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3rd Year > Caries > Flashcards

Caries Flashcards

1
Q

How do we see periodontal pockets on a radiograph?

A

We place a GP point in the pocket

Therefore, the GP will show the depth of the pocket on the radiograph.

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1
Q

Classify this caries

A

Decalcification.

It presents as white or brown spot lesions.

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2
Q

Classify this caries

A

Pit or fissure caries.

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3
Q

Classify this caries

A

Smooth surface caries.

This presents as caries on the buccal, lingual or cervical areas

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4
Q

Classify this caries

A

Interproximal caries.

Caries that develops where the teeth touch.

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5
Q

Classify this caries

A

Early childhood caries

It typically affects

  • maxillary incisors
  • Maxillary and mandibular 1st molars
  • Mandibular canines.
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6
Q

Classify this caries

A

Secondary caries

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7
Q

Classify this caries

A

Arrested caries.

The caries is still present but it will not get worse.

It is black and hard rather than brown and sticky.

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8
Q

What is rampant caries?

A

When the patient has more than 10 new lesions a year.

Caries in lower anteriors is a warning sign (Normally well protected)

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9
Q

Discuss the caries pattern in primary teeth

A
  • Caries is found in lower molars, upper molars and upper anteriors.
  • If caries found in the lower anterior buccal or lingual surfaces = rampant caries.
  • Occlusal caries is more common on the 2nd primary molar than the 1st primary molar. (as 1st primary molar is easily cleansible)
  • MIH
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10
Q

Discuss the caries pattern in mixed dentition.

A
  • Caries is more commonly found in lower 6s than upper 6s.

Found in:
-Upper 6 palatal groove

  • upper 2 palatal groove
  • upper 2 cingulum pits
  • lower 6 buccal
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11
Q

What should you do in high risk patients with early permanent dentition.

A

Seal the second molars with fissure sealant when they erupt.

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12
Q

Why do we stabilise the teeth?

A
  • If the patient needs lots of restorative work and you can’t get it all done in one go.
  • To prevent pain
  • Arrest restorable lesion s
  • decrease bacterial load in the mouth.
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13
Q

Why is the developmental stage of the teeth relevant to restoring?

A

There is no point restoring a primary tooth if it is close to exfoliation

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14
Q

Discuss the importance of space maintainers?

A

The earlier primary teeth are removed, the greater degree of space loss.

  • The loss of primary teeth will cause crowding.
  • The loss of 1st permanent molars allows mesial drift of the second molars.
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15
Q

Discuss the balance and compensation of teeth after extraction.

A

We may need to extract the other tooth to prevent a central line shift or overuption

Canines- BALANCE (extract from same arch)

First primary molars- BALANCE if arch is crowded.

Lower first permanent molars- Compensate (Extract from same side)

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16
Q

What is the optimum age of extraction of maxillary First permanent molars?

A

Complete erruption of the 7s

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17
Q

What is the optimum age of extraction for the mandibular 1st permanent molars

A

Calcification of the bifurcation region of the lower 7s.

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18
Q

What happens when the maxillary first permanent molars are lost before optimum age

A

Rotation and mesial movement of the 7

Distal drift of the 5.

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19
Q

What happens when the mandibular first permanent molars are lost before optimum age

A

The 7s tilt

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20
Q

What happens when the mandibular first permanent molars are lost after optimum age

A

The 5 drifts distally and rotates.

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21
Q

Name and Describe this space maintainer

A

This is the band and loop space maintainer.

It is an orthodontic band for the 1st permanent molar with a wire that touches the distal surface of the 1st primary molar.

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22
Q

Name and describe this space maintainer.

A

This is a distal shoe.

It has a metal spike that slides down into bone.

This means that the unerrupted permanent molar will errupt into the right space.

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23
Q

List some dental symptoms of sepsis

A
  • Abscess
  • Sinus
  • INter-radicular radiolucency
  • Non-physiological mobility.
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24
Q

How do we make a lesion self cleansing & why do we want this?

A

You remove the obstacles to good cleaning

To allow saliva in to make the caries inactive

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25
Q

What is partial caries removal?

A

When superficial caries is removed, up to the line of the ADJ but there is still caries left in the cavity.

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26
Q

Why would we chose to complete partial caries removal?

A

To reduce the risk of pulp exposure.

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27
Q

Compare hall technique crowns to performed metal crowns?

A

Performed metal crowns- The tooth is prepared to remove the caries

Hall crowns- The crown is applied without preparation (It seals the caries in)

28
Q

Describe interproximal discing of the primary anteriors?

A

If there is caries on the primary anteriors:

You take away a slither of carious material (look at dotted lines) to allow saliva access to clean the gaps.

29
Q

What are strip crowns?

A

The type of crowns we apply to incisors.

A labial grove is used to attach the crown as well as an incisal reduction and a taper to the gingival margin

30
Q

How do you treat early enamel caries in permanent teeth?

A
  1. Apply a fluoride varnish.
  2. OHI and monitor.
31
Q

What is a sealant restoration and when do we use these for treatment?

A

A sealant restoration is when we remove the caries, restore the tooth and seal the remaining fissures.

We do this if we see microcavitation, shadowing under enamel or dentinal caries.

32
Q

How do we protect a FPM if it is developing beside a carious E?

A

We can place a performed crown on the E or make it self cleansing.

33
Q

What is silver Diamine Fluoride?

A

A liquid containing silver fluoride stabilised in ammonia.

34
Q

How does Silver diamine fluoride work?

A

SDF occludes the dentinal tubules to relieve sensitivity.

Silver is antibacterial.

Fluoride promotes remineralisation.

35
Q

When can you not use SDF?

A

If there:

  • ​are signs of infection.
  • Is Caries to the pulp
  • are inflamed or ulceated gingiva.
36
Q

Discuss the disadvantages of SDF?

A

It causes discoloration of carious tissue (very dark staining) and it can also stain tissue (so you put vaseline on the tissue to protect it)

37
Q

Compare the conditions for inspecting teeth for caries?

A

Wet teeth- Dental shadowing can be best seen

Dry teeth-Enamel demineralisation shows up white.

Both conditions are beneficial.

38
Q

When do we use temporary tooth seperation

A

To check if lesions on the inner half of enamel or outer half of dentine are cavitated.

39
Q

You have dried the tooth and an opacity is visible, what does this tell us about the location of the demineralisation?

A

Demineralisation is only within enamel.

40
Q

An opacity is visible without drying the tooth.

What does this tell us about the location of the demineralisation?

A

There is minimal dentinal involvement.

41
Q

On visual examination,

There is a cavity in the middle of an area of white demineralisation?

A

There is significant soft caries.

42
Q

How can you distinguish between staining and discoloration from underlying dentinal involvement.

A

Look around the stain.

If there is translucent enamel around the ‘stain’ it is a dark stain in the fissure.

If there is a periphery of white stain around the dark stain, caries is more likely.

43
Q

compare detection techniques for enamel caries?

A

Transilumination- Because carious lesions absorb light

Temporary elective tooth separation so that you can inspect the surface for cavities.

44
Q

What do we check before diagnosing root surface caries?

A

Texture- active lesions are soft and progressing.

Location- active lesions are within 1mm of the gingival margin.

Colour- lighter lesions have more bacteria.

45
Q

How does occlusal caries develop?

A

From the sides of the fissure instead of the base.

46
Q

How does secondary caries develop?

A

It starts from the outside and works its way in.

47
Q

What is non-operative caries treatment?

A

Trying to modify the host, bacteria, time or substrate through:

  • Dietary analysis.
  • Increased fluoride exposure
  • OHI
  • Ensuring areas are self cleansing.
48
Q

What is ICON?

A

A treatment to reverse white spot lesions through resin infiltration.

(You remove the liquid in the enamel pores replace the porous enamel with resin. )

49
Q

When do we intervene for coronal caries?

A

WHen we see-

  • cavitated lesions (Or feel them with our probe)
  • enamel discoloration
  • Localised surface destruction
  • Plaque trap area
    *
50
Q

When do we intervene for secondary caries?

A

when we see:

  • carious lesions
  • plaque traps.

Tactile-When there are ditches wide enough to admit a periodontal probe.

51
Q

When do we intervene for root surface caries?

A

WHen we see:

A pale coloured or black lesion <1mm from the gingival margin.

Tactile- when you use a sharp probe and the lesion feels soft.

52
Q

Describe non selective removal of carious tissue to hard dentine?

A

You keep cutting until all of the carious tissue is removed.

But this comes with a risk of pulp exposure.

53
Q

Compare stepwise excavation to Selective removal to soft dentine?

A

Stepwise excavation- majority of the caries is removed, but we leave some soft caries and come back in to remove it at a later date.

Selective removal to soft dentine- soft dentine is left behind and a peripheral seal created. This AVOIDS pulp exposure.

54
Q

What is the most important question to ask parents during dietary analysis?

A

What do you do in the last hour before bedtime.

55
Q

What are the two types of Fluoride in the mouth?

A

Mineral deposists (CaF2 in saliva and the fluid phase of plaque)

Biologically/ bacterially bound. (Bugs in the mout have fluoride attached aswell)

56
Q

Compare upstream and downstream prevention.

A

Upstream prevention is the population based approach.

Downstream prevention refers to what we would do on an individual basis.

57
Q

How is water fluoridation beneficial?

A

When water is ingested, fluoride becomes encorporated into saliva.

This means your saliva contains low but constant amounts of fluoride, so you are constantly absorbing fluoride.

58
Q

How does fluoride work?

A

At lower pH’s Fluoride products have a greater bioavailability.

The presence of fluoride ions drives remineralisation.

59
Q

How much toothpaste a day would a child aged 1 have to swallow to cause fluorosis?

A

1mg/day.

60
Q

How much toothpaste a day would a child aged 5-6 have to swallow to cause fluorosis?

A

2mg/day.

61
Q

Name some key caries pathogens:

A
  • Streptococcus mutans
  • Lactobacillus acidophilus
  • Candia Albicans.
62
Q

Discuss the virulence factors of strep mutans

A
  • Adhesions- to help bacteria bind to enamel
  • Binding proteins- Take your sugars and turn them into glucans
  • Sugar modifying enzymes- turn sugars into sticky things
  • Polysaccharides- act as a matrix to provide protection and store glycogen.
  • Acid tolerance and adaption- If the pH reduces, the pump returns the pH to a more neutral one to ensure that the bacteria will survive.
63
Q

Compare the two types of Glucans produced by Strep mutans

A

Water Soluble Glucans- They can be readily degraded for an energy source and form lactic acid.

Water insoluble glucans- These stick to tooth surface, are hard and promote plaque accumulation

64
Q

How do glucans cause demineralization?

A

Glucans take aprt in glycolysis which produces CO2 and drives acid production (latic acid/ acetic acid)

A drop below 5.5 (acidic pH) drives demineralization.

65
Q

What is the ecological plaque hypothesis?

A

If you give bacteria the oportunity (e.g. modifying environment) it will grow and take over.

66
Q

How does a high protien diet affect dental disease?

A

The organisms present in a high protein diet are associated with periodontal disease.

P for protein.

P for Periodontal disease.

67
Q

How does a high carbohydrate diet affect dental disease?

A

In high carb diets the aciduric ogranisms thrive.

This drives cariogenic processes.

C for carbs C for caries.

68
Q

When would you treat a lesion with a fissure sealant and why?

A

We would treat teeth without cavitation with a fissure sealant.

This is to seal in the caries.

3rd Year (63 decks)

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