Caries prevention and management Flashcards
Contra-indications for the hall technique
Signs/ symptoms of irreversible pulpitis
Clinical/ radiographic signs of pulpal involvement/ pulpal exposure/ peri-radicular pathology
Crowns so broken down they might normally be considered un-restorable
Indications for the hall technique
Co-operative patient
Non-cavitated/ cavitated occlusal lesions where the patient is unable to accept - FS, partial caries removal or a conventional restoration
Proximal lesions - cavitated/ non-cavitated
How often should you give toothbrushing advice and instruction for standard vs enhanced prevention?
Standard - once a year for both
Enhanced - at every recall visit
When and what teeth should have FS for standard prevention?
Place sealants in ALL pits and fissures of FPM as soon as possible after eruption.
Check integrity of sealants at every visit and top up as required
When and what teeth should have FS for enhanced prevention?
FS all first and second permanent molars, and palatal pits on upper lateral permanent incisors, occlusal and palatal surfaces of D’s and E’s
Check integrity of sealants at every visit and top up as required
How often should sodium fluoride varnish be applied for standard prevention?
Applied twice a year to children 2 years and up
How often should sodium fluoride varnish be applied for ENHANCED prevention?
Apply 4 times per year for children 2+
What are the fluoride preparations in toothpaste that should be recommended for STANDARD prevention?
under 3 years - smear of toothpaste minimum 1000ppm fluoride.
3-6 years - pea-sized amount of toothpaste, minimum 1000ppm fluoride
7+ - pea-sized amount toothpaste 1350ppm-1500ppm fluoride
What are the fluoride preparations in toothpaste for ENHANCED prevention?
Recommend use of 1350-1500ppm fluoride toothpaste for children up to 10 years old
Prescribe 2800ppm high fluoride toothpaste children 10-16 years old
5000ppm for 16+
What is the function of SDF?
De-sensitisation of non-carious tooth lesions
Arrests caries
Indications for SDF?
Active dentinal carious lesions that are easily cleansible
Teeth with exposed root surfaces causing dentine hypersensitivity
MIH
Pre-co-operative children
Good OH
What are the contra-indications for SDF?
Irreversible pulpitis
Dental abscess
Radiographic signs of pulpal invovlement or PA pathology
Infection/ pulpal pain
What are the advantages of SDF?
Can maintain space in primary dentition if it avoids extraction
Useful for improving co-operation in pre-co-operative children
May avoid extractions/ invasive dental procedures
Quick
Avoids LA
Painless
Disadvantages of SDF?
Aesthetics - stains carious portion of the teeth black
Difficult to monitor success
Relies to some extent on cleansability of the lesion and patient’s OH
How often is recall appointment for standard vs. enhanced?
Standard - 6 months
Enhanced - every 3 months
