Dental prophylaxis

Dental prophylaxis Amoxicillin 2 g PO 1 hour prior to procedure Clindamycin 600 mg PO 1 hour prior to procedure... 

Dental prophylaxis Glass and steel manufacturing Cyclosarin (GF) 4.29... 

The surfaces of the mouth are coated with a layer of salivary proteins known as the acquired pellicle, which provides a protective effect from both chemical and mechanical attacks to the tooth surface. The pellicle layer both moderates diffusion of ions away from the tooth surface, thus inhibiting the dissolution of enamel by erosion, and provides a lubricating layer to protect from mechanical attacks [10, 11], It is known that dental prophylaxis and the use of regular oral hygiene procedures are able to reduce or remove the pellicle layer. However, recent evidence has shown that the pellicle is able to re-form very rapidly and thus, maintain a protective layer over the tooth surface [10]. For this reason, tooth wear studies performed in vivo or in situ, where the mediating effects of pellicle are present, will give a much more realistic assessment of tooth wear than in vitro studies. For a more detailed discussion on the effects of pellicle, see chapter 2. 

This book is mainly concerned with repair materials for teeth damaged in a variety of ways. However, clinical dentistry also has to be concerned with the source of much of the damage, namely oral bacteria. Dental prophylaxis is that aspect of dentistry concerned with cleaning of the oral cavity as well as strengthening the teeth against acid attack, and is thus important as a preventive treatment to assist in the maintenance of sound oral health in patients. 

Microbial plaque is the primary cause of both deutal caries and periodontal disease [134,135]. In principle, most plaque can be ranoved using appropriate oral hygiene devices, such as toothbrushes aud dental floss, but in practice many patients lack both the skill and the motivation to maintain a reliable plaque-free state [136]. For this reason, professional dental prophylaxis has an important part to play in helping maintain sound oral health in individuals. The primary function of such prophylaxis is ranoval of plaque, stain and calculus [137] and elimination of the factors that cause plaque to build up and be retained [138]. This may be augmented by the topical application of fluoride in an appropriate form. 

The procedures resemble dental prophylaxis and biopsies have been conducted on over hundreds of patients without apparent complaint. No more enamel is lost than in pumice treatments and it also gives a highly polished surface and chair-time is brief (about 2 min). Several very thin layers of the in vivo enamel can be successively removed from individual teeth under a variety of oral environments. Long-term programmes of fluoride—enamel interactions can thus be very conveniently studied. 

Dental plaque, a mass of bacteria that develops around teeth in all people, is the primary cause of dental caries and diseases of the periodontium. Following dental prophylaxis, a tooth becomes covered with a thin film, or pellicle, selectively deposited from the saliva. Bacteria in the oral cavity attach to the pellicle. The early colonizers are predominantly Gram-positive bacteria. The bacterial population increases and undergoes a predictable pattern of change as it approaches maturity. Supragingival and subgingival plaque masses... 

The goal of antimicrobial prophylaxis in dental procedures is to prevent endocarditis. According to American Heart Association guidelines, at-risk individuals should receive 2 g of amoxicillin 1 hour prior to the procedure.23 Patients with a (5-lactam allergy may receive clindamycin 600 mg 1 hour prior to the procedure. Interested readers should refer to the American Heart Association guidelines for a complete discussion on risk stratification and recommendations. 

Cardiac Conditions Associated with the Highest Risk of Adverse Outcome from Endocarditis for Which Prophylaxis with Dental Procedures Is Recommended... 

Endocarditis prophylaxis is recommended for all dental procedures that involve manipulation of the gingival tissue of the periapical region of teeth or perforation of the oral mucosa. 

Fluorine is an essential element involved in several enzymatic reactions in various organs, it is present as a trace element in bone mineral, dentine and tooth enamel and is considered as one of the most efficient elements for the prophylaxis and treatment of dental caries. In addition to their direct effect on cell biology, fluoride ions can also modify the physico-chemical properties of materials (solubility, structure and microstructure, surface properties), resulting in indirect biological effects. The biological and physico-chemical roles of fluoride ions are the main reasons for their incorporation in biomaterials, with a pre-eminence for the biological role and often both in conjunction. This chapter focuses on fluoridated bioceramics and related materials, including cements. The specific role of fluorinated polymers and molecules will not be reviewed here. 

Various antimicrobials agents is used in dentistry for prevention of local oral wound infection and prevention of distant infection i.e., bacterial endocarditis. Generally, prophylaxis by the use of antibiotics is not required for routine type of dental surgery... 

It is indicated for treatment of scurvy, for prophylaxis of vitamin C deficiency, to acidify urine, anaemia of vitamin C deficiency, as antioxidant to protect natural colour and flavour of many foods, dental caries and increased capillary fragility. 

Fluoride is well established as effective for the prophylaxis of dental caries and has been under investigation for the treatment of osteoporosis. Both therapeutic applications originated from epidemiologic observations that subjects living in areas with naturally fluoridated water (1-2 ppm) had less dental caries and fewer vertebral compression fractures than subjects living in nonfluoridated water areas. Fluoride is accumulated by bones and teeth, where it may stabilize the... 

Clindamycin is indicated for the treatment of skin and soft-tissue infections caused by streptococci and staphylococci. It is often active against community-acquired strains of methicillin-resistant S aureus, an increasingly common cause of skin and soft tissue infections. Clindamycin is also indicated for treatment of anaerobic infection caused by bacteroides and other anaerobes that often participate in mixed infections. Clindamycin, sometimes in combination with an aminoglycoside or cephalosporin, is used to treat penetrating wounds of the abdomen and the gut infections originating in the female genital tract, eg, septic abortion and pelvic abscesses and aspiration pneumonia. Clindamycin is now recommended rather than erythromycin for prophylaxis of endocarditis in patients with valvular heart disease who are undergoing certain dental procedures. Clindamycin plus primaquine is an effective alternative to trimethoprim-sulfamethoxazole for moderate to moderately severe Pneumocystis jiroveci pneumonia in AIDS patients. It is also used in combination with pyrimethamine for AIDS-related toxoplasmosis of the brain. 

Prophylaxis is recommended for the following dental procedures known to induce gingival or mucosal bleeding, tonsillectomy or adenoidectomy, surgical procedures that involve respiratory mucosa, and rigid bronchoscopy. 

Antimicrobial prophylaxis is used as an attempt to prevent IE in patients at high risk (such as persons with prosthetic heart valves) before a bacteremia-causing procedure (e.g., dental extraction). 

Patients with certain cardiac lesions, particularly those with prosthetic heart valves or a history of bacterial endocarditis, are at high risk for developing IE (see Table 109-10). Nevertheless, only 15% to 25% of patients who develop IE are in a definable high-risk category. Few cases of IE are preventable with antibiotic prophylaxis, even with 100% effectiveness. The concern of antibiotic resistance also questions the routine use of antimicrobials in this setting. Despite the low probability that IE will develop, prophylaxis is recommended for some dental, respiratory, gastrointestinal, and genitourinary pro-... 

Penicillin, a naturally occurring antibiotic, is indicated in the treatment of group A streptococcal upper respiratory infections, prophylaxis of poststreptococcal rheumatic fever, syphihs of less than one year s duration, moderate to severe systemic infections, uncomphcated gonorrhea, pneumococcal pneumonia, and endocarditis prophylaxis for dental surgery (see Table 23). 

Penicillin, a natnrally occurring antibiotic, is indicated in the treatment of mild to moderate susceptible infections and endocarditis prophylaxis for dental surgery. 

Vancomycin (500 mg IV q. 6 hours) is indicated for the treatment of severe staphylococcal infections, when other antibiotics are ineffective or contraindicated. Vancomycin (125 to 500 mg p.o. q. 6 hours for 7 to 10 days) is indicated for the treatment of antibiotic-associated pseudomembranous and staphylococcal enterocolitis and vancomycin (1 g IV given slowly over 1 hour, starting 1 hour before a procedure) is indicated for endocarditis prophylaxis for dental, Gl, biliary, and genitourinary instrumentation procedures and... 

Prior to 1997, erythromycin was an alternative antibiotic choice to amoxicillin for prophylaxis prior to dental, oral, esophageal, and respiratory procedures to prevent infective endocarditis (IE). Erythromycin is an alternative choice for treating a recurrence of acute rheumatic fever in patients allergic to penicillin [12]. Recently updated recommendations by the American Heart Association for IE... 

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