Glass-Ionomers as Medicine – Dental Care For All International

Part 2 of Dr. John Frachella’s Medical Management of Caries lecture. Complete the quiz at the bottom of the page to earn 1.5 continuing education credits.

Join us for an overview of the most current and effective medical protocols for dental disease management. The course will help you understand bioactive methods, materials and strategies for caries arrest and prevention that are medical vs. surgical. Learn why dental antimicrobial, re-mineralizing and desensitizing medicines are not “alternative” or of a lower standard than treatments that treat symptoms of the disease. We will consider medical measures as initial treatments of choice as being in the best interest of patients in diverse socioeconomic populations. You will learn how, when and why to best employ medical measures for dental disease management before using surgery, sedation or general anesthesia.

Discuss what GI is and what it is not
Understand the role of GIC in Atraumatic Restorative Treatment (ART), which is suggested by WHO as the best first-measure against the disease of
caries.
Assess comparisons in case studies that highlight GIC-use as an antimicrobial, re-mineralizing and desensitizing medicine as well assessing its use
as a restorative material
Define exactly how GIC re-mineralizes de-mineralized tooth structures
Discuss how GIC and SDF are compatible and synergistic in combination for healing caries lesions
Understand the healing response of the pulp to stimuli created by fluoride and silver ions and GIC used in combination
Discuss how GIC is a totally unique restorative dental medicine
Identify the handling characteristics of GIC as medicine first and as a restorative second
Recognize the most important protocols necessary for success when using GIs to heal and restore teeth

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Glass Ionomer as Medicine – Dr. John Frachella at Hood River, Part 2

Complete this quiz to earn 1.5 continuing education credits.

To get your CE credits from the Academy of General Dentistry, must pass this quiz and submit your full name, state of licensure, license number, and AGD ID number. You may retake the quiz if necessary.

NameEmailState of LicensureLicense NumberAGD ID Number

1 / 10

1. Which 2 statement are accurate?

Many in vivo studies on GIC and RMGI strength and wear are available in the literature

Care should be taken when evaluating GIC and RMGI strength and wear studies

GIC and RMGI are taught in the literature and in dental school as being superior in strength and wear

New formulations of GIC and RMGI are far stronger and wear much better than older formulations

2 / 10

2. When applying GIC and RMGI with our gloved fingers which 2 of the following do we **not want** to do:

Dry tooth surfaces thoroughly

Moisten our gloved finger, push down and slide sideways

Push down then lift up

Have the patient bite down before the material begins to set ( while it’s still glossy) to establish the bite, then quickly remove excess

Apply fluoride varnish over the GIC or RMGI after initial set

3 / 10

3. Before applying GIC and RMGI to teeth, which one of the following do we **want** to do?

Remove all unsupported enamel

Keep GIC and RMGI caps handy at all times in our scrub pockets

Dry all tooth surfaces well before application

Work fast , keep all surfaces moist and don’t manipulate these materials once they lose their initial gloss

4 / 10

4. Which 2 of the following properties of **mature** GIC and RMGI restorations and sealants assure caries-free treatment outcomes?

They release fluoride which is re-chargeable into GIC/RMGI with fluoride toothpaste, fluoridated water, fluoride varnish and fluoride from the diet.

Their outer surfaces are highly polishable

They form a permanent acid-resistant zone of chemical fusion that remains on tooth surfaces even if the GIC/RMGI is lost to wear or fracture.

They can be light cured

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5. When are GIC and RMGI restorations and sealants as strong or stronger than composite?

During initial adhesion ( 2-4 minutes post- application)

After maturation ( 48 hrs to 3 months post- application)

During crosslinking (10 minutes post- initial adhesion)

6 / 10

6. Water in GIC and RMGI is important

For conditioning

For disinfection

For re-mineralization of decay by mineral ion transfer which can’t happen through dry air without moisture

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7. Of the 3 physical components found in GIC and RMGI which is the most critical for healing?

Water

Glass

Polyacrylic acid

8 / 10

8. Which one of the following is true regarding excavation of decay in caries lesions?

We must remove all discoloration down to white tooth structure

Leathery dentin can’t re-mineralize

Excavation is more important than disinfection

60% of caries lesions in the outer half of dentin are non-cavitated and can re-mineralize

9 / 10

9. Which 2 of the following statements are true about current GIC and RMGI formulations?

Composite resins are stronger

GIC and RMGI are essential medicines, effective restorative materials and effective when used as dental sealant material

GIC and RMGI can continually be re-charged with fluoride from toothpastes, mouth rinses, fluoride varnish, fluoridated water, and fluoride in the food chain.

GIC and RMGIs adhere to teeth via micromechanical interlocking

10 / 10

10. GIC and RMGI are considered medicine because of which 2 of the following:

They provide prevention against caries in treated teeth as well as in teeth adjacent to teeth treated.

They provide the two most evidence-based strategies for caries control – fluoride and sealants since they release fluoride and they seal chemically and permanently at the Zone of Chemical Fusion.

They’re very highly polishable.

GIC and RMGI can be light cured.

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This activity has been planned and implemented in accordance with the standards of the Academy of General Dentistry Program Approval for Continuing Education (PACE) through the joint program provider approval of One Community Health: Hood River and Dental Care For All International. One Community Health: Hood River is approved for awarding FAGD/MAGD credit.

The lectures for this course were filmed on May 1st, 2023, and were reviewed and re-released on this website in June, 2024. This content will expire on June 1st, 2027.

One Community Health | Hood River
Nationally/ Approved PACE Program Provider for FAGD/MAGD credit.
Approval does not imply acceptance by any regulatory authority, or AGD endorsement.
(month/day/year) to (month/day/year). Provider ID <AGD ID Number>