Caries Symposium

Question 1

what is a caries risk assessment?

Answer 1

the risk of the patient developing new/progressive disease in the future

Question 2

what are GENERAL caries risk factors typically based on?

Answer 2

socioeconomic factors

Question 3

what are general caries risk factors?

Answer 3

• social

* general health

Question 4

what are local caries risk factors?

Answer 4

• oral hygiene
• diet
• fluoride experience
• past caries experience
• orthodontic treatment

Question 5

what are the 7 elements of caries risk?

Answer 5

1. clinical evidence
2. dietary habits
3. social history
4. fluoride use
5. plaque control
6. saliva
7. medical history

Question 6

what is DMFT?

Answer 6

decayed missing & filled teeth (adult)

Question 7

what is dmft?

Answer 7

decayed missing & filled teeth (children)

Question 8

what is meant by DMFT > 5 ?

Answer 8

higher caries risk

Question 9

what things can increase a persons caries risk?

Answer 9

• previous caries experience
• orthodontic appliances
• prosthetics

Question 10

what dietary indication can suggest high caries risk?

Answer 10

• greater than 3 sugar intakes

* eating highly processed/refined carbs are more cariogenic

Question 11

what is the most cariogenic sugar?

Answer 11

sucrose!

Question 12

what is the SIMD category?

Answer 12

scottish index of multiple deprivation

Question 13

what are the 7 domains that the SIMD looks at?

Answer 13

1. income
2. employment
3. education
4. health
5. access to services
6. crime
7. housing

Question 14

what social aspects make someone a higher caries risk?

Answer 14

• education
• unemployment
• SIMD category
• work stressors
• single parent families
• violence
• inequalities & access to healthcare
• dependants

Question 15

what does fluoride do?

Answer 15

• incorporation into enamel crystal to form FLUOROAPITITE which is more caries resistant

Question 16

what oral hygiene habits can make someone more high caries risk?

Answer 16

• poor technique
• irregular brushing
• unassisted (very young/very old)
• access to toothpaste/toothbrush
• difficulty due to changes (mixed dentition/orthodontics/gaps)

Question 17

what is a lack of saliva known to cause?

Answer 17

caries!

Question 18

what is meant by the buffering capacity of saliva?

Answer 18

the ability of saliva to neutralise acid

Question 19

what is xerostomia?

Answer 19

dry mouth!

Question 20

what is mucosititis?

Answer 20

lots of ulceration and fragile mucosa

Question 21

what are the typical social aspects of a high risk caries child?

Answer 21

• mother’s education secondary school only
• poor dental attender
• single parent family/low social class/unemployed parents

Question 22

what are the 8 elements of prevention of caries?

Answer 22

1. radiographs
2. toothbrushing
3. strength of fluoride in toothpaste
4. fluoride varnish
5. fluoride supplementation
6. diet advice
7. fissure sealants
8. sugar free meds

Question 23

what things are required for development of caries?

Answer 23

• bacteria
• time
• tooth surface
• plaque

Question 24

what is a biofilm?

Answer 24

organised bacterial population

Question 25

what are white spot lesions?

Answer 25

demineralisation of the enamel

Question 26

how do white spot lesions occur?

Answer 26

due to a loss of inter-rod regions & the thickness of crystallises is reduced

Question 27

how does an active white spot lesion appear on an SEM?

Answer 27

surface appears rough

Question 28

how does an inactive white spot lesion appear on an SEM?

Answer 28

surface appears smooth

Question 29

why should a dentist NOT poke a white spot lesion with a probe?

Answer 29

can cause enamel to collapse

Question 30

why is sealing root caries particularly difficult?

Answer 30

there is no enamel to attach restoration to

Question 31

what are some risk indicators for caries in children?

Answer 31

- oral hygiene - diet - bacterial exposure - socioeconomic status - breast/bottle feeding - fluoride exposure - parental oral health status - parental smoking

Question 32

what is a typical cause of nursing caries?

Answer 32

inappropriate use of feeding cups and bottles

Question 33

what should be recommended to parents once their child has reached 6 months old?

Answer 33

use of a feeding cup (free flow spout) rather than a bottle

Question 34

what are the only safe drinks to have between meals?

Answer 34

plain water or milk

Question 35

If a high caries risk child is taking medicine, what should be requested?

Answer 35

sugar free medicines (taken at meals & never after tooth brushing)

Question 36

what are examples of good snack ideas to minimise likelihood of caries?

Answer 36

- cheese - milk/water - crackers - bread sticks

Question 37

when should tooth brushing begin in an infant?

Answer 37

as soon as the first primary teeth erupt

Question 38

In ppm, what should the fluoride content of child toothpaste (ages 4-16) be?

Answer 38

1000ppm - 1500ppm

Question 39

what is the standard fluoride (in ppm) of toothpaste?

Answer 39

1400-1500ppm

Question 40

what is the fluoride content of duraphat toothpaste?

Answer 40

2800ppm

Question 41

what should the fluoride content of toothpaste be for high risk children 10 and over be?

Answer 41

2800ppmF

Question 42

what should the fluoride content of toothpaste be for high risk patients aged 16 and over?

Answer 42

5000ppmF

Question 43

how often & what type of radiographs should be taken for high risk children?

Answer 43

bitewings every 6 months

Question 44

how often & what type of radiographs should be taken for low risk children?

Answer 44

bitewings every 12-18months