI caries
incisal edge of anterior teeth or cusp tip of posterior teeth
class V caries
cervical or gingival 1/3 of facial or lingual surface
what is demineralization?
dissolution of CALCIUM and PHOSPHATE from hydroxyapatite crystals
when does demineralization occur for enamel?
when pH is at 4.5- 5.5
when does demineralization occur for cementum?
when pH is at 6.0- 6.7
what are requirements to prevent demineralization, encouraging REmineralization?
- good plaque control
- fluoride therapy
- restricted sugar intake
What bacteria produces acids that dissolve tooth structure?
**
LACTIC
**
*
BUTYRIC
*
**
PROPIONIC
**
bacteria involved in caries process are _______ and __________
-Acidogenic: acid producing
-Aciduric: acid tolerant
*
What is the main species involved in caries process?
**
Streoptococcus mutans
characteristics of Streptococcus mutans
- gran positive
- sticky, adhere well to tooth structure
- produces higher amounts of acid from sugars than other bacterial types, mainly lactic acid
- have ability to produce glucans from sucrose
- produce intracellular polysaccharides for energy
- decre
do infants have streptococcus mutans?
NO, they have no teeth!
characteristics of lactobacillus species
- cannot drop pH, incapable of producing range of pH values needed for caries initiation
- gram positive
- found in large numbers after cavitation of tooth occurred
what bacteria is associated with root caries?
- Actinomyces viscosis
what are fluoride's role in caries process?
- reacts w/ hydroxyapatite to form fluorapatite
- fluoride interferes w/ bacterial metabolism
What is Bactericidal?
*
- HIGH concentration; destroys bacteria
*
What is bacteriostatic?
*
LOW concentration, inhibits bacteria
*
Substantivity?
*
- Released over a period of time
*
Class II furcation
- moderate bone loss in furca area, instrument enter furca but CANNOT pass btwn roots
class I furcation
- early bone loss in furca, instrument enter depression leading to furca
Class III furcation
- severe bone loss in furca, instrument pass between roots through ENTIRE furca
class IV furcation
- SEVERE bone loss and RECESSION (soft tissue loss).instrument pass between roots through entire furca
Class I mobility
slight horizontal mobility, greater than normal
class II mobility
- moderate horizontal mobility, greater than 1mm displacement, doesnt move vertically
Class III mobility
- SEVERE mobility, move horizontally and vertically
if Extrinsic stain is not removed, what can happen?
it can become intrinsic, especially areas of demineralization
Brown stains are associated with what?
- poor oral hygiene, drinking dark colored beverages: coffee, tea, fruit juices, wine
Dark brown and black stains associated w/
tobacco products
Yellow- brown stain
-associaed w/ chlorhexidine and stannous fluoride, difficult to remove
black stain
-usually thin lines on cervical third of tooth. in healthy mouth. iron and insoluble ferric sulfide, gram positive bacteria
green and yellow green stain
- on anterior teeth, poor oral hygiene, chromogenic bacteria
orange stains
poor oral hygiene. located on anterior teeth
bluish green stain
- occupational exposure to metallic dust
fluorosis would occur where and what color?
usually incisal/ occlusal third.
opaque or brownish
describe tetracycline stains
- striated shades of yellow to brown to orange to gray
- fluoresce when under certain light
- exposure to tetracycline during tooth development
what oral physiotherapy aids is less effective at removing plaque than others
oral irrigator
indications for use of powered toothbrush
- arthritis
- caregivers
- manual dexterity problems
- implant
indications for interdental brushes
- open embrasures
- diastemas
- implants
- MILD ARTHRITIS
- class III and IV furcation areas
turfted brushes are indicated for what?
- rotated teeth
- hard to access 3rd molars
- class III or IV
super floss is AKA?
tufted floss
when should you start flossing child's teeth?
when their proximal surfaces contact each other
bass technique
- 45� angulation towards gingival margin, place bristles in gingival sulcus
Stillman technique
angle bristles 45� towards gingival margin, place 1/2 of bristles on tooth, other 1/2 on gingiva
antihypersensitivity agents in toothpastes are what?
*
- POTASSIUM NITRATE
*
*
- STRONTIUM
*
*
- CHLORIDE
*
*
- SODIUM CITRATE
*
antibacterial agent in toothpaste is what?
- TRICLOSAN
Whitening agents in toothpaste are what
*
CARBAMIDE
*
*
HYDROGEN PEROXIDE
*
explain systemic fluoride
- absorbed thru blood stream of developing teeth
- stomach and small intestine absorb it quickly
- fluoride retained in body is stored in bones
- effect 6 months- 14 yo
- excreted through kidneys
who monitors the fluoride levels in domestic water supply?**
*
EPA
*
who monitors fluoride levels in bottled water?**
*
FDA
*
what is optimum fluoride level?
0.7ppm
compounds added to water supply to protect against caries without causing fluorosis include:
- Sodium fluoride
- Sodium silicofluoride
- Hydrofluorisilic acid
Larger communities cost lower or less to have fluoride in water?
less! vice versa for small communities
what is the recommended amount of fluoride for infants - 6 months of age?
0
recommended amount of fluoride at or less than 0.3ppm for 6 months- 3 years?
.25 mg/day
what is recommended amount of fluoride for concentration of 0.3- 0.6 ppm for those 6 months to 3 years old?
0! shouldnt have more than 0.3ppm fluoride in water for 6 months to 3 years old
what is recommended amount of 0.3 ppm or less fluoridated water for 3-6 yos?
0.5 mg/ day
what is recommended amount of 0.3- 0.6 ppm fluoridated water for 3-6 yos?
0.25 mg/ day
what is recommended amount of 0.6 ppm or greater fluoridated water for 3-6 year olds?
0!!
whats the recommended amount of 0.3 ppm or less fluoridated water for 6-16 year olds?
1 mg/ day
whats the recommended amount of 0.3 ppm- 0.6 ppm fluoridated water for 6-16 year olds?
0.5 mg/ day
whats he recommended amount of 0.6 ppm and greater fluoridated water for 6- 16 year olds?
0!!
when is enamel maturation period?
up to 2 years after eruption of tooth
when is fluoride rapidly absorbed in enamel?
- when not completely calcified
self applied topical fluoride provides what effect? therefore you need ___________
bacteriostatic. need routine exposure
what is 0.4% stannous fluoride; 1000ppm used for?
- caries control and plaque reduction
- ortho and perio patients
- dentinal hypersensitivity
what is 1.1% Neutral Sodium; 5000ppm used for?
- porcelain or composite restorations
- those who cannot have acidic fluorides, bulimics
- rampant caries; ortho patients
- decalcification, home whitening.
what is chlorhexidine's mechanism of action?
-bactericidal
- effective against gram positive and negative microorganisms
- lysis
- absorbed then slowly released