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SDCEP guidelines > Caries in Children > Flashcards

Caries in Children Flashcards

1
Q

how would you treat a child in pain due to pulpitits in a vital primary tooth with irreversible symptoms and no evidence of dental abscess?

A

pulpotomy

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2
Q

what factors should you take into account when choosing a caries management strategy in a primary tooth?

A
  • the time to exfoliation
  • the site and extent of the lesion
  • the risk of pain or infection
  • the absence or presence of infection
  • preservation of tooth structure
  • the number of teeth affected
  • avoidance of treatment-induced anxiety
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3
Q

what factors should you take into account when choosing a caries management strategy in a **permanent **tooth?

A
  • the site and extent of the lesion
  • the risk of pain or infection
  • preservation of tooth structure
  • the health of the dental pulp
  • avoidance of treatment-induced anxiety
  • lifetime prognosis of the tooth
  • orthodontic considerations
  • occlusal development
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4
Q

state 3 priorties of the dental team

A
  • to relieve pain or infection if present
  • to invoove both the child and their parent/carer in decisions regarding the child’s oral health care
  • if caries in the permanent dentition does occur, to diagnose it early and manage it appropriately
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5
Q

what elements should be included in a comprehensive assessment of a child if the personal care plan is to be effective in improving the child’s oral health?

A
  • parent/carer motivation and responsibility
  • patient history
  • clinical examination
  • caries risk assessment
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6
Q

why does caries affected enamel have a white appearance?

A

acidic solutions preferentially dissolve prism sheaths in enamel, creating pores
these pres refect light, relfecting it back instead of letting it pass through

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7
Q

how would you describe the caries shown?

A
  • matt, opaque chalky white lesion
  • suggests only the enamel layer is affected
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8
Q

how would you desribe the caries shown?

A
  • opalescent white lesion
  • suggests caries has passed enamel dentine junction and infected the dentine
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9
Q

how would you desribe the caries shown?

A
  • cavitation visible as dark, carious dentine
  • surrounded by an opalescent white halo (where the enamel sub-surface is partially demineralised and refelcts light back)
  • white halo isis not affected and appears shiny rather than matte white
  • dark halo is due to carious dentine underneath
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10
Q

why must teeth be clean and dry for effective caries diagnosis?

A

if surface enamel pores fill with saliva, they allow light to be transmitted through the enamel

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11
Q

how do you tell the difference between active and arrested enamel caries through its clinical characteristics?

A
  • arrested enamel surface will feel smooth to a probe lightly drawn across it
  • if the surface feels rough or the probe is felt to drag compared to adjacent sound enamel, the lesion is active
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12
Q

what is the difference in appearance of active and arrested dentinal caries?

A

active- soft lesion, matt in apearance
arrested- harder lesion, may appear shiny
colour is not a reliable indictor

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13
Q

give an example of when a panoramic radiograph would be clinically justified

A

as part of a gre-general anaesthetic assessment

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14
Q

what can you use to assess for cavitation if enamel-only proximal lesions are identified?

A

orthodontic separators

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15
Q

how can cusp of carabelli sometimes show on a bitewing radiograph?

A

a traingle shaped radiolucency seen on the mesial surface
can be mistaken for proximal caries

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16
Q

how is initital occlusal caries in primary teeth classifed?

A

noncavitated, dentine shadow or minimal enamel cavitation
radiograph- outer third dentine

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17
Q

how is advanced occlusal caries in primary teeth classified?

A

dentine shadow or cavitation with visible dentine
radiograph- middle or inner third dentine

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18
Q

how is initial proximal caries in primary teeth classified?

A

white spot lesion or shadow
radiograph- lesion confined to enamel

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19
Q

how is advanced proximal caries in primary teeth classified?

A

enamel cavitation and dentine shadow or cavity with visible dentine
radiograph- may extend into inner third dentine

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20
Q

how is initial anterior caries in primary teeth classified?

A

white spot lesions but no dentinal caries

21
Q

how is advanced anterior caries classified in primary teeth?

A

cavitation or dentine shadow

22
Q

how is caries with pulpal involvement classified in primary teeth?

A

any tooth with clinical pulpal exposure or no clear separation between carious lesion and dental pulp radiographically

23
Q

how is caries in a tooth near to exfoliation classified in primary dentition?

A

clinically mobile
root resorption shown in radiograph

24
Q

how is an unrestorable carious tooth classified in primary teeth?

A

crown destroyed by caries or fractured, or pulp exposed with pulp polyp

25
Q

how is initial occlusal caries classified in permanent dentition?

A

noncavitated enamel carious lesions;
* white spot lesions
* discoloured or stained fissures
radiograph- up to the enamel-dentine junstion or not visible

26
Q

how is moderate occlusal caries classified in permanent dentition?

A

Enamel cavitation and dentine shadow or cavity with visible dentine Radiograph: up to and including middle third dentine

27
Q

how is extensive occlusal caries classified in permanent teeth?

A

Cavitation with visible dentine or widespread dentine shadow Radiograph: inner third dentine

28
Q

how is initial proximal caries classified in permanent dentition?

A

White spot lesions or dentine shadow. Enamel intact Radiograph: outer third dentine

29
Q

how is moderate proximal caries classified in permanent dentition?

A

Enamel cavitation or dentine shadow
Radiograph: outer or middle third dentine

30
Q

how is extensive proximal caries classified in permanent dentition?

A

Cavitation with visible dentine or widespread dentine shadow Radiograph: inner third dentine

31
Q

how is initial anterior caries in permanent teeth classified?

A

White spot lesions but no dentinal caries

32
Q

how is advanced anterior caries classified in permanent dentition?

A

cavitation or dentine shadow

33
Q

how is caries with pulpal involvement classified in permanent dentition?

A

Any tooth with clinical pulpal exposure or no clear separation between carious lesion and dental pulp radiographically

34
Q

when is a permanent tooth classified as unrestable?

A

Crown destroyed by caries or fractured, or pulp exposed with pulp polyp (pain/infection free)

35
Q

what is molar incisor hypomineralisation (MIH)

A

hypomineralisation of systemic origin of 1-4 permanent first molars, frequently associated with affected incisors

36
Q

what are the signs/symptoms of MIH?

A
  • sensitive to temperature
  • painful on toothbrushing
  • increased caries susceptibility
  • lesions can range from small white opacities with no breakdown, to large, dark yellow/brown areas that can fracture off
37
Q

where are sinuses usually present?

A

on the non-attached mucosa adjacent to the attached mucosa

38
Q

name indicators of established dental infection

A
  • tenderness to percussion in a non-exfoliating tooth
  • alveolar tenderness, sinus or swelling
  • non-physiological mobility
  • radiographic signs, including inter-radicular radiolucency
39
Q

which factors must you take into consideration when deciding on management of a carious primary tooth?

A
  • extent of the lesion
  • site of the lesion
  • activity of the lesion
  • time to exfoliation
  • number of other lesions present in the dentition
  • the child’s medical status
  • anticipated cooperation of the child
  • anticipated cooperation of the parent/carer with the preventative interventions and to attend repeat management appointments
  • the range of clinical procedures the clinician has the skill to provide
40
Q

what does a pulp polyp in a carious primary molar suggest about the canals?

A

at least one of the root canals is vital and the other canals may be necrotic

41
Q

what are the 4 possible scores when recording plaque levels?

A
42
Q

which children would you class as being at increased risk of dental caries?

A
  • SIMD score 1-3
  • decayed teeth present
  • missing teeth due to caries
  • any filled teeth
43
Q

at what age are the effects of dental anxiety most apparent?

A

< 4 years

44
Q

how can you measure a child’s dental anxiety?

A

the modified child dental anxiety scale (MCDAS)

45
Q

what is the aim of behaviour management?

A

to promote a positive attitude to dental care and facilitate ongoing prevention and care

46
Q

give examples of behaviour management strategies

A
  • communication
  • enhancing control
  • tell show do
  • behaviour shaping and positive reinforcement
  • structured time
  • distraction
  • relaxation
  • systematic desensitisation
47
Q

what advice would you give a parent with severe dental anxiety?

A

another adult should bring the child to appointments- reduces risk of child developing same anxiety as parent

48
Q

if a cooperative child presents with irreverisble pulpitis symptoms in a primary molar, what treatmetn should you consider other than extraction?

A

pulpotomy

49
Q

what is the treatment for symtoms of pain thought to be due to food packing/reversible pulpitis but diagnosis is uncertain?

A

place a temporary dressing
review 3-7 days later to check symptoms

SDCEP guidelines (4 decks)

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