1. Where do biofilms form in the office?
    • Dental water lines
    • Air/water syringe
    • Cavitron water lines
    • Drinking water reservoirs
    • Medical implants
    • Stents
    • On teeth
  2. Specifis Plaque hypothesis
    Quality of the plaque is more important then quantity
  3. About how many species of bacteria contribute to plaque biofilm and how many specifically seen in perio disease?
  4. What 3 bacteria are specifically seen in active perio pockets with bone loss?
    • Pophyromonas gingivalis
    • Tannerella forsynthesis
    • Treponema denticola
  5. What are the four stages of plaque formation
    • Initial adherence
    • Lag phase
    • Rapid growth
    • Steady state
  6. At what phase does a colony of gram + cocci begin to form a community of bacteria
    Lag phase
  7. What three properties does rinses posses
    • Selectivity
    • Sunstantivity
    • Penetrability
  8. Substantivity
    Ability of the rinse to bind and be released from the binding sites, How long it last
  9. Selectivity
    Ability of the rinse to affect specific bacteria within a mixed bacterial population
  10. Penertrbility
    Ability of the rinse to go into the biofilm
  11. The 3 major therapeutic mouthrinses
    • Chlorhexidine
    • Essential Oils
    • CPC (Cetlypyridinium chloride)
  12. Patients taking what 2 medications shouldn't use alcohol containing mouthrinse
    • Antabuse (disulfiram)
    • Flagyl (metronidazole)
  13. What is the make
  14. What is the make up of EO?
    • Combination of
    • Eucalyptol 0.092%
    • Menthol 0.042%
    • Methyl Salicylate 0.060%
    • Thymol 0.064%
  15. What are the components of CPC?
    Quaternary Ammonium compounds
  16. What are the components of 0.12% CHX
    A bacerial bisbiguanide antiseptic
  17. What is coaggregation and what stage does it occur in
    Different bacterial species in the matrix & adhere to early colonizers

    Rapid growth
  18. What are the phenolic-related therapeutic mouthrinsed for perio disease
    • Triclosan (Bisphenol)
    • Essential oils
  19. What are some of the properties of Chlorhexidine Gluconate 0.12% rinse
    • Highest level of substantivity
    • 11.6% pharmaceutical alcohol
    • Available by prescription
    • Not approved by the ADA
    • Gold standard
  20. Mechanisms of action of CHG
    • Bactericidal or bacteriostatic
    • Active against gram + n - bacteria as well as yeast, aerobes, anaerobes, HIV, Herpes Hep B
    • 30% absoprtion in oral cavity
    • Selectivity Sunstantivity & Penetrability
  21. Indications for usage of CHG Rinse
    • Antiplaque Antigingivitis & Anticaries
    • Oran fungal infection
    • Immunosuppressed patients
    • Post surgical healing
    • Implant maintenance
  22. CHG Rinse is commercially available as
    • Peridex
    • Periogard
    • GUM (Alcohol free)
  23. What are some potential interactions with CHG Rinse
    Use rise 30 minutes after brushing because toothpaste containing sodium lauryl sulfate 0.4% Stannous fluoride can minimize the effects of CHG
  24. What are the adverse effects of CHG rinse
    • Altered taste perception
    • Staining of the teeth, tongue & anterior composite restorations
    • Increase in supragingival calculus
  25. What are the mechanisms of action of Triclosan
    • Antibacterial agent: Bisphenol & nonionic germicide
    • Substantivity
    • Therapeutic effects against gingivitis
  26. Indications for usage for Triclosan
    • Management of gingivitis and plaque
    • Contains sodium fluoride so has anti caries potential
  27. What is Triclosan commercially available as
    • Toothpaste form: Colgate Total
    • Rinse: In Europe and Canada
  28. What are the mechanisms of action for EO
    • Phenolic related compound with antiseptic properties
    • Disrupts cell membrane and inhibits bacterial enzymes
    • Exhibits anti-inflammatory properties
    • Poor substantivity due to neutral elecrical charge
    • Good selectivity and penetrability
  29. What is the alcohol content of EO
    Previously 26.9% now 21.6%
  30. What is the antiseptic component of the EO
  31. What is the cleaning agent of the EO
    Methyl salicylate
  32. What are the indications of usage for EO
    • Pre-procedural rinse
    • Antiplaque and anti-gingivitis
    • Implant maintenance
    • Post operative healing
    • Can kill candida on dental prosthesis
  33. What are the adverse effects for using EO
    • Tissue sloughing with excessive use
    • Initial burning sensation
  34. What are the mechanisms of action for QAC
    • No ADA seal
    • 6-14% alcohol content
    • Low substantivity
    • Bactericidal and decreases bacteria to adhere to biofilm on teeth
    • Cationic surface active agents bind to oral tissues
  35. What are the indications of usage for QAC
    • Antiplaque
    • May be used 2-3 times/day
  36. What are the QAC commercially available as in a cosmetic rinse
    • Scope 0.05%
    • Cepacol 0.05%
  37. What are the QAC commercially available as in a therapeutic rinse
    • Crest Pro Health 0.07%
    • Discus Breath Rx 0.05%
    • Colgate Viadent 0.05%
  38. What are the two adverse effects of using QAC
    Staining and increased supragingival plaque
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