Dental Disease in Primary Care Lecture Powerpoint

Question 1

Dentition through the life cycle

Answer 1

• 2 sets of teeth
• 20 deciduous teeth 6 month to 2 years
• shed between ages 6-12
• replaced with 32 permanent teeth

Question 2

Crown of tooth

Answer 2

Portion of tooth exposed to oral cavity, covered in enamel which is the hard white substance covering it acting as the hardest material in the body

Question 3

Root of tooth

Answer 3

Portion of tooth under gums extending into the bone

Question 4

Dentin

Answer 4

Calcified part of tooth surrounding pulp but underneath enamel extending thru the root and is capable of regenerating unlike the enamel

Question 5

Cementum

Answer 5

Thin covering of calcified tissue that covers the tooth root and anchors it to alveolar bone

Question 6

Pulp

Answer 6

Soft tissue in the center of tooth, contains neurovascular structures of tooth

Question 7

Gingiva

Answer 7

Tissue that surrounds neck of tooth and covers the alveolar bone

Question 8

Gingival sulcus

Answer 8

Small space between tooth and the gum

Question 9

Periodontal ligament

Answer 9

Attaches tooth to the alveolar bone

Question 10

Alveolar bone

Answer 10

Bony tissue of the maxilla and mandible that support the teeth

Question 11

Strong association between gingivitis, peridontitis, and dental caries exists with…

Answer 11

….coronary and cerebrovascular disease (bacteria get access into the blood stream from poor dentition

Question 12

Dental caries

Answer 12

Most common disease nation wide involving multifactoral components such as hygiene, diet, and genetics essentially with local destruction from microorganisms forming plaque, destroying enamel, and colonizing the surface of the tooth causing decay

Question 13

Most common presentation with dental caries

Answer 13

Initially asymptomatic (if treated early then reversible) but most commonly pain (sometimes upon percussion of the teeth with tongue blade), obvious decay (yellow or brown coloration)

Question 14

Dental caries treatment options (2)

Answer 14

• amoxicillin if infection

- NSAIDS

Question 15

Dental caries prevention (3)

Answer 15

• Fluoride
• limit fruit juice
• annual dentist visit

Question 16

Dental caries complications (1 common and 3 rare)

Answer 16

• tooth loss
• osteomyelitis
• dental abscess
• infeection of face

Question 17

Periodontal disease 3 subtypes

Answer 17

1) gingivitis
2) periodontitis
3) periodontal abscess

Question 18

Gingivitis

Answer 18

Gingival inflammation often when microorganisms penetrate the perriodontum - see bleeding of gums with minor trauma, halitosis, reddened gums, and presence of plaque, often painless***

Question 19

Periodontitis

Answer 19

Gingival inflammation (chronic gingivitis) + loss of supportive connective tissue, see looseness of tooth

Question 20

Periodontal abscess

Answer 20

Untreated periodontitis with red fluctuant swelling gingiva and pus formation (will often lose the tooth)

Question 21

Predisposing factors of gingivitis (4)

Answer 21

• Poor oral hygiene
• certain drugs that decrease salivation
• phenytoin (gingival hyperplasia)
• Vit C deficiencyV

Question 22

Vincent’s angina (trench mouth)

Answer 22

Polymicrobial opportunistic infection from poor oral care, painful bleeding gingiva, fever, etc

Question 23

Vincent’s angina (trench mouth) treatment (1)

Answer 23

-PCN + metronidazole

Question 24

Periodontal abscess treatment (3)

Answer 24

• I&D
• extraction of the tooth
• antibiotics only if systemic signs

Question 25

Ludwig’s angina treatment options (2)

Answer 25

• Airway management

- admission and antibiotics

Question 26

Ludwig’s angina diagnostic study of choice (1)

Answer 26

-CT scan

Question 27

Temporomandibular myofascial pain dysfunction syndrome (TMJ) causes, diagnosis, treatment (3)

Answer 27

• Occlusal problems and teeth grinding (bruxism)
• usually unilateral and pain is dull and worsens as day progresses, diagnosis based on history
• treated with heat, bite appliances, or muscle relaxants

Question 28

Best imaging study for mandibular fractures

Answer 28

Panorex

Question 29

How to differentiate between oral thrush and leukoplakia

Answer 29

Oral thrush can be removed manually and has red spot underneath, leukoplakia cannot

Question 30

Familial Adenomatous polyposis (FAP) (what study is required immediately upon diagnosis)

Answer 30

Growth of multiple torus (slow growing bone on palate or mandible) that require immediate colonoscopy as cancer will develop

Question 31

Most common risk factor for leukoplakia

Answer 31

Tobacco use

Question 32

Erythroplakia

Answer 32

Red flat worn away area with possible erosion, more ominous sign of oral squamous cell carcinoma

Question 33

Squamous cell carcinoma of the mouth treatment and prognosis

Answer 33

Treated with primary surgery, good chance of 5 year survival but need careful followup

Question 34

Most significant risk factor for HPV leading to oral cancer is ___, HPV serotype ___ is the most common type to cause oral cancer

Answer 34

Oral intercourse, 16