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BDS2 CDS > Caries symposium > Flashcards

Caries symposium Flashcards

1
Q

7 elements of caries risk

A

social
oh/plaque
diet
medical history
fluoride exposure
clinical evidence
saliva

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2
Q

whats the worst type of sugar

A

sucrose
highly processed carbs
milk left in mouth overnight
soya is bad too

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3
Q

whats good about fluoride

A
  1. stronger, more resistant to demineralisation
  2. antimicrobial, interferes with bacterial glycolysis and adhesion to tooth surface
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4
Q

what are we looking for in patient’s mouth? clinical evidence

A

dmft >5
3 year caries increment >3
ortho
prosthetics
caries in 6s at 6yo

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5
Q

whats dmft

A

decayed
missing
filled teeth
index

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6
Q

what are we looking for in saliva consistency

A

pH
viscosity
buffering
flow
amount

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7
Q

what is an example of a medication that affects salivary flow?

A

asthma inhaler

prilocarpine is a drug that TREATS xerostomia

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8
Q

how do meds affect oral health

A

xerostomia
some meds contain sugar
some people take sugary drinks to make meds more palatable

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9
Q

what are early childhood caries?

A

drinking milk when sleeping

decreased salivary flow when sleeping, no cleansing of the milk sugars

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10
Q

lactulose

A

a medication for constipation but may cause caries

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11
Q

know diet diary

A

time
4 days
1 weekend
details of food
tooth brushing and bed times

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12
Q

before bed, what time to stop eating

A

20 min beforehand

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13
Q

xylitol gum adv

A

Xylitol gum is good
- Sugar free chewing gum
- Increase salivary flow rate
- Neutralize acid in the mouth

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14
Q

5 ways of classifying caries

A
  1. extent
  2. location
  3. site
  4. cavitation
  5. activity
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15
Q

using ICDAS classification system, what is 0-6

A

0 No evidence of caries
1 Initial caries
2 Distinct visual change in enamel
3 Localised enamel breakdown due to caries with no visible dentine
4 Underlying dark shadow from dentine
5 Distinct cavity with visible dentine
6 Extensive distinct cavity with visible dentine

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16
Q

sensitivity vs specificity

A

sensitivity =% of disease found correctly

specificity = % of health found

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17
Q

Clinical examination basics

A
  • Good light
  • Dry
  • Time
  • Do not use sharp prob, may accidentally cavitate a non carious lesion
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18
Q

Improving accuracy

A

ICCMS - dry and good light

magnification - loupes

x rays - BW for approximal caries

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19
Q

whats Fibre optic transillumination diagnodent?

A

FOTI works quite simply. By placing an intense, narrow beam of light on the tooth’s surface, your visual inspections can quickly provide you with a wealth of information. When a healthy tooth is illuminated, the light will transmit uninterrupted across the tooth (1).

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20
Q

how to know if a cavity is a cavity?

A

blunt probe or perio probe, run gently to see if it catches onto anything

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21
Q

D1, D2 vs D3

A

D1 stop before adj, outer half od enamel

D2 before adj, inner half of enamel

D3 caries are at or beyond adj, detectable lesions in dentine

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22
Q

epidemiology

A

study of the distribution and determinants of diseases in populations

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23
Q

prevalence

A

proportion of population with a disease at any given point or period

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24
Q

ICDAS

A

intl caries detection and assessment system

25
Q

SIC

A

significant caries index

takes into account skewed distribution of caries in population

The Significant Caries Index is a variation of the DMFT Index that focuses on identifying the most severe cases of dental caries within a population.

26
Q

determinants

A

cause or risk factor

27
Q

when accessing dmft, what do you consider caries?

A

caries into dentine (OBVIOUS decay, stage 5 or 6)

28
Q

epidemiology is all about data, how do u get data?

A

WHO, CDC, Adult/child dental health surveys, NDIP (national dental inspection program scotland)

29
Q

what has been the main driver of improvement in dental caries since 1970s?

A

fluoride toothpaste

30
Q

burden

A

distribution

31
Q

SIMD

A

scottish index of multiple deprivation

32
Q

turku sugar studies

A

The results showed a massive reduction of the caries increment in relation to xylitol consumption. Fructose was found to be less cariogenic than sucrose. It was suggested that the non- and anticariogenic properties of xylitol principally depend on its lack of suitability for microbial metabolism and physico-chemical effects in plaque and saliva.

33
Q

vipenholm caries study

A

It concluded that the risk of sugar increasing caries activity is greatest if the sugar is consumed between meals and is in the form in which the tendency to be retained on the surfaces of the teeth is pronounced with a transiently high concentration of sugar on those surfaces. This study would now be considered to be unethical.

34
Q

bell curve shift in populations

A

a whole population approach may be more ideal than a specific targeted approach. shifting the whole population into a lower risk category benefits more individuals than just shifting high risk individuals into a lower risk category

35
Q

proportionate universalism

A

entire population gets positive outcome but the most deprived get an even bigger push to close the gap

36
Q

strategies for delivery of fluroide

A

toothpaste
water fluor
community fluoride schemes

37
Q

strategies for better population diet

A

sugar tax
industry
sugar subs
reformultion
labelling
links with obesity

38
Q

sugar tax

A

(18p per litre) applies to drinks with sugar content between 5 grams and up to (but not including) 8 grams per 100ml

(24p per litre) applies to drinks with sugar content equal to or greater than 8 grams per 100ml

39
Q

what is upstream, midstream and downstream actions?

A

upstream = macroeconomic policies

midstream = community like schools or community assets

downstream = individual behaviour, psychosocial, health services

40
Q

is there benefit of taking fluoride supplements during pregnancy

A

no

41
Q

what is a better alt to sugar?

A

sweeteners like xylitol

42
Q

what are some safe snack recs

A
  • milk
  • water
  • fruit
  • savoury sandwiches
  • crackers
  • cheese
  • bread sticks
  • occasionally a pack of crisps

Cheese has casein
1. Prevents bacteria sticking
2. Neutralise acids

43
Q

what is the fluoride toothpaste rec for a high risk child age 7

A

1500ppmF

44
Q

what is the fluoride toothpaste rec for a high risk child age 12

A

2800pppmF

45
Q

what is the fluoride toothpaste rec for a high risk child age 17

A

5000ppmF (prescription)

46
Q

what is the fluoride toothpaste rec for a standard risk child age 5

A

1000-1500ppmF

47
Q

fluorosis

A

enamel defects due to high levels of fluoride

increase in mineral resistance

48
Q

whats the toxic dose of fluoride?

A

5mg/kg of body weight

49
Q

what info do you need to determine fluoride toxcitiy ?

A

body weight and amount of fluroide consumed

50
Q

what happens if you over consume toxic levels fluroide?

A

below5mg/kg-give calcium orally

5-15mg/kg - calcium orally or calicum gluconate

Above 15mg/kg – admit to hospital cardiac monitoring and IV calcium gluconate

51
Q

duraphat fluoride content

A

22600ppmF

52
Q

how to determine high risk or low risk usually?

A

look at timescale of development of caries

  • fast, ie many caries in a year indicates worry
  • not acute, caries have been around for long time may mean that the caries are arrested
53
Q

Caries appear white because?

A

 Demineralization causes the enamel prisms to not transmit light through, cannot see yellowish dentine under

54
Q

stippled appearance of gum indicates?

A
  • Gingivae very healthy, stippled appearance indicates collagen is bound tightly to the periosteum
55
Q
  • How to tell if caries arrested?
A

colour smoothness hardness

active usually white chalky soft

56
Q

STRCTURE of enamel rods and ir region in enamel lesions

A
  • In enamel lesion, the rods are still present but the gaps between the rods are larger
  • When caries arrest, the IR region become chalky -> smooth
57
Q

purpose of FS

A
  • In kids, the enamel is weaker/ immature, more carbonate-apatite which is more acid soluble
  • Fissure sealants allow time for young enamel to mature
58
Q

why is comp weak on root caries?

A
  • Composite binds to enamel and dentine, root caries doesn’t have enamel only dentine
  • Bonding is weaker
59
Q
  • Why surface of the tooth has higher fluoride content in enamel than subsurface enamel?
A

 Higher potential of fluoride being incorporated into hydroxyapatite when demineralised enamel is being remineralised

BDS2 CDS (15 decks)

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