Caries Pattern and Diagnosis - Caring for Children and Young People Flashcards
Where are decalcification spots commonly found
Mesial wall of first permanent molar
Smooth surface of teeth at cervical region
Bands on teeth when orthodontic braces are removed
Where are pit and fissure caries most commonly found in children
Buccal pits of lower first permanent molars
Palatal pits of upper first permanent molars
Cingulum pit behind upper lateral incisors
Which teeth are commonly affected by nursing bottle caries
Maxillary incisors
First molars
Mandibular canines
Which teeth are protected from nursing bottle caries and why
Lower incisors due to increased saliva in the lower arch and protection by the tongue
What is rampant caries
=>10 new lesions per year
Lower anterior affected
Describe the pattern of attack in caries of the primary dentition
Lower molars, upper molars and upper anteriors first
Rare in lower anteriors, and buccal and lingual surfaces
Occlusal caries found more in the second primary molars than the first
Interproximal caries not found until contact develops
Can have enamel hypomineralisation
Which teeth are most commonly saved when teeth are removed in the primary dentition
Save canines to guide other teeth in
Usually lower anteriors are saved
Describe the caries patten in the mixed dentition
Caries rate in the lower 6s > upper 6s
Found in pits and grooves in the palatal upper 6s, palatal upper laterals and the buccal lower 6s
If found in upper and lower incisors then it is rampant caries
What should be checked in an extra-oral examination in children
Facial symmetry
Lymph nodes
What should be checked in the soft tissues in an intra-oral examination in children (5)
Oral hygiene Swellings Sinuses Ulceration Gingival health
What should be checked in the hard tissues in an intra-oral examination in children (6)
Teeth present Occlusion Loose, missing and extra teeth Trauma Dental anomalies Caries activity - past and present
What should be considered when thinking about removing a child’s tooth (6)
Is the tooth restorable Parent compliance Stage of dental development Space management Anticipated difficulties Overall prognosis
How may carious teeth be stabilised in children
Prevent pain by arresting restorable lesions and using temporary restorations with IRM or GIC
Hand excavate gross caries and use carisolv to dissolve carious dentine
What can be used to prevent crowding when removing a child’s tooth
Band and loop space maintainer
SS crown in a distal shoe
When can a distal shoe be used
For removing a second primary molar when the first permanent molar isn’t there
The first permanent molar will then erupt in to the correct space
What is the result of early primary tooth extractions
Increased crowding which causes increased tendency for space loss
The earlier removed the higher degree of space loss
Give an examples of balancing/compensating extractions
If taking out one primary canine, take out the other in the opposite arch so centreline will be in the middle and won’t shift
Which teeth are often used in balancing/compensating extractions
Primary canines
First primary molars
What happens if there is early loss of the upper first permanent molars
Loss before complete eruption of 7s causes rotation and mesial movement of the 7s and distal drift of the 5s
What happens if there is loss of the lower first permanent molars
Loss after optimum age - tilting 7s
Loss before optimum age - 5s drift distally and rotate
How are treatment conditions optimised for children
Pain free LA - topical, warm cartridge
If child doesn’t have lower 6s, can use an intra-papillary infiltration rather than an IDB
Use rubber dam
How does rubber dam increase safety
Decreases damage to soft tissues, risk of inhalation and cross-infection
How does rubber dam benefit the operator and patient
Increases isolation and moisture control, retraction of gingivae and cheeks
Gives effective inhalation sedation
Increases patient and operator confidence
Describe the sequence of restoration in children
Fissure sealants
Preventative restorations
Simple restorations - shallow cervical cavities
Fillings requiring LA but not into the pulp - upper arch first
Pulpotomies/pulpectomies
Extractions
