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What substance have the ability to reduce biofilm, reduce gingivitis, prevent dental caries, remineralize early noncavitated dental caries, reduce supragingival calc formation?
therapeutic agents
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What are the main substances used as therapeutic agents?
- triclosan
- zinc citrate
- pyrophosphatte salts
- zinc salts
- sodium hexametaphosphate
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What are the two main agents used to reduce biofilm?
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What is the primary agent that has shown efficacy in reducing gingival inflammation?
triclosan combined with what agent increases the substantivity of the dentifrice?
- triclosan
- polyvinyl methoxyethylene (PVM/MA)
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What therapeutic agent has been effective in preventing dental caries?
fluoride
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What therapeutic agent is most commonly used for reduction of sensitivity and hypersensitivity?
potassium nitrate
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What are 4 agents that are used in dentifrices shown to help inhibit dentifrices?
- phyrophosphate salts
- zinc salts (zinc chloride and zinc citrate)
- sodium hexametaphosphate
- triclosan
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What agent in dentifrice is used to lower surface tension, penetrate and loosen surface deposits, emulsify debris for easy removal by toothbrush, and contribute to foaming action?
What are 2 substances used for this?
- detergents
- sodium lauryl sulfate USP
- sodium N-lauryl sarcosinate
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What agent of dentifrice is used to clean well with no damage to tooth surface, as a polishing agent to produce a smooth tooth surface which can prevent or delay the reaccumulation of stains and deposits?
What are 4 substances used?
- Abrasives:
- calcium carbonate
- phosphate salts
- hydrated aluminum oxide
- silica, silicates, and dehydrated silica gels
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What agent of dentifrice is used to stabilize the formulation, and prevent separation of the solid and liquid ingredients during storage?
what are 4 substances used for this?
- Binders:
- mineral colloids
- natural gums
- seaweed colloids
- synthetic celluloses
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What agent of dentifrice is used to retain moisture, and prevent hardening on exposure to air?
What are 2 substances used?
- humectants:
- xylitol
- glycerol
- sorbitol
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What agent of dentifrices is used to prevent bacterial growth and prolong shelf-life?
What are 3 substances used?
- preservatives:
- alcohol
- benzoates
- dichlorinated phenols
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What agent of dentifrice is used to impart a pleasant flavor for pt acceptance, and mask other ingredients that may have a less pleasant flavor?
what are 4 substances used?
- flavoring agents:
- essential oils (peppermint, cinnamon, wintergreen, clove)
- artificial noncariogenic sweetner:
- xylitol
- glycerol
- sorbitol
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a chemical that is used for therapeutic reasons
chemotherapeutic agent
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The following is the mechanism of action is used for what mouthrinsing agent?
deposit FL ion on enamel of carious lesion
sodium flouride
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The following is the mechanism of action for what mouth rinse?
deposit FL ion on enamel of carious lesion and has a tin ion that interferes with cell metabolism for antimicrobial effect
stannous fluoride
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The following mechanism of action is used for what mouth rinse?
inhibits demineralization and enhances remineralization
cariostatic fluoride
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The follwing is the mechanism of action for what type of mouth rinse?
cationic bisbiguanide with antibacterial ctivity binds to hard and soft tissues - damages cytoplasm of cell membrane (bacteriocidal); binds to pellicle to prevent biofilm accumulation; bacteriostatic conc. interfere with cell wall transport system, and it lasts 8-12hrs
chlorhexidine (CHX)
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What type of mouth rinse's mechanism of action is effective against gram-negative and positive bacteria?
triclosan - bisphenol and nonionic
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What type of mouth rinse's mechanism of action is bacteriolysis: causes leakage of cell contents by acting on microbial cyctoplasmic membrane?
triclosan antimicrobial agent
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What type of mouth rinse's mechanism of action has a low toxicity?
triclosan antimicrobial agent/antigingivitis agent
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What type of mouth rinse's mechanism of action is to disrupt cell walls/inhibit bacterial enzymes; it has poor substantivity, and decreases the pathogenicity of biofilm?
phenolic-related essential oils
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What type of mouth rinse's mechanism of action has cationic agents that bind to oral tissue, ruptures cell wall and alters cytoplasm, strong intitial attachment, decreases bacterial attachment to pellicle, and has a low substantivity?
quaternary ammonium compounds
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What type of mouth rinse's mechanism of action uses oxygen that acts to debride area, alters bacterial cell membrane, and has low substantivity?
oxygenating agents
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What are 3 different types that fluorides are available in?
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What are 3 uses of fluoride?
- prevent caries
- reduce hypersensitivity
- reduces gingivitis
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What is the most effective preventive and therapeutic type of mouth rinse?
chlorhexidine
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How is chlorhexidine available?
for clinical use, Rx 0.12% in US
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What are 3 different ways chlorhexidine is available?
- mouthrinse
- varhish
- controlled delivery
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What are 6 indications for the use of chlorhexidine?
- pre-procedural rinse
- perio debridement
- dental caries
- immunocompromised
- post-surgery
- temporary use for poor OH
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What are 2 ways that triclosan is available?
- mouthrinse and dentifrice in other countries
- dentifrice in US
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What are 2 reasons triclosan is used?
- reduce gingivitis
- reduce biofilm accumulation
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What are 4 ways phenolic related essential oils are available?
- thymol
- eucalyptol
- menthol
- methyl salicylate
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What are 4 reasons phenolic related essential oils are used?
- OH difficulty
- helps improve OH
- adjunct for home care
- pre-procedural rinse
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How are quaternary ammonium compounds available?
CPC (cetylpyridinium chloride) 0.05%-0.07%
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What are 2 reasons to used quaternary ammonium compounds?
- reduces biofilm
- adjunct for self care
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What are 2 ways that oxygenating agents are available?
- 10% carbamide peroxide
- 1.5% hydrogen peroxide
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What is an indication of use for oxygenating agents?
short term use for symptoms of peroicoronitis and NUG
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List 2 considerations for the use of fluoride.
- stannous type may stain teeth
- avoid swallowing
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List 4 considerations for the use of chlorhexidine.
- it has low toxicity - poor absorption thru mucous membranes
- stains teeth and restorations
- increase in supra calc formation
- minor soft tissue irritation; desquamation of oral mucosa
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Why should you eat before rinsing with chlorhexidine?
because it may alter your taste perception
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Why should you wait at least 30 minutes after brushing before you rinse with chlorhexidine?
because the sodium lauryl sulfate (detergent) in dentifrice will inactivate the chlorhexidine
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What is a consideration with triclosan products?
it is easily released from oral tissue binding sites such as tooth surface and soft tissue
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What are 4 considerations with the use of phenolic related essential oil mouth rinses?
- burning sensation
- bitter taste
- must follow manufacturer instructions for use
- has a high alcohol content (contraindicated for alcoholics)
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What are 3 considerations with the use of quaternary ammonium compounds?
- stains teeth
- increases supragingival calc formation
- burning sensation from occasional desquamation
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What is a consideration for use of oxygenating agents?
prolonged use in 3% hydrogen peroxide may result in gingival irritation and delayed tissue healing
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How deep does delivery of chemotherapeutic agent clean in a sulcus or pocket?
2 mm
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What are 4 purpose of irrigation?
- reduce bacteria that lead to perio disease
- for pt, part of routine self-care for inflammation control
- keeps subgingival bacterial challenge at levels compatible with health
- reduce subgingival pathogenic bacteria and inflammatory mediators
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What are 5 benefits of irrigation?
- reduction of gingivitis and bleeding
- reduction or alteration of subgingival dental biofilm
- subgingival access to pathogenic microorganisms
- subgingival delivery of antimicrobial agents
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