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BDS2 Clinical Dental Science > Caries Symposium > Flashcards

Caries Symposium Flashcards

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1
Q

what factors are necessary for caries

A

tooth surface
substrate - carbohydrate
flora - bacteria, strep mutans
time

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2
Q

what are the 7 factors for caries risk assessment

A 
clinical evidence
oral hygiene
diet
fluoride exposure
saliva
medication
social status
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3
Q

what can be measured for someones clinical evidence

A

caries experience - dmft either primary or permanent

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4
Q

what causes white spot lesions

A

build up of plaque, acid produced, demineralisation of enamel but not cavitated

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5
Q

what is the consequence of white spot lesion on dentine

A

causes demineralisation of dentine, can get tertiary dentine formed

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6
Q

why are pits and fissures higher risk of caries

A

more likely to get food down here and stuck, but have reduced flow of saliva down for clearance, allows for demineralisation of enamel. also difficult for bristles of toothbrush to get down. the enamel at this region is also thinner, so gets into dentine quicker - fast spread

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7
Q

what are different strategies of intervention for prevention of caries

A

individual - specific education and prevention measures tailored to individual, caries risk assessment
targeted population level - target the population at higher risk, fluoride varnish on high risk children’s teeth
whole population - health education and promotion for everyone

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8
Q

what is the benefit of targeting the whole population

A

moves the distribution of whole population to a lower risk category - not just those high risk

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9
Q

what is proportionate universalism

A

targeting the whole population but increasing measures for those at high risk

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10
Q

what are the different levels of interventions

A

upstream - national, change in policies and programmes
midstream - community level, training other people
downstream - chairside dental education

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11
Q

what are risk indicators for children

A

bottle feeding, parental smoking and oral hygiene, diet, fluoride exposure, socioeconomic status

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12
Q

what are the 8 preventative measures

A 
tooth brushing technique
diet advice
fluoride toothpaste
fluoride varnish
fluoride supplementation
sugar free medication
radiographs
fissure sealants
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13
Q

what diet advice can be given to prevent caries

A

water and milk only - if need juice, only at meal times and as diluted as possible, and through a straw
sugary foods and snacks at mealtimes only
cheese can be given after meal - anticariogenic
snack ideas - cheese and crackers, bread sticks, crisps

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14
Q

what is nursing caries

A

caries in children who have been given a bottle to go to bed, suck on it all night. constantly low pH in mouth. caries on upper anteriors and molars

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15
Q

what bottle should children use

A

free flowing spout

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16
Q

what levels of fluoride should be in toothpaste for standard risk

A

under 4 - 1000ppm

4-16 - 1000-1500ppm

17
Q

what levels of fluoride should be in toothpaste for high risk

A

under 10 - 1500ppm
10-16 - 2800ppm
16+ - 5000ppm

18
Q

what are the classifications of caries

A

extent - enamel only or enamel and dentine
cavitation
activity - active or inactive, demineralising or re
location - primary or secondary
site - occlusal, approximal, smooth surface, root surface

19
Q

what are the 2 components of accuracy

A

sensitivity - % of correctly identified disease

specificity - % of correctly identified health

20
Q

what is required for clinical examination in detecting caries

A

dry tooth surface, light, probe but not sharp (ball ended) and time

21
Q

what can be used in helping to diagnose caries

A

magnificiation, radiographs, ICCMS

22
Q

what are advantages and disadvantages of using magnification to detect caries

A

improves sensitivity for D1, much greater detail seen, but smaller field of vision - D3 sensitivity not as good

23
Q

what are advantages and disadvantages of using radiographs to detect caries

A

allows more surfaces to be seen - approximal, good for D3, but not as good for D1 - also exposes patient to ionising radiation

24
Q

what is ICCMS

A

drying every surface of tooth for 30 seconds, and spending more time detecting caries

25
Q

what are advantages and disadvantages of ICCMS

A

increase in sensitivity for both D1 and D3

but decrease in specificity - more false positives, looking for something that isnt there

26
Q

what is infected dentine

A

top layer of dentine, infected by bacteria, structure has been compromised by MMP’s - needs to be removed. irreversible denaturation of matrix

27
Q

what is affected dentine

A

the layer underneath infected, no bacteria present, still contains hydroxyapatite crystals. but some collagen has been compromised but is remineralisable

28
Q

what makes bond strength to affected dentine poor

A

poor infiltration of resin and increase in dentinal fluid

29
Q

what is the ethos for dealing with caries

A

remove as little tooth tissue as possible
achieve restorative seal
maintain pulpal health
successful restoration - right cavity size and shape

30
Q

what must be done before restoring caries

A

find out the reason and cause - address these issues first. if not, caries will be recurring

31
Q

what is the similarities with partial caries removal and stepwise technique

A

access caries, visualise extent at ADJ, remove as much caries as possible in dentine without damaging pulp, maximise cavity for restoration

32
Q

what is different between stepwise technique and partial caries removal

A

partial caries removal - removes as much caries as possible, any caries over pulp is left. definitive restoration is placed
stepwise technique - temporary restoration is placed - RMGI, allows tertiary dentine to form from pulp, can then go back in, remove the rest of caries and place definitive restoration

33
Q

what is a differential diagnosis for a patient with infalmmaed gingiva most of the time, all over with plaque present

A

chronic generalised plaque induced gingivitis

BDS2 Clinical Dental Science (6 decks)

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