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2nd year > Dental Disease-Caries > Flashcards

Dental Disease-Caries Flashcards

1
Q

What are the 7 elements to caries risk assessment?

A
  1. Clinical Evidence
  2. Dietary habits
  3. Fluroide use
  4. Plaque control
  5. Social history
  6. Saliva
  7. Medical history.

Every Dentist Fears People Selling Sugar mice.

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2
Q

What clinical evidence are we looking for in caries risk assessment?

A

We use the dmft (decayed, missing or filled teeth) >5

caries in the 6s of a 6 year old= high risk

3 carious lesions in 3 years= high risk

Fresh or undiagnosed decay.

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3
Q

What dietary habits are we looking for in caries risk assessment?

A

>3 sugar intakes a day (as frequency is worse than volume)

The composition of the diet (Worrying if patient is eating lots of highly processed carbohydrates)

Giving a baby milk before bed (natural sugars still cause harm)

Toothbrushing habit should be no less than 20 minutes after eating.

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4
Q

What social history are we looking for in caries risk assessment?

A

Their SIMD category

Education?

Employment?

Work stresses

Are they in single parent family?

How many dependents do they have (less dependents are normally better off )

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5
Q

What fluoride use are we looking for in caries risk assessment?

A

Are they brushing their teeth twice a day?

Are they using fluoride toothpaste?

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6
Q

What Plaque control are we looking for in caries risk assessment?

A

Does the patient struggle brushing their teeth properly?
Does the patient brush irregularily?
Is the patient unassisted but require help brushing?

Does the patient have access to a toothbrush and toothpaste?

Are there changes in the patient’s mouth (gaps) that are causing brushing difficulties.

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7
Q

What saliva factors are we looking for in caries risk assessment?

A

Does the patient produce a low volume of saliva

Does the patient have a reduced salival flow

Is the pH of the patient’s saliva suitable for buffering?

Is the patient’s saliva too thick?

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8
Q

What Medical history elements are we looking for in caries risk assessment?

A

Is the patient using drugs that cause xerostomia?

Frequency of sugar medication? as this will increase to >3 sugar hits a day.

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9
Q

What are the 8 elements of caries prevention?

A
  1. Radiographs
  2. Toothbrush instruction
  3. Strength of F- in toothpaste
  4. F- varnish application
  5. F- supplement (e.g. mouthwash)
  6. Diet advice
  7. Fissure sealants
  8. Using sugar free medication.
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10
Q

What is a white spot lesion?

A

This is an enamel lesion and is caused by demineralisation causing a loss in the transparency of enamel . This makes it more white.

However, the surface of enamel stays intact.

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11
Q

Why do we not probe a white spot lesion?

A

The subsurface is less mineralised than the surface of enamel.

This mineral loss means that putting pressure on the deeper areas using a probe could fracture it.

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12
Q

describe the process of enamel demineralisation and cavitation

A
  1. Demineralisation produces the white spot lesion
  2. Dentine starts to demineralise (sclerosis of dentine occurs)
  3. Further development of the white spot lesion causes the production of tertiary dentine.
  4. Cavitation occurs
  5. cavity allows bacteria into the dentine.
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13
Q

Compare lesion A and Lesion B

A

Left- This is an active lesion-

Because the white spot is at the gingival margin where plaque builds up. (red swollen gums)

Right- This is inactive lesion

Because the white spot lesion has moved away from the gingival margin (there is no plaque build up)

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14
Q

Describe these histological images of enamel?

A

In image 1- This is a white spot lesion and you can see the gaps where the crystalites get thin.

In image 2, the enamel is re-mineralised and the surface becomes smooth again.

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15
Q

What is mature plaque?

A

When the organic structure of plaque has matured enough to block the function of the salivary buffer.

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16
Q

describe this image?

A

The white spot is surrounding the pit.

The plaque build up here makes it more difficult for the salivary buffer to reach.

As the plaque recieves sugar it produces acid causing a high cocentration of acid in the pit.

This high concentration re-organises the crystalites. (enamel)

17
Q

Discuss this image?

A

There is a cavity:

  • There are opaque parts of the enamel
  • There is a dark grey shadow under the enamel (green) this means the dentine has been compromised.
18
Q

Why does dentinal caries spread quickly?

A

It spreads quickly as the dentinal tubules branch at the ADJ providing a quick spread.

19
Q

What is tubular sclerosis?

A

This is the defensive response of dentine to caries.

It is when mineral is deposited in the dental tubules (called sclerotic dentine or the transparent zone)

20
Q

Is this root caries active or inactive?

A

This root has a soft surface and looks wet, This means there is active caries.

21
Q

What is shown in this radiograph?

A

This is not caries, as caries is found at the contract points and this dark area is below the contact point.

22
Q

Compare the location of adult absesses to children’s absesses.

A

Adult absesses are found at the apex of the tooth.

Children’s absesses are found at the pulp chamber.

23
Q

What is nursing caries?

A

This is early childhood caries.

It typically affects the upper anteriors and molars.

This is caused by inappropriate use of feeding cups and bottles.

24
Q

How do we assess if the toothpaste swallowed by a child is toxic?

A

We need to know:

The weight of the child

How much toothpaste they have ingested

The strength of the toothpaste they have swallowed?

25
Q

What is a toxic dose of fluoride?

A

5mg/kg

26
Q

What do we give to help if a patient is at risk of fluroide toxicity and why?

A

We advise giving the child milk.

As the calcium will bind with the Fluoride reducing the dose in the child’s system.

27
Q

Compare health education and health promotion

A

Health education increases the knowledge of people related to health

Health promotion is to help people develop habits.

28
Q

How do we diagnose caries by tooth illumination?

A

You illuminate the teeth and look for the shadow of caries in dentine.

29
Q

How do we measure caries?

A

The DMF- Decayed missing or filled teeth

ICDAS- Looking at enamel level decay and dentinal level decay.

30
Q

What is D1 caries?

A

D1 caries is enamel lesions with intact tooth surfaces.

31
Q

What is D2 caries?

A

D2 caries is caries causing enamel cavitation

32
Q

What is D3 caries?

A

D3 caries is clinically detectable lesions in the dentine and into the pulp.

33
Q

How can you classify caries by the cavitation?

A

If caries has been cavitated it will not fix itself so will need a restoration.

If enamel is not cavitated the tooth should be able to remineralise.

34
Q

How do we identify and classify the caries by its activity?

A

If the caries is active the tooth is demineralising and Active caries is brown.

If the caries is inactive, The tooth is remineralising. Inactive caries is black.

35
Q

What is an arrested carious lesion?

A

This is re-mineralised decay.

If you make a lesion cleansable by the patient then they can re-mineralise it.

36
Q

Compare sensitivity to selectivity

A

Sensitivity is the percentage of disease found correctly, S for sickness

Selectivity is the percentage of health found correctly.

37
Q

What are the most important examination tools?

A

Dry teeth and good light.

38
Q

Give advice for taking radiographs to identify caries.

A

You need to use a bitewing

Caries is shown as darker areas as there is less mineral so more of the xray gets through.

39
Q

Compare accuracy to precision

A

Accuracy is how good you are at identifying the decay

Precision is are you measuring all the decay the same “s’ for the same

2nd year (63 decks)

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