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Caries Symposium > Caries Pattern + Diagnosis > Flashcards

Caries Pattern + Diagnosis Flashcards

1
Q

Define caries

A 
> Disease of mineralised tissues: 
enamel 
dentine 
cementum
caused by the action of microorganisms on fermentable carbohydrates

> Can be arrested and remineralisation can occur in early stages

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2
Q

How does decalcification appear clinically?

A

Chalky white/brown lesions

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3
Q

When is decalcification most commonly seen?

A

Under ortho brackets

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4
Q

What 3 pits should be checked for possible caries?

A
  1. Buccal pits of lower 6s
  2. Palatal pits of uppers 6s
  3. Cingulum + palatal pits of upper 2s
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5
Q

Where is smooth surface caries found?

A
  1. Buccal
  2. Lingual
  3. Cervical
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6
Q

How does active caries present clinically?

A
  • Light brown caries

- Soft mushy if you check with a probe

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7
Q

What teeth does early bottle caries affect?

A

MAXILLARY
Incisors
1st Molars

MANDIBULAR
Canines

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8
Q

Why are lower incisors normally not affected by early bottle caries?

A

They are protected by the tongue

+ saliva from floor of the mouth (salivary glands)

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9
Q

What is an amalgam tattoo caused by?

A

Amalgam gets into the dentinal tubules and stains them grey

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10
Q

Define rampant caries

A

More than or equal to 10 new lesions per year

- Lower anteriors affected

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11
Q

Pattern of attack for caries in deciduous dentition (yrs)

A

0 to 6

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12
Q

Pattern of attack for caries in young mixed dentition (yrs)

A

6 to 12

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13
Q

Pattern of attack for caries in young permanent dentition (yrs)

A

12+

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14
Q

What teeth is caries most prevalent in the primary dentition?

A
  • Lower primary molars
  • Upper primary molars (2nd)
  • Upper anteriors
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15
Q

What teeth is caries least prevalent in the primary dentition?

A
  • Lower anteriors

- Buccal + lingual surfaces

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16
Q

Why is interprox caries harder to develop in primary dentition?

A

Because primary dentition is very spaced out making the areas self cleansing

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17
Q

What teeth can enamel hypomineralisation occur in the primary dentition?

A

2nd primary molars

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18
Q

Whats usually the pattern of extraction for caries in primary dentition?

A

8 primary molars removed + centrals + laterals

  • Canines saved to guide teeth in
  • Lower anteriors usually spared as they don’t get caries
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19
Q

What teeth can be fissure sealed if the child has a high caries risk?

A

Molars and premolars

20
Q

What steps are part of the assessment for caries? (7)

A
  1. Parent+patient management
  2. Symptoms
  3. HPC
  4. PDH
    - Tx to date
    - OH habits, F habits + Dietary habits
  5. MH
  6. SH
  7. Caries Risk Assessment
21
Q

What steps are part of the e/o I/o examination for caries?

A
  1. Extra-oral
  2. Intra-oral
Soft tissues:
OH
Swelling
Sinuses
Ulceration
Hard tissues:
Teeth present
Dental age 
Occlusion 
Loose/missing/extra teeth 
Trauma
Dental anomalies 
Caries activity
22
Q

Clinical examination for caries

A

VISUAL

  • dry teeth
  • good light
23
Q

What tests can be done for caries diagnosis

A
  1. Radiographs
  2. Sensibility testing:
    - Nerve (hot/cold/electric)
  3. Vitality testing:
    - Blood supply (laser dopler)
    - Difficult to use, bulky
24
Q

How is fiberoptic transillumination used for caries detection?

A

Light doesn’t carry through carious material

25
Q

Why would you want to avoid extracting a second primary molar?

A

FPM will drift and take its place (of the premolar under it)

Resulting in crowding

26
Q

What are some key considerations before you decide your tx?

A
  1. If tooth is restorable
  2. Patient/parent compliance
  3. Stage of dental development
  4. Space management
  5. Anticipated difficulties
  6. Overall prognosis
27
Q

If the tooth is restorable what considerations do you need to make in terms of tx? (4)

A
  1. Choice of restorative material
  2. Choice of restorative technique
  3. Cavity shape
  4. Permanent vs temp restos
28
Q

State an example of a temporary restoration material

A

Zinc oxide eugenol based temp material
- Prevents pain + worsening

Can hand excavate gross caries first

29
Q

What material is used for stabilisation of caries?

A

GIC - GI Cement

30
Q

What is carisol used for?

A

Dissolves carious dentine

31
Q

Name 2 types of space maintainers (2)

A
  1. Ortho brackets

2. Band and loop space maintainer

32
Q

When is a distal shoe used?

A

When removing a 2nd primary molar when the 1st permanent molar isn’t there

33
Q

Function of a distal shoe

A

Spike goes into bone so the unerupted FPM can slide up the metal and sit into the right space

34
Q

Disadvantages of primary tooth extractions

A
  • Increased crowing

- Tendency for space loss

35
Q

Whats a rule for extractions

A

If you take out one you need to take out the other in the same arch to prevent centre line shift

36
Q

What is an emergency tx options for caries?

A
  1. Caries excavation + sedative dressing
  2. Pulp therapy - Pulpotomy or Pulpectomy
  3. Drainage of pus
  4. Extraction (LA +- IHS or GA)
37
Q

What age is IV sedation considered for?

A

12 years +

Young permanent dentition

38
Q

Lower 6s rule for LA

A
  • If a child doesn’t have lower 6s then can get away with infiltration rather than IDB
  • If 6yrs or 6s erupting then IDB
39
Q

Advantages of rubber dam

A
  1. Isolation + moisture control
  2. Retraction of gingivae + cheeks
  3. Damage to soft tissues
40
Q

Are linings usually required in primary teeth?

A

No

Limited room for cavity prep

41
Q

Anatomical features of pulp in primary teeth (2)

A
  1. Large
    - Limited room for cavity prep
  2. Pulp horns close to surface
    - Pulp exposure easy
42
Q

Anatomical features of roots in primary teeth (2)

A

Narrow mesio-distally, long + slender

43
Q

Implications of a narrower root in primary teeth for root tx

A

Pulpectomy more difficult

44
Q

When do you know to plan for pulp tx just off of your clinical examination?

A

When the marginal ridge has breakdown of more than 2/3rds of its length -> theres caries in the pulp (pulpotomy needed)

45
Q

When do you know to plan for pulp tx just off of your radiographic examination?

A

Caries greater than or equal to 2/3rds into dentine - pulp involved

Pulp caps dont tend to work very well in the primary teeth so go to pulpotomy

Caries Symposium (2 decks)

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