Clinical presentation of caries

Question 1

What is the defintion of dental caries?

Answer 1

a disease of the mineralised tissues of the teeth caused by the action of micro-organisms on fermentable carbohydrates

Question 2

is dental caries preventable

Answer 2

yes, fully

Question 3

enamel is organic or inorganic?

Answer 3

inorganic

Question 4

dentine is organic or inorganic?

Answer 4

organic so more suceptible to caries

Question 5

when can you get root surface caries?

Answer 5

on an exposed root following recession or shrinkage

Question 6

when to operatively treat a tooth?

Answer 6

1. caries (clinically or radiographically
2. following trauma
3. tooth wear (NCTSL)
4. developmental defects

Question 7

treatment of a white spot lesion

Answer 7

1. ohi
2. topical fluoride
3. diet advice

Question 8

when was a global decline in dental caries seen?

Answer 8

1970

Question 9

what does NDIP stand for?

Answer 9

national dental inspection program

Question 10

what is the duty of NDIP?

Answer 10

• monitors if child smile is working
• inspects all p1 - p7 students in scotland
• one basic inspection each year
• one detailed inspection every second year

Question 11

what is the function of screening for dental caries in children?

Answer 11

to identify individuals at greatest risk of developing caries in future

Question 12

caries is a dynamic process meaning…

Answer 12

your caries risk can change at any time

Question 13

having a natural dentition when elderly leads to an increase in what 3 things?

Answer 13

• root caries
• treatment required
• NCTSL

Question 14

why are elderly patients more liekly to get root caries?

Answer 14

had teeth for longer = increased change of having disease at some point = shrinkage occuring = increased root exposure = vulnerable to caries

Question 15

what age should bitewings be taken from?

Answer 15

age 5

Question 16

A patient with medium caries risk is due their annual bitewings but they had a dpt taken for ortho 6 months ago. what do you do?

Answer 16

wait 6 months and take bitewings

Question 17

most common type of caries in a deciduous tooth?

Answer 17

occlusal

Question 18

why does caries spread quicker in a deciduous tooth?

Answer 18

it does not have as far to go to reach the ADJ

Question 19

define rampant/acute caries

Answer 19

rapidly occurring caries affecting several teeth

Question 20

rampant caries can be called nursing bottle caries if on what surfaces?

Answer 20

the labial surfaces

Question 21

what is the clinical appearance of an active white spot lesion?

Answer 21

white and chalky with a loss of lustre (shine)

Question 22

what is the clinical apperance of an inactive white spot lesion?

Answer 22

white or brown with a glossy surface

Question 23

how does enamel caries progress?

Answer 23

in an EPISODIC fashion

Question 24

arrested root surface caries will look…

Answer 24

very dark and hard

Question 25

why are bitewings essential?

Answer 25

visual exam is only 50% of approximal caries

Question 26

what are the 2 things that happen to protect the pulp-dentine complex when caries reaches dentine?

Answer 26

1. bacterial toxins elicit pain by moving through dentine tubules and evoke an inflammatory reaction in pulp (pulpitis) 2. reactionary (tertiary) dentine forms which decreases the permeability of the tubules and allows the pulp to retreat

Question 27

when will you get acute pulpitis?

Answer 27

when the pulp is exposed to caries

Question 28

pulp exposed to caries leads to....

Answer 28

pulp necrosis which releases toxins (irriversible pulpitis)

Question 29

toxins from the pulp necrosis spread where? causing what?

Answer 29

the apex of the root which causes periradicular periodontitis or apical periodontits

Question 30

what is periradicular periodontitis?

Answer 30

- pain and inflammation of the periodontium at the root at the root of the tooth

Question 31

what is the aim of restoring a cavity?

Answer 31

to remove any bacterial infection before carious exposure of the pulp

Question 32

how can pulpitis be resolved?

Answer 32

- complete caries removal and restoring with non irritant material and resolution of pain

Question 33

what are the two types of pulpitits?

Answer 33

1. reversible | 2. irriversible

Question 34

what is cellulitis?

Answer 34

localised blood poisoning giving a swelling of the mouth and facial soft tissues due to a spread of infection and inflammation across the facial planes

Question 35

what is ludwig angina? how does it carry a risk of death?

Answer 35

a progression of severe cellulitis causing an elevated tongue > asphyxiation

Question 36

what is primary root caries?

Answer 36

caries on root surface that has no inital involvement of adjacent enamel or restorations

Question 37

what is secondary root caries?

Answer 37

caries on root surface adjacent to an existing restoration