Caries Symposium Flashcards
what aspects must be present for caries to occur
tooth
saliva
bacteria
time
what are the seven elements of caries risk
clinical evaluation
medical history
social history
fluoride use
saliva
diet
plaque control
what is DMFT
decayed missing and filled teeth in the permanent dentition
what is dmft
decayed missing and filled teeth in the primary dentition
name three pieces of clinical evidence that would make a child high risk for caries
caries in 6s at 6
dmft more than or equal to 5
if there are three new carious lesions in 3 year period
what would make a child high risk for caries with regards to their diet
3 intakes of sugar per day
what is the action of fluoride
fluoride incorporated into enamel crystals to form fluoro-apatite which is more caries resistant
bactericidal role
affects adhesion force of bacteria
what two drug side effects may make oral hygiene more difficult
xerostomia
mucositis
what is a white spot lesion
demineralisation stays within enamel
has the ability to remineralise with good OH
what is the Stephan Curve
shows the relationship between pH and time in mouth
from what age should the use of a feeding cup with a free flow spout rather than a bottle be recommended
6 months
what fluoride strength toothpaste should enhanced prevention kids be getting under 10
1450 ppmF
what fluoride strength toothpaste should enhanced prevention kids be getting over 10
2800ppmF
what fluoride strength toothpaste should enhanced prevention kids be getting over 16
5000ppmF
what is ICDAS
international caries detection and assessment system
what is D1 vs D3
D1 = all visibly detectable lesions
D3 = lesions extending into dentine
what are the four aspects of ICCMS (formally ICDAS)
classification
management
history
decision making
what is cervical burnout on an xray
caused by relative lower xray absorption on the mesial or distal aspect of teeth between the edge of enamel and the adjacent crest of alveolar ridge
what are the types of caries
pits and fissure caries
smooth surface
root
approximal
secondary
what are rampant caries
more than 10 new lesions per year
what can be placed as a space maintainer from losing a primary molar (E)
distal shoe placed on the D before the FPM has erupted so it cannot tilt into the space
when can IDBs be used
6 years old or 6s erupting
name benefits of rubber dam use
decrease damage to soft tissues
decrease risk of inhalation
increased isolation and moisture control
retraction for gingivae and cheeks
give five methods of caries removal
hand excavation
rotary instruments
chemo-mechanical removal
air abrasion
lasers
what is suitable management of an occlusal non-cavitated lesion in kids
complete caries removal and restoration
PRR
seal caries with FS
what management strategies are there for an occlusal cavitated lesion in primary teeth
complete caries removal and restoration
PRR
seal caries with hall crown
if no cooperation - provide prevention or make lesion self cleansing
what are the management strategies of an approximal lesion in primary teeth
complete caries removal and restoration
PRR
seal caries with hall crown
if no cooperation - provide prevention and make lesion self cleansing
what are management strategies for anterior cavitated lesions in primary anteriors
complete caries removal
PRR
provide prevention
what is the management strategy for a grossly carious unrestorable tooth without pain
provide prevention
XLA
what is the mercury regulation treaty
Minimata treaty
what is in the Minimata treaty that is relevant to dentistry
no amalgam in primary teeth
no amalgam in persons under 25
no amalgam in pregnant and breastfeeding women
name restorative options for primary molars
composite
stainless steel crowns
GIC
RMGIC
what are indications for preformed crowns
more than 2 surfaces affected
extensive 2 surface lesions
space maintenance
developmental defects
what are the steps for a traditional preformed metal crown
give LA
remove caries
cut mesial and distal slice
reduce occlusal surface enough to allow a straight probe to passed through when teeth are in occlusion
select correct size of preformed metal crown
place with GIC
remove excess and clear contacts with floss
how do you make a lesion in a primary tooth self cleansing
only enamel and carious dentine removed using high speed
apply fluoride varnish
what are indications for discing of primary anteriors
exfoliation time close
child is pre-cooperative
extensive superficial
minimal interproximal
what is the technique for interproximal discing of primary anteriors
sandpaper discs used to taper the interproximal edges (narrow incisally)
round of proximal surfaces
polish and fluoride varnish
what are indications for strip crowns in primary anteriors
enamel hypoplasia
amelogenesis imperfecta
dentinogenesis imperfecta
labial and interproximal caries
what should be provided where there is an enamel lesion developing on a FPM that is next to a carious E
provide preformed crown or hall crown on the E
when is the ideal time for XLA of the 6s if need be
start of calcification of bifurcation of unerupted 7s
ideally all premolars and 3rd molars present
what is SDF
colourless liquid - BUT TURNS BLACK
44, 800ppmF
SDF occludes dentinal tubules to relive sensitivity
silver acts as antibcaterial
fluoride promotes remineralisation
what are contraindications for SDF
signs of infection
symptoms
caries into pulp
inflamed/ ulcerated gingiva
describe the procedure for placing SDF
place petroleum jelly on the soft tissues and lips
moisture control with cotton wool
dry tooth
single capsule per patient
apply to tooth
wait to dry for 1 minute
continue with isolation for 3 minutes
what is TETS
temporary elective tooth separation
what is CPP-APP
brand name tooth mousse
caesin phosphopeptide-amorphous calcium photsphate
what does CPP ACP do
remineralises subsurface enamel
casein peptides dissolve into plaque and calcium
what are the three steps of ICON
etch the lesion
dry the lesion with ethanol
infiltrate the lesion
name three topical management systems of caries
fluoride application
CPP-APC
SDF
what are IV agents used in GA for children
propofol
what are the levels of anaesthesia
induction
excitement
surgical anaesthesia
respiratory paralysis/ overdose
what is Gillick competence
children under 16 can consent if they are perceived to have sufficient maturity and judgement to enable them to fully understand what is proposed
what should a referral for GA state
patient name, address, contact numbers
MH
GP details
parental responsibility
justification for GA
proposed tx plan
previous tx details
recent radiographs
what is the fluoride concentration for fluoride varnish
22, 600 ppmF
name four factors determining anticaries rate of fluoride toothpaste
fluoride conc
frequency of application
rinsing habits
when brushing takes place
what are the micrbiological stages in caries progression
adhesion
survival and growth
biofilm formation
complex plaque
acid
caries
what is Koch’s postulates
microbe must be present in every case of the disease
microbe must be isolated from the diseased host and grown in pure culture
disease must be reproduced when pure culture is introduced into susceptible host
name virulence factors of S mutans
adhesins
binding proteins
sugar modifying enzymes
polysaccharides
acid tolerance and adaptation
what is stepwise caries removal
2 stage technique
firstly, caries is removed in soft dentine then a temp restoration applied
then at next visit the temporary material is removed along with the rest of the caries and the permanent restoration is applied
