Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

BDS3 Caries Symposium II > Caries Pattern and Diagnosis > Flashcards

Caries Pattern and Diagnosis Flashcards

1
Q

caries definition

A

“disease of mineralised tissues; enamel, dentine and cementum, caused by action of micro-organisms on fermentable carbohydrate…… In it’s very early stages the disease can be arrested since it is possible for remineralisation to take place” (Kidd et al 1987)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

caries classification (8)

A
  • Decalcification
    • White/ brown
    • Spot lesions

Poor OH, free flowing saliva, angle 45o into necks of teeth

  • Pit and fissure caries
    • Narrow so toothbrush cannot get in
  • Smooth surface - harder
    • Buccal
    • Lingual
    • Cervical

Light brown – active, soft

  • Interproximal caries
  • Early childhood or nursing bottle caries
    • Max incisors, 1st molars, mandibular canines
    • lower incisors protected by the tongue
  • recurrent/ secondary caries
    • take out and replace – larger cavity
  • arrested caries
    • dark brown leather like – good OH and F
  • rampant caries
    • greater than or equal to 10 new lesions a year
    • lower anterior affected
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

rampant caries

A
  • greater than or equal to 10 new lesions a year
  • lower anterior affected
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

arrested caries

A

dark brown, leather like

good OH and F

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Dx

A

secondary caries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

early childhood or nursing bottle caries

A
  • \Max incisors, 1st molars, mandibular canines
  • lower incisors protected by the tongue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Dx

A

interproximal caries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Dx

A

smooth surface caries

  • buccal
  • cervical
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

cause of pit and fissure caries

A

narrow space so toothbrush bristles cannot get in to clean

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

decalcification

A
  • White/ brown
  • Spot lesions

Poor OH, free flowing saliva, angle 45o into necks of teeth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

deciduous dentition between

A

0-6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

mixed dentition ages

A

6-12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

permanent dentition

A

12+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

caries pattern in primary dentition

A
  • lower molars, upper molars, upper anteriors
    • occlusal caries – 1st primary molars

rare in lower anteriors, buccal / lingual surfaces (except rampant caries)

interproximal caries -not until contacts develop

enamel hypomineralisation (MIH- problems in pregnancy?)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

caries pattern in mixed dentition

A
  • caries rate lower 6s> upper 6s
  • pits/grooves
    • palatal upper 6s
    • palatal upper laterals
    • buccal lower 6s
  • cingulum pits of lateral incisors
  • upper and lower incisors = uncontrolled caries
  • second molars erupting
  • host factors
    • reduced salivary flow rate
    • high mutans counts – temporise so easier to clean
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

3 caries management factors particular to children

A
  • Parental involvement – motivation, diet, appointment attendance
  • Patient development
  • Dealing with two dentitions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

assessment and diagnosis of caries in children

A
  • Parent/patient management (at least 2 people)
  • Symptoms?
    • Common
    • Turn up in pain, already discomfort and scared
  • History of present complaint
  • Past dental history
    • treatment experience to date – happy experience?
    • Oral hygiene habits, F history, Dietary habits
  • Medical history
  • Social history
  • Caries Risk assessment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

examination in children looks at

A

Extra-oral- asymmetry, nodes etc.

Intra-oral

  • soft tissues
    • Oral hygiene/swellings / sinuses, ulceration, gingival health
  • hard tissues
    • teeth present, dental age
    • occlusion
    • loose, missing, extra teeth
    • trauma
    • dental anomalies
    • caries activity - past and present
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

caries detection on clinical examination

A
  • visual
    • dry teeth, good light, sharp eyes
    • FOTI
  • ortho separators
  • caries detector dyes
  • lasers
  • Radiographs
  • Sensibility testing – nerve (hot/cold/electric)
  • Vitality testing - blood supply (laser dopler)

(Only gentle probing to appreciate surface texture)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

retain or extract?

A

try best to retain

esp if only one tooth has caries

extraction - traumatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

evaluation of dentition

consider (6)

A
  • Tooth restorable?
  • Patient/parent compliance
  • Stage dental development – how long going to remain in mouth
  • Space management – avoiding drifting
  • Anticipated difficulties
  • Overall prognosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

is the tooth restorable?

A
  • Choice of restorative material
  • Choice of restorative technique
  • Ideally decide cavity shape/ form and restoration before starting.
  • Permanent vs temporary restorations
    • ​build pt up
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

stabilisation of pt

A
  • prevent pain
  • preventive therapy
  • arrest restorable lesions
  • acclimatisation
    • e.g. hand excavation, use of carisolv®/ ART/ IRM/GIC, diet advice, OHI
  • decrease bacterial load in mouth
  • improve OH by making areas easier to clean
24
Q

factors in pt/parent compliance

A

motivation

co-operation

25
Q

motivation (pt/parent compliance)

A
  • parent - compliance with prevention regimes, attendance, support at home
  • child – compliance, OH, try make fun (apps, music)
26
Q

co-operation in pt/parent compliance

A
  • parent - own anxieties
  • child - emotional maturity, fears, previous bad experience, behavioural problems, ability to co-operate
27
Q

why consider stage of development of caries?

A
  • Primary teeth
    • are they close to exfoliation?
  • Permanent molars
    • what is the long term prognosis?
    • could extractions be part of the ortho treatment plan?
    • what about space maintenance?
28
Q

caries activity consideration

A
  • Pattern indicates level of caries activity – is treatment worthwhile in long term
29
Q

prognosis dependent on

A
  • Prognosis dependant on preventive issues and motivation
30
Q

why consider space maintenance?

A
  • Effect of premature loss of primary teeth
    • depends on:
      • tooth size / jaw relation
      • muscle behaviour
      • age at loss
      • tooth
  • Loss of 1st perm molars
  • Crowding due to loss of primary teeth
31
Q

2 space maintainers

A

band and loop space maintainer

distal shoe (placed when FPM still unerupted, will come into correct space)

32
Q

possible results of primary tooth extractions

A

Increased crowding, increased tendency for space loss

  • Earlier removed, increase degree of space loss

Balancing/ compensating extractions

  • balance primary canines to prevent center-line shift
  • consider balance of lower 1st primary molars if arch crowded
    • Must always consider balance/compensation when removing FPM’s
  • in general no other b’s or a’s necessary in the primary dentition
33
Q

early loss of maxilla FPMs (16, 26)

A

loss before complete eruption of 7 = rotation and mesial movement 7 and distal drift of 5

34
Q

early loss of mandible FPMs (36, 46)

A

loss after optimum age = tilting 7’s

loss before optimum age = 5 drifts distally and rotates

35
Q

3 aims of dental Tx - caries in children

A
  • Relief of symptoms
  • Prevention of disease initiation and progression
  • Restore function and aesthetics
36
Q

relief of symtoms tx depends on

A
  • nature of the pain
  • status of pulp
  • stage of dental development
  • level of patient compliance
37
Q

pain history from child

A
  • Where is the pain?
  • What does the tooth feel like?
  • How long has the tooth been painful?
  • Does anything make the pain better or worse?
  • Does the pain keep the patient awake or wake them from sleeping?
  • Is the pain spontaneous or precipitated e.g.by eating?
  • Is the pain relieved with analgesics or antibiotics?
    • (Note: antibiotics should only ever be prescribed when there is systemic illness, pyrexia and/or facial swelling).
38
Q

emergency treatment options for carious teeth children

A
  • Caries excavation and sedative dressing
  • Pulp therapy - pulpotomy or pulpectomy
  • Drainage of pus
  • Extraction ->
    • LA +/- inhalation sedation
    • GA

(IV sedation only considered for 12 years and over)

39
Q

optimising caries treatment conditions

A
  • Pain-free LA
    • topical
    • warm LA cartridge
    • Lower 6s rule
      • 6 years old or 6s erupting - use IDB (no lower 6s can do infiltration)
  • intra-papillary infiltration avoids palatal injection
  • Rubber Dam
40
Q

rubber dam use increases safety by decreasing (3)

A
  • Damage to soft tissues
  • Risk of inhalation
  • Cross-infection
41
Q

rubber dam use benefit to operator by increasing

A
  • Isolation and moisture control
  • Retraction of gingivae and cheeks
  • Effective inhalation sedation
  • Patient confidence
  • Operator confidence
42
Q

6 stage sequence of restoration in carious teeth in children

A
  • fissure sealants
  • preventive restorations
  • simple fillings eg. shallow cervical cavities
  • fillings requiring LA but not into pulp
    • upper arch first
  • pulpotomies/pulpectomies (another lecture)
  • extractions
43
Q

5 methods of caries removal

A
  • Hand excavation
  • Rotary Instruments
  • Chemo-mechanical removal
    • Caridex - N-monochloro-DL-2-aminobutyric acid (NMAB)
    • Carisolv gel - amino acids & hypochlorite
    • Ozone
  • Air abrasion
  • Lasers
    • Erbium-YAG
44
Q

anatomical features of primary teeth

crown

A
  • shorter
  • narrower occlusal tables
  • thin enamel/dentine
  • broad contact areas
  • enamel rods in gingival 1/3 extend occlusally
  • marked cervical constrictions
  • whiter
45
Q

anatomical features of primary teeth

pulp

A
  • large
  • pulp horns close to surface
46
Q

clinical features of primary teeth

roots

A
  • narrow mesio-distally
  • long, slender
  • flared
47
Q

clinical significance of primary teeth crown anatomical features

A
  • limited room for cavity prep - linings not usually required
  • clinical caries only detected if large - bitewings essential
  • enamel at floor of box not undermined
  • retention of ss crown
48
Q

clinical significance of primary tooth pulp anatomical features

A
  • limited room for cavity prep
  • pulp exposure easy
49
Q

clinical significance of root morphology in primary teeth

A

pulpectomy more difficult

50
Q

clinical examination considerations for primary teeth

A
  • extent of lesion
    • When the marginal ridge has breakdown more than 2/3 of its length there is caries in the pulp so plan pulp treatment not simple restoration
51
Q

radiographic examination considerations for primary teeth

A
  • proximity of caries to pulp?
    • 2/3 into dentine - pulp involved!
  • pathology / root length
52
Q

choosing material/technique

general consider

A
  • Longevity of the tooth - how long must it last?
  • Co-operation - how easy?
  • Medical and Dental history
  • Extent of lesion - how much of restoration exposed to wear?
  • Which tooth?
  • Oral Hygiene
  • Diet History
  • Attitude
  • Parental preference

de

53
Q

chosing material/technique

dental consideration

A
  • Extent of lesion
  • how much of restoration exposed to wear?
  • Which tooth?
  • Oral Hygiene
54
Q

Which primary teeth are most commonly affected in Nursing Caries/Early Childhood Caries?

  1. 55,54,52,51,61,62,64,65,74,84
  2. 54,52,51,61,62,64,74,84
  3. 54,52,52,61,62,64,74,72,71,81,82,84
  4. 54,52,51,61,62,64,72,71,81,82
A

54,52,51,61,62,64,74,84

55
Q

Where are you least likely to detect decalcification lesions?

A

At the base of a preexisting composite restoration

  • this would be secondary or recurrent dentine caries not enamel decalcification

BDS3 Caries Symposium II (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions