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IPAP > Dental Block 1 > Flashcards

Dental Block 1 Flashcards

1
Q

What is the vermillion border a junction between?

What type of cells is it made of?

A

Skin and Mucous membranes

Stratified squamous

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2
Q

What type of glands are located in the vermillion border?

A

Fordyce Granules- Ectopic sebaceous glands at corners of the mouth and cheeks opposite molar teeth

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3
Q

What are the characteristics of the Masicatory Mucosa

A

25%, Gingiva covering hard palate, primary mucosa in contact w/ food during chewing,
Keratinized

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4
Q

What are the characteristics of the Lining Mucosa

A

60%, floor of mouth, ventral tongue, and tissues of soft palate with no function during mastication,
Non-keratinized

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5
Q

What are the characteristics of Specialized Mucosa?

A

15%, covers dorsal tongue

Non/cornified papillae

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6
Q

How does the Lamina Propria differ between the Lining and Masticatory Mucoasa?

A

Lining- NKSS loose CT w/ collagen, contains glands

Masticatory- P/KSS, variable lamina propria, para/kartinized strat squamous

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7
Q

Gingiva belongs to what category of mucosa?

What are the 3 parts of the gingiva?

A

Masticatory

Attached, Interdental, Free (includes sulcus)

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8
Q

Characteristics of Attached Gingiva

A

Keratinized, stippled, separated from aveolar mucosa by mucogingival groove, attached to tooth by junction of epithelium

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9
Q

Characteristics of Marginal/Free Gingiva

A

Keratinized, not stippled, bound on inner margin by gingival sulcus (separate from tooth), bound to outer margin by oral cavity and apically by free gingival groove

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10
Q

How does gingiva attach to teeth?

A

Attach on neck of tooth by junctional epithelium

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11
Q

What type of muscle makes the tongue?
What divides it into halves?
What are the three parts and two surfaces of the tongue?

A

Striated
Median septum
Parts: oral, pharyngeal, root
Surface: dorsal, ventral

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12
Q

What is the most important articulator for speech production?
What is a second function of the tongue?

A

Tongue

Taste

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13
Q

Where are bitter, sour, salty and sweet tastes located on the anterior 2/3s of the tongue?

A

Bitter- posterior surface
Sour- inner middle
Salty- peripheral except tip
Sweet- tip

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14
Q

What are the four types of papillae on the tongue?

A

Filiform- anterior 2/3, fine hair-like
Fungiform- anterior 2/3, round red spots
Circumvallate- V shaped row near posterior
Foliate- posterior lateral border of the tongue

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15
Q

There are no taste buds on the posterior 1/3 of tongue, but what is located there?

What is the most numerous type of papillae?

A

Nodular surface due to lingual tonsils

Filliform, lack any taste buds

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16
Q

What CN innervates the general/taste sensations of the anterior 2/3 of tongue?

A

Sensation- lingual nerve, CN5 general sensory

Taste- chorda tympani, CN7 special sensory

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17
Q

What CN innervates the general/taste sensations of the posterior 1/3 of tongue?

A

Glossopharyngeal nerve- CN9, general and special

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18
Q

What CN innervates the generals sensation at the base of the tongue?

A

Internal laryngeal nerve- CN10

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19
Q

What types of muscle fibers make up the intrinsic tongue muscles and what is their function?

A

Longitudinal, Transverse, Vertical

Alter shape of tongue

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20
Q

What are the four extrinsic muscles of the tongue?

What is their function?

A

Palatoglossus, Genioglossus, Hypoglossus, Styloglossus

Tongue movement, connect tongue to surrounding structures: soft palate/bones (mandible, hyoid, styloid)

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21
Q

What are the functions of the extrinsic muscles?

A

Tongue movement

Connect tongue to surrounding structures: soft palate and bones (mandible, hyoid, styloid)

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22
Q

What muscle is responsible for tongue protrusion?
What muscle is responsible for tongue retraction?
What muscle is responsible for tongue depression?
What muscle is responsible for tongue elevation?

A

Genioglossus
Styloglossus
Hyoglossus and Genioglossus
Styloglossus and Palatoglossus

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23
Q

What nerve innervates the intrinsic nerves?

What nerve innervates the extrinsic muscles?

A

Hypoglossal

Hypoglossal EXCEPT the palatoglossus muscle- supplied by CN10

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24
Q

What artery and vein supply the tongue/mouth?

A

Artery: Dorsal lingual artery
Vein: Lingual Vein- drains to internal jugular

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25
Q

What lymph nodes are on the tip of the neck?
What lymph nodes are on the anterior 2/3 of the neck?
What lymph nodes are the posterior 1/3 of the neck?

A

Submental bilateral, Deep cervical
Submandibular unilateral, Deep cervical
Deep cervical

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26
Q

Characteristics of the Parotid Gland

A

Largest
Serous saliva w/ ptyalin- starches
30% of saliva

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27
Q

Characteristics of Submandibular gland

A

Bi-lobed, excretes through submandibular duct
10% mucous, 90% serous
60% of saliva produced w/ salivary amylase
“Gleeks”

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28
Q

What are the characteristics of the sublingual gland?

A

Smallest
Mostly mucous
Mulitple ducts of Rivinus (8-20)
Only 5% of total saliva produced

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29
Q

Where are minor salivary glands located in the mouth?

A

Between 600-1000 that line oral cavity and oropharynx secreting serous, mucous or mixed saliva directly into oral cavity

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30
Q

What are the functions of PNS CNs 3 7 9 and 10

A

3- narrow pupil, focuses lens
7- tears, nasal, salivary glands
9- parotid gland
10- viscera down to proximal half of colon, cardiac, pulmonary, esophageal plexus

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31
Q

What are the two parts of the roof of the oral cavity?

A

Hard Palate: bony, anterior

Soft Palate: muscular, posterior

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32
Q

What structures does the hard palate help make?

A

Roof of oral/floor of nasal cavities
Ant: Maxilla palantine process
Post: Palatine plates
Bound by alveolar arches

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33
Q

What is the under surface of the hard palate covered with?

What structure does it show in the anterior parts of the mouth?

A 
Mucoperiosteum
Transverse ridges (rugae)
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34
Q

What is the function of the masseter muscle?

Where does the Masseter muscle span from and to?

A

Elevate mandible, crush/grind chewing

Zygomatic arch to mandible angle

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35
Q

What happens to hypertrophy or bruxism occurs in the masseter muscle?

A

Bruxism- hypertrophy, which leads to reduced/occluded parotid gland

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36
Q

What is the function of the temporalis muscle?

Where does the Temporalis muscle span from and to?

A

Largest muscle that elevates/retracts mandible
Exerts light chewing forces
Temporal fossa to body of mandible

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37
Q

What is the function of the Medial Pterygoid muscle?

Where does the Medial Pterygoid muscle span from and to?

A

Elevate, protrusion and lateral shift of the mandible

Sphenoid bone to medial surface of mandibular ramus

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38
Q

What is the function of the Lateral Pterygoid muscle?

Where does the Lateral Pterygoid muscle span from and to?

A

Protrusion/retrusion/depression of mandible

Pterygoid plate/Sphenoid bone to articular disc

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39
Q

What event occurs if the lateral pterygoid muscle premature contracts prematurely?
What two muscles make up the “mandibular hammock” of the face?

A

TMJ shifting

Masseter
Medial Pterygoid

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40
Q

Term dentition is used to describe ?

A

Natural teeth in jaw bones

Primary, mixed, permanent

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41
Q

All four muscles of mastication are innervated by what CN?

A

5-3

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42
Q

The first set of 20 primary teeth are AKA what 3 names?

A

Baby teeth
Milk teeth
Deciduous teeth

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43
Q

Define/when does Mixed Dentition occur?

Permanent dentition refers to what?

A

When both primary and permanent teeth are present between 6-12y/o

32 secondary/adult teeth

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44
Q

How are the mouth quadrants broken up by the World Dental Federation?

A

UR- 1-8 MRQ
UL- 2-8 MLQ
LL- 3-8 ManLQ
LR- 4-8 ManLQ

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45
Q

Define Mesial

Define Distal

A

Towards midline of dental arch

Away from midline of dental arch

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46
Q

What are the 3 basic food processing functions of teeth?

What are the four basic types of teeth?

A

Cut, Hold/grasp, Grind

Incisor, Canine, Premolar, Molar

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47
Q

Function of incisors
Function of canines
Function of premolars (bicuspis)
Function of molars

A

Cut w/out heavy force
Cut and tear w/ force
Hold and grind food
Chew and grind food

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48
Q

How do premolar and molars differ in number from baby to adult teeth?

A

Pre-molar: none in primary, two in permanent

Molar: two sets in primary, three sets in permanent

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49
Q

Define Eruption

Define Exfoliation

A

Movement of tooth from developmental position to occlusion plane
Process of roots of primary teeth are reabsorbed so primary too falls out

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50
Q

Define Occlusion

Occlusal contact is the trigger that stops ?

A

Mandibular/maxillary relationship at closing

Tooth eruption

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51
Q

What are the 3 phases of tooth eruption?

A

Pre-eruptive phase
Eruptive- root formation, penetration, movement, occlusion
Post eruptive

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52
Q

What is the second layer to begin forming in tooth anatomy?

A

Enamel

Begins 6-8wks in utero

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53
Q

How does in utero tooth formation occur?

A

Ameloblasts lay collagenous matrix which is mineralized by alkaline phosphatase
Enamel proteins are removed leaving mineralized tissue behind

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54
Q

Enamel has what type of structure?

What is the make up?

A

Rod/crystaline
97%- hydroxyapatite
3%- other

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55
Q

What is the middle layer of the tooth?

A

Dentin- equal hardness to bone

First layer to form, grows inward towards pulp

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56
Q

How is dentin formed during tooth formation?

Where does the dentin receive nutrients from?

A

Odontoblastic for growth/repair

Pulp

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57
Q

What is the make up of dentin?

A

70% hydroxyapatite
20% organic
10% water

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58
Q

What is the last tissue to form during tooth development?

Development of cementum results in ?

A

Cementum

Tooth eruption

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59
Q

Where does the cementum receive it’s nutrients since it’s an avascular structure?
What is the composition of cementum?

A

Periodontal ligament

50% hydroxyapatite, 50% organic and water

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60
Q

What does pulp comprise of?

A 
Fibroblasts
Odontoblasts
Vascular/nerve/lymph components
Type 1 and 2 collagen
Unmineralized
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61
Q

Where does pulp exit the tooth?

What joins cementum of tooth to the alveolar bone?

A

Apex

CT Type 1 Collagen

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62
Q

What are the 4 functions of the periodontal ligament?

A

Supportive, Remodel, Sensory, Nutrition

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63
Q

Define BioFilm

A

Group of microbes that adhere to surfaces

Frequently embedded under self produced matrix of extracellular polymeric substances

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64
Q

Define Pellicle

A

Acellular layer of salivary proteins, mucins and macromolecules on oral surfaces that is 10micrometers thick

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65
Q

How does enamel pellicle stick and adhere to tooth surfaces?

A

Mucus component

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66
Q

What are the four functions of the dental pellicle?

A

Protect
Lube
Prevent desiccation
Substrate for bacterial attachment

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67
Q

Enamel pellicle forms how fast?

A

Less than 30m after brushing

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68
Q

What type of bacteria initially attach to sticky surfaces of pellicle?

A

Planktonic

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69
Q

How is a firm anchor established between bacteria and surfaces?

A

Covalent ionic/H bond mediated by organisms and receptors on surface

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70
Q

What is the essential first step in biofilm development?

What is the only non-shedding surface in the body?

A

Attachment to tooth surface

Enamel

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71
Q

Bacteria have what two structures that aid in surface attachment?

A

Fimbriae

Fibrils

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72
Q

What are the four phases of plaque formation?

A

Pellicle formation
Attachement
Young Supragingival plaque- gram pos cocci
Aged Supragingival plaque- gram neg anaerobic bacteria

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73
Q

What are the “early” colonizers of biofilm attachment?

Where do secondary colonizers emerge from?

A

Non-mutan streptococci and Actinomyces spcs.

Gingival crevice
Tongue
Saliva

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74
Q

What microbes are the Secondary Colonizers?

A 
P. Intermedia
P. Ioescheii
Capnocytophaga
Fusobacterium nucleatum
Prophyromonas gingivalis
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75
Q

What process is essential for ongoing development of plaque’s microenvironment?

A

Quorom sensing

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76
Q

Supragingival plaque is mostly what type of microbes?

Subgingival plaque is mostly what type of microbes?

A

Gram positive facultative anaerobes

Mixed facultative strict anaerobe bacteria that are
Asacchorolytic- metabolizes peptides

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77
Q

What three processes/excretions result in decreased oxygen as tooth plaque matures?

A

Strep and Actinomyces are Sacchorolytic and Acidogenic and secrete a Polymeric substance causing decreased O tension

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78
Q

What does the Latin word Carie mean?

A

Rot, decay

Similar to Greek word for death

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79
Q

Define Caries

A

Infectious transmissible disease from oral bacteria that metabolize sugars into acids causing tooth demineralization

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80
Q

What two bacteria are the main cariogenic bacteria?

A

Streptococci

Lactobacillus

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81
Q

In order for cavities to form, what three requirements must exist?

A

Cariogenic bacteria
Sugar
Tooth surface

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82
Q

How do dental caries first appear?

A

Chalky white spot due to loss of translucency of enamel rods due to demineralization

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83
Q

What is the main microbe of the pathogenesis of caries?

A

Mutans Streptococcus

Actinomyces and Lactobacillus

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84
Q

Define Vertical Transmission

A

S. mutans transmitted from caregiver to infant through saliva

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85
Q

Most carious lesions occur where on teeth?

A

Interproximal surface of primary teeth

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86
Q

Four processes that reduce caries on teeth

A

Often brushing
Fresh produce
Flossing
Parents have good habits

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87
Q

How does saliva help prevent caries?

A

pH 6-8
IgA, lysozyme, lactoferrin, histatins, peroxidase
Supersaturated Ca, PO4, and BiCarb (addition of Flouride, not natural occurence)

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88
Q

What can cause xerstomia?

A

Systemic diseases
Gland damage
Surgery/radiation
Medications

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89
Q

Intermediate restorative material is made up of ?

A

Zinc oxide
Eugenol
Reqs mechanical retention and can remain for one eyar

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90
Q

Healthy gingiva are absent of four things and have four characteristics present?

A 
Absent of inflammation or deformity of:
Marginal
Attached
Alveolar
Periodontium (bone, cementum and PDL)

Have: uniform color, knife edge, scalloped, firm and stippled

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91
Q

Gingivitis is AKA?

It is indicative of ?

A

Early gum disease

Precursor to advanced gum disease if inflammation extends into alveolar process, PDL and/or cementum

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92
Q

What is the etiology of gingivitis?

A

Bacterial biofilm- plaque

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93
Q

What are the four types of gingivits?

A

Plaque associated gingivitis
NUG
Medication induced
Allergic

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94
Q

Characteristics of plaque-associated gingivitis?

A

Pathogenic bacteria on salivary pellicle from poor hygiene causing inflammation
Gram pos/neg an/aerobes
Etiology- plaque and calculus

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95
Q

Characteristics of NUG

A

Stress and smoking leading to blunted/punch out interproximal papillae with a gray pseudomembrane, bad breath and pain
Can arise from immunosuppressed or nutrition

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96
Q

How is NUG treated?

A

Chlorhexidine

ABX- metronidazole

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97
Q

How does medication induced gingivitis present?

A

Gingival hyperplasia and excess collagen, caused by Cyclosporine, Phenytoin or Nifedipine

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98
Q

Allergic gingivitis is caused by ? but commonly by ?

How is it treated

A

Herbs, mouth wash, mints, gum, peppers
Cinnamon or lauryl sulfate
Topical steroids

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99
Q

What are four systemic causes of gingivitis?

A

Hormones
Drugs
Stress
Vitamin C deficiency

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100
Q

What are four local factors that can cause gingivitis?

A

Crowded teeth
Dental caries
Frenulum attachments
Overhanging restorations

101
Q

What is the name of the tooth brushing technique?

A

Bass Sulcular Toothbrush Technique at 45* angle twice a day for 2 min each
Floss daily
Scrape tongue
Rinse w/ mouth wash

102
Q

Define Gingivitis, what it includes, it’s etiology and if it’s reversible

A

Inflamed soft tissue
Epithelial and CTs
Poor hygiene, injury or immunocompromised
Is reversible

103
Q

Define Periodontitis, what it includes, it’s etiology and if it’s reversible

A

Inflamed hard and soft tissue

Including alveolar bone, gingiva, and PDL from anaerobic bacteria

104
Q

Define inflamed PDL, what it includes, it’s etiology and if it’s reversible

A

Excessive wear, mobility and widened PDL
Non-bacterial causes: poor restoration, ill fitting appliances/trauma
Bacterial- near apex due to inflammation in pulp
Reversible

105
Q

What is the number cause of tooth loss in adults?

What is this cause always preceded by?

A

Periodontal disease

Always by gingivitis

106
Q

Periodontal Dz is inflammation of what supporting structures?

A

Inflammation of peridontium and it’s structures:
Gingiva
PDL attachment
Aveolar bone

107
Q

What are the three diseased states of periodontal diseases?

A

Gingiva- red/receded
PDL- loose, wide, deep
Alveolar bone- resorbs
No Tx

108
Q

How will diseased tissue present with probing?

A

Apical migration of junctional epithelium from Cementum Enamel Junction
Loss of PDL attachment from cementum

109
Q

Untreated gingivitis can advance to periodontitis creating what three issues?

A

Chronic inflammation
Deep pockets
Bone loss

110
Q

Periodontal diseases cause deteriorating bone as a result of ?

A

Calculus and bacterial toxins

111
Q

Classification of Gingival Periodontal Disease

A

Erythema/edema
Attachment at CEJ
No bone loss

112
Q

Classification of Slight Periodontitis

A

Erythema/edema
Loss of attachment and mild reduction of bone HEIGHT
Restored w/ nonsurgical cleaning by hygienist

113
Q

Classification of moderate periodontal disease

A

Erythema/edema
Moderate bone LOSS
Furcation invasion
Tooth mobility

114
Q

Classification of Severe Periodontal disease

A 
Severe bone loss
Furcation invasion
Migration of teeth
Loss of occlusal vertical dimension
Dentures needed
115
Q

What are the early warning signs of future periodontal disease?

A 
Gingivitis
Probing apical to CEJ
X-ray evidence of bone loss
Tooth mobility
Migration of teeth
116
Q

What are S/Sx of an active periodontal disease?

A 
Mobile teeth
Mouth sores/purulence
Bone loss 
Halitosis
Blunted interproximal papillae
117
Q

Define Red Bacterial Complex

A

Tannerella forsythia
Treponema denticola
Porphyromonas gingivalis

118
Q

Define Pophyromonas gingivalis

A

Non motile gran neg anaerobic rod that releases enzymes/collagenases to initiate inflammation

119
Q

What is the keystone pathogen for periodontal disease process?

A

Prphyromonas gingivalis

Chiefly responsible for bone loss

120
Q

Characteristics of Tannerella Forsythia

A

Gram Neg Obl Anaerobe Spindle pleomorph that forms biofilm and surface layer protein adnhesion to epitherlial cells
Produces cysteine proteases and subverts host immune system

121
Q

Characteristics of Treponema denticola

A

Gram Neg anaerobe motile spirochete that travels in viscous environment
Produces enzymes to degrade collagen and invade tissue
Unable to synthesize fatty acids, found in periocornitis sites and NUG

122
Q

Treponema denticola is one of how m an types of treponems found in the oral cavity?

123
Q

What are the non-surgical treatment methods of periodontal disease?

A

Sub/supra-gingival scaling and root planing every 3mon
ABX into sulcus
Rest, diet, exercise
No smoking/remove occlusion

124
Q

What are the surgical innervations of treating periodontal disease?

A

For pockets >5mm
2-6mon after non-surgical methods
Irreversible

125
Q

What are the three phases of treating periodontal diseases?

A

Assessment- PA/medic
Initial Dx- GenDen
Treatment- periodontist/hygienist

126
Q

How does a periapical abcess appear on x-ray and what is the treatment?

A

Localized preiapical radiolucency with widened PDL

Treated w/ local anesthesia, I&D, refer to dentist for root canal therapy

127
Q

Define Periodontal Abscess

A

Acute inflammation in sulcus of a periodontal pocket from pre-existing periodontal lesion with a vital tooth.
Presents as pain, edema that involves bone/PDL attachment, mobile tooth, pus and foul taste

128
Q

How does a periodontal abscess appear on radiographs and how is it treated?

A

Bone loss from previous periodontal pocket

Local anesthetic, I&D, saline rinse, refer to dentist for scaling/root planning every 3mon

129
Q

Define Pericornitis

A

Acute inflammation in tissues surrounding crown of partially erupted tooth from trapped food/bacteria beneath flap

130
Q

How will a periconitis PT present?

A

Throbbing pain to ear/throat/floor of mouth
Foul taste
Trismus- facial edema
NUG like necrosis

131
Q

How does a pericornitis appear on x-ray and how is it treated?

A

Impacted/erupted mandibular 3rd molar

Antiseptic lavage to remove debris, ABX, refer to dentist for removal of flap or extraction

132
Q

Define Alveolar Osteitis

A

Dry Socket- post extraction inflammation of exposed alveolar process due to loss of initial blood clot due to negative pressure, suction, smoking, trauma or bacteria

133
Q

How does Dry Socket present

A

3-4 days post extraction

Exposed unprotected bone w/ severe pain and foul odor

134
Q

How are dry sockets treated?

A

Remove sutures and irrigate with warm saline, place Peridex antimicrobial rinse for PT home irrigation, analgesics x 1wk.
If paste is used, replace x 24hrs

135
Q

What type of facial trauma causes more visible scars?

How are they sutured?

A

Perpendicular lacerations or normal lines of expression
Two layer closure- absorbable on inner muscle first, close skin second
Suture at vermillion border first

136
Q

What type of tissue injury is treated first in facial trauma?

A

Hard tissues

137
Q

What vascular structure needs to be noted and avoided in facial trauma?

A

Labial artery

138
Q

What are the three classes of sutures?

A

Collagen
Synthetic absorbable
Non-absorbable

139
Q

How are suture sizes referenced?

What size is usually used?

A

Diameter of suture strand denoted by zeroes.
More zeroes= smaller the strand diameter
4.0 absorbable for mouth use

140
Q

What size suture material is used for different closures?

A 
Lips- start at vermillion border
Muscle- 3 or 4
Subcutaneous- 4 or 5
Epithelium- 6 nylon non-absorbable
Avoid silk to skin, causes acute inflammation and scarring
141
Q

Define Un/Complicated Crown Fracture

A

Uncomplicated- partial fracture of tip of tooth, still intact
Complicated- separation of crown from tooth body

142
Q

How are teeth that are traumatically removed from the mouth stored?

A

Saliva, under tongue
Lowfat milk
Coconut water
Pedialyte

No water/gatorade
Don’t wrap in tiddue
Don’t leave exposed to air

143
Q

Traumatically removed teeth need to be replaced within what time frame or what ?

A

Within 1 hr to reduce ankylosis or root resorption

144
Q

Why do you not scrub root surface of a tooth avulsion?

A

Injures PDL cells and cementum will not attach to alveolar bone

145
Q

Define Lefort Fractures 1-3

A

1: Transverse maxillary, above level of teeth
2: Pyramidal, level of nasal bones
3: craniofacial dysfunction, orbital level

146
Q

What is the most common midfacial fracture?

What is the most common facial fracture?

A

Zygomatic complex from lateral blow to cheek, can depress the cheek bone (dimple)

Nasal bone

147
Q

What kind of optical s/sx can be seen in an orbital fracture?

A

Bleeding into cornea of Fx side

Restricted movement

148
Q

Fx to orbital rim risk interfering with which CN?

149
Q

Define Blow Out Fx

A

Orbital rim remains intact but crack forms in thin bone in floor of socket (double vision, lowered globe, restricted movement, enophthalmos)

150
Q

Unilateral condylar fractures lead to deviation to what side?

A

Affected side when mouth is open

151
Q

Define Angle Class 1
Define Angle Class 2
Define Angle Class 3

A

Masiobuccal cusp of maxillary 1st molar aligns w/ buccal groove of Mandibular 1st molar
Masiobuccal cusp of maxillary 1st molar is anterior to buccal groove of Mandibular 1st molar
Masiobuccal cusp of maxillary 1st molar is posterior to buccal groove of Mandibular 1st molar

152
Q

What are S/Sx of a severe oral/perioral infection?

A 
Dyspnia
Dysphagia
Severe trismus
Fever and swelling
ABX resistant
153
Q

What is a life threatening sequel to a severe oral/perioral infection?

A

Septicemia
Airway obstruction
Cavernous sinus thrombosis
Ludwigs angina

154
Q

What are the four primary maxillary space infections?

A

Canine- infected maxillary canines
Buccal- infected maxillary and mandibular pre/molars
Vestibular abscess
Palatal abscess

155
Q

Primary mandibular spaces and the infections that reside there

A 
Submental- madibular incisors
Buccal- infected maxillary/mandibular pre/molars
Submandibular- mandibular pre/molars
Sublingual- mandibular pre/molars
Vestibular abscess
156
Q

Define Ludwig’s Angina

A

Bilateral involvement of sublingua, submental and submandibular spaces

157
Q

What is the purpose of I&D?

A

Remove pus/debris/bacteria in abscesses/cellulitis
Reduce tissue tension
Changes oxygen tension

158
Q

What are the steps of an I&D procedure?

A

Nerve block
Incise area of max flactulance
Blunt dissection and copious irrigation
Insert/stabilize a drain

159
Q

When/why would you follow up an I&D with ABX?

A

Swelling w/ systemic problem
Pericornitis w/ systemic problems
Facial space infections
Compromised host defenses

160
Q

What are the risks of ABX use?

A

Allergy
Toxicity
C Diff
Resistant strains

161
Q

Oral infection considerations for ABX therapy?

A

Polymicrobic
Broad spectrum
Culture
Systemic protection

162
Q

What are five scenarios ABX are not used?

A 
Chronic/localized abscess
Dental sinus tract (fistula)
Alveolar osteitis
Pericornitis w/out systemic involvement
Vestibular abscess w/out systemic
Routine root canal
163
Q

What is the ABX of choice for odontogenic infections?

A

Amoxicillin- broad spectrum, bacericidal against Gram-Pos/Neg that’s more absorbed in GI than PenVK
Low protein binding to inc bioavailability

164
Q

How much Amoxicillin is used?

A

1000mg loading dose

Maintain- 500mg PO x 8hrs x 7 days

165
Q

When is Augmentin used?

A

Amoxicillin and Clavulanic Acid combo
When Sx don’t improve s/ amoxicillin
Inc spectrum in persistent infections but is $$
Risk of GI/hepatic toxicity from severe anaphylactic allergic reactions

166
Q

How much Augmentin is used?

A

Clavulanic Acid- 125mg PO x 8hrs x 5-7 days

167
Q

When is Clindamycin used?

A

PT allergic to penicillin
Only a bacteriostatic for anaerobic bacteria but can penetrate bone
PT must stop at first sign of diarrhea or risk 8x inc of C Diff

168
Q

How much Clindamycin is used?

A

Loading- 600mg

Maintain- 300mg PO x 6hrs x 7days

169
Q

Define Tori

A

Variation of normal that is composed for normal bone and covered by normal mucosa on hart palate of maxilla/lingual side of teeth in mandible

170
Q

Define Exosstosis

A

Variation of normal composed of normal bone and covered by normal mucosa on buccal side of maxillary/mandibular teeth

171
Q

Define Benign Migratory Glossitis

A

Geographic tongue

172
Q

What type of PT population is fissured tongue found in?

A

Melkersson-Rosenthal Syndrome
Down Syndrome
Xerostomia PTs

173
Q

How to distinguish lingual varicosities from pathological issue?

A

Asymptomatic that blanches

174
Q

Define Linea Alba

A

White raised ridge of tissue that’s horizontally or bilaterally from benign hyperkeratosis of buccal mucosa

175
Q

Define Lichen Planus

A

Benign developmental variation of normal buccal mucosa

White/yellow thin lines forming lace-like pattern bilateral pattern

176
Q

Define the pathognomonic sign Wickham’s Striae?

What causes this?

A

Lichen Planus

Auto immune response to damage on basal cells of oral epithelium, only topical steroids to treat if erosive/painful

177
Q

Define Hairy Leukoplakia and it’s cause

A

Parallel hair-like white lesions on lateral tongue surface made of Candida Albicans from the Epstein Barr virus or HIV exposure
Treat HIV and Acyclovir and anti-fungals

178
Q

Define Leukoplakia

A

White patch that does not rub off due to thickened surface keratin layer
Only clinical name, doesn’t imply histopathologic tissue alteration
Considered pre-malignancy

179
Q

Define Candidiasis

A

Curdy white layer that leaves inflammed base when wiped off from Candida Albicans that presents as burning, dysgeeusia and can be co-infected with Staph
Acute- atrophic red patches or white/curd colonies
Chronic- denture related form confined to area

180
Q

What are the local and systemic risks of a Candidiasis infection?

A

Local: Topical steroids, Broad spectrum antibiotics , Xerostomia, Heavy smoking

Systemic- poorly controlled DM, immunosuppressed, leukemia PTs, infants

181
Q

How are Cadidiasis infections treated?

A

Nystatin suspension
Clotrimazole
Ketoconazole tabs
Fluconazole tabs

182
Q

Define Angular Cheilitis

A

Dry cracks on commissures from candida albicans infections from excessive sun exposure, anemia or denture wearers treated w/ antifungals

183
Q

Define Black Hairy Tongue

A

Elongation of filiform papillae, papillae grow longer and don’t shed due to bad oral hygiene, ABX use, tobacco or coffee/tea

184
Q

How is Black Hairy Tongue treated?

A

Improve oral hygiene
Superoxide mouth rinse
Topical antifungal

185
Q

Smokeless tobacco can cause what visible changes to mucosa?

A

Keratosis- white wrinkled mucosa in mandibular vestibule at the site of placement OR from osmotic water loss
Reversible within two weeks of cessation

186
Q

Define Nicotinic Stomatitis

A

Benign variation of normal buccal mucosa that looks like white inflamed opening to minor salivary glands from heat generated from pipes or prolonged tobacco exposure
Reversed with cessation

187
Q

How does mucosal allergy present?

A

Circumscribed erythematous patches at site of contact that’s treated with corticosteroids and antihistamines

188
Q

Define Glossitis and how’s it treated

A

Enlarged tongue causing inability to close lips

Samyloidosis, Downs, Beckwith-Wiedemann Syndrome and hypothyroidism

189
Q

Define Ankyloglossia

A

Tongue tied

190
Q

How does a traumatic ulcer present?

A

Rolled white border of hyperkeratosis at area of trauma (chemical, thermal or mechanical cheek biter)
Treated w/ topical peroxide and avoid biting

191
Q

Aphthous ulcer only grow on what type of tissue?

A

Non-keratinized

192
Q

Define primary herpetic gingivostomatitis

A

Vesicle that progresses to ulcers with red halos that can spread during asymptomatic saliva from HSV-1
Possible fever malaise and lymphadenopathy

193
Q

What meds can be used for Primary Herpetic Gingivostomatitis

A

Acetaminophen

Severe cases- Acyclovir

194
Q

Primary Herpetic Gingivostomatitis activates but then goes dormant in which CN?

A

CN5 sensory ganglia of oral and perioral regions

195
Q

Define Herpangina/Herpetic Whitlow

A

Herpes in the finger

196
Q

How does primary syphilis present?

What type of microbe transmits it?

A

Painless lesion w/ central depression at site of inoculation
Treponema pallidum bacteria

197
Q

How does secondary syphilis present?

A

Gray/white plaques covering ulcerated mucosa appearing 6wks after primary chancre appeared
Will have rash on hands, feet and body
MOST infectious stage of syphilis

198
Q

Define Amalgam tattoo

A

Blue/purple dot on alveolar soft tissue from accidental implantation during amalgam restoration proximal to tattoo

199
Q

Define hemangioma

A

Vascular anomaly from rapid growth phase of endothelial cell proliferation
Blanches to touch

200
Q

Define Hematoma

A

Red/brown/blue lesion that does NOT blanch to pressure

Doesn’t resolve in 2wks, consider Dyscrasia

201
Q

What are the different sizes of petechiae, purpura, and ecchymosis?

A

Petichiae: 1-2mm
Purpura: 2mm-2cm
Ecchmosis: >2cm

202
Q

What can cause petechiae, purpura, and ecchymosis?

A

Trauma
Systemic Dz
Clotting disorder
Mono

203
Q

Define melanotic macule

A

Painless tan/brown macule less than 0.5cm from genetics/solar radiation

204
Q

Define Melanocytic Nevus

A

Intraoral mole/freckle less than 0.5cm in diamter that’s usually raised and has a smooth surface
Benign proliferation of melanocytes

205
Q

What types of cells make up the majority of neoplasms in the oral cavity?

A

SCC- 90%, flat squamous arranged like scales

Verrucous- 5%, squamous, rarely spreads

206
Q

Where does minor salivary gland carcinoma occur?

A

Lining oropharynx and hard palate

207
Q

What are the neoplasm lymphomas of the oral cavity?

A

Non/Hodgkin

208
Q

What are the benign tumors of the oral cavity?

A 
Leukoplakia
Erythroplakia
Pyogenic
Grauloma
Fibroma
209
Q

When are Kaposi Sarcoma seen?

A

Painless blue/purple macule that’s a tumor of vascular proliferation from cytomegalovirus usually seen in HIV Pts treated with retro-viral therapy

210
Q

Characteristics of Squamous Cell Carcinoma

A

Deep ulcerated mass w/ possible local pain, referred pain to ear or parasthesia of lip
Caused by tobacco, alcohol, solar radiation or genetics

211
Q

How are Squamous Cell Carcinoas biopsied?

A

Brush biopsy

212
Q

Define Squamous Papilloma

A

Painless solitary white lesion with narrow base caused by local trauma or HPV

213
Q

Define Cerruca Vulgaris

A

Common Wart

Painless solitary lesion with pedunculated/broad base usually occurring on labial mucosa and tongue from HPV-2/4/40

214
Q

Define Condyloma Acuminatum

A

Painless multiple nodules on broad base in clusters usually on lip, tongue or soft palate caused by HPV-6/11/16/18

215
Q

Define Inflammatory Papillary Hyperplasia

A

Painless erythematous nodules from ill fitting dentures and poor hygiene (possible candidiasis infection)

216
Q

Define Pyoenic Granuloma

A

Pregnancy tumor

Red elevated lesion in between interproximal papillae from local factors/hormonal changes

217
Q

Define Irritation Fibroma

A

Firm solitary nodule on buccal mucosa on labial mucosa, tongue and gingiva from reactive hyperplasia of CT in response to trauma/mechanical erosion

218
Q

Define Epulis Fissuratum

A

Painless excessive nodular tissue with crease where dentur sits from hyperplasia caused by fibrous CT changes from ill-fitting dentures

219
Q

Define Mucocele

A

Traumatic rupture of minor salivary gland and accumulation of saliva

220
Q

Define Ranula

A

Block of major salivary duct causing accumulation of saliva, usually caused by sialolith or local trauma

221
Q

What is the acronym for primary teeth eruption times?

A

CI LI M C M

6 9 13 16 23

222
Q

What’s the acronym for permanent teeth eruption times?

A

M IC IL C M

6 6 7 9/11 11/12

223
Q

What is the plaque formation timeline?

A 
Mins- pellicle and adhesion
2hrs- aerobic gram pos
6hrs- plaque established
2days- doubled mass
5-7 days- gram neg and filamentous bacteria dominate
21- plaque accumulation stabilizes
224
Q

Caries process involves demineralization of what three things?

A

Enamel
Dentin
Cementum

225
Q

During the caries process dental plaque metabolize fermentable carbs into ?

A

Organic acids

Once below critical pH, enzymes break down organic component

226
Q

Saliva’s pH

Enamal begins to demineralize at what pH?

227
Q

What are the hallmark signs and symptoms of unhealthy gingiva?

A 
Dolor
Calor
Rubor
Tumor
Functio laesa
228
Q

What can cause Xerostomia?

A

Systemic Diseases
Gland damage fro surgery/radiation
Medication s/e

229
Q

What microbe is present in NUG and pericornitis?

A

Treponema denticola

230
Q

What does each microbe of the Red Bacterial Comples do?

A

T.F.: forms biofilm, produces cysteine proteases
T.D: pericornitis and NUG, produces proteolytic enzymes to degrade collagen
P.G: keystone pathogen for periodontal disease process, chiefly responsible for bone loss

231
Q

Define Dental Anesthesiology

A

Science of managing pain/anxiety for overall PT health during procedures

232
Q

Define Endodontics

A

Morphology, physiology, and pathology of pulp

Biology of normal pulp, etiology/prevention of diseases and injuries to pulp

233
Q

Define Oral/Maxillofacial Pathology

A

Diseases of oralmaxillofacial regions

234
Q

Define OMFS

A

Surgical/adjunct treatment of disease/injury to hard and soft tissue of oral and maxillofacial region

235
Q

Define Orthodontics and Dentofacial Orthopedics

A

Malocclusions, neuromuscular and skeletal abnormalities

236
Q

Define Periodontics

A

Supporting/surrounding tissues

237
Q

Define Prosthodontics

A

Missing teeth or tissues

238
Q

Dental Class 1-3 questions?

A

Restoration
Any -dontic
Surgery
Oral pathology

239
Q

How does a periapical abscess present?

A

Edema
Sensitive to percussion/palpation
No response to cold

240
Q

How does a periodontal abscess present?

A 
Throbbing pain
Edema
Mobile tooth
Foul taste
Gingival enlargement lateral to tooth
241
Q

How is inflammatory papillary hyperplasia treated?

A

Remake dentures
Treat Candidiasis
Surgical removal of lesions

242
Q

What drugs are given for geographic tongue?

A

Topical anti-inflammatory agents:

  • Triamcinolone (Kenalog in Orabase)
  • Fluocinonide (Lidex)
243
Q

What drug is used for mucosal allergy?

A

*Triamcinolone (Kenalog in Orabase)

244
Q

What drug is given for apthous ulcer?

A

*Triamcinolone (Kenalog in Orabase)

Decadron elixir rinse QID

245
Q

Of the oral pathology, what three have bases and which one is uniquely pendunculated?

A

Squamous papilloma- pedunc.
Verruca- broad
Condyloma- broad

246
Q

What are the S/Sx of gingivitis inflammation?

A 
BP HELPERS
Bleeding
Pain
Heat
Edema
Loss of stipling
Purulence
Erythema
Receding margin
Shiny
247
Q

Acronyms for remembering microbe data?

A

PG- GRAN
Tanner- NG SOAP
Treponema- MANGS

248
Q

Non-surgical care for periodontal disease should be conducted how often?

IPAP (212 decks)

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