Dental Disease in Primary Care Lecture Powerpoint Flashcards
Dentition through the life cycle
- 2 sets of teeth
- 20 deciduous teeth 6 month to 2 years
- shed between ages 6-12
- replaced with 32 permanent teeth
Crown of tooth
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
Root of tooth
Portion of tooth under gums extending into the bone
Dentin
Calcified part of tooth surrounding pulp but underneath enamel extending thru the root and is capable of regenerating unlike the enamel
Cementum
Thin covering of calcified tissue that covers the tooth root and anchors it to alveolar bone
Pulp
Soft tissue in the center of tooth, contains neurovascular structures of tooth
Gingiva
Tissue that surrounds neck of tooth and covers the alveolar bone
Gingival sulcus
Small space between tooth and the gum
Periodontal ligament
Attaches tooth to the alveolar bone
Alveolar bone
Bony tissue of the maxilla and mandible that support the teeth
Strong association between gingivitis, peridontitis, and dental caries exists with…
….coronary and cerebrovascular disease (bacteria get access into the blood stream from poor dentition
Dental caries
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
Most common presentation with dental caries
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)
Dental caries treatment options (2)
- amoxicillin if infection
- NSAIDS
Dental caries prevention (3)
- Fluoride
- limit fruit juice
- annual dentist visit
Dental caries complications (1 common and 3 rare)
- tooth loss
- osteomyelitis
- dental abscess
- infeection of face
Periodontal disease 3 subtypes
1) gingivitis
2) periodontitis
3) periodontal abscess
Gingivitis
Gingival inflammation often when microorganisms penetrate the perriodontum - see bleeding of gums with minor trauma, halitosis, reddened gums, and presence of plaque, often painless***
Periodontitis
Gingival inflammation (chronic gingivitis) + loss of supportive connective tissue, see looseness of tooth
Periodontal abscess
Untreated periodontitis with red fluctuant swelling gingiva and pus formation (will often lose the tooth)
Predisposing factors of gingivitis (4)
- Poor oral hygiene
- certain drugs that decrease salivation
- phenytoin (gingival hyperplasia)
- Vit C deficiencyV
Vincent’s angina (trench mouth)
Polymicrobial opportunistic infection from poor oral care, painful bleeding gingiva, fever, etc
Vincent’s angina (trench mouth) treatment (1)
-PCN + metronidazole
Periodontal abscess treatment (3)
- I&D
- extraction of the tooth
- antibiotics only if systemic signs
Ludwig’s angina treatment options (2)
- Airway management
- admission and antibiotics
Ludwig’s angina diagnostic study of choice (1)
-CT scan
Temporomandibular myofascial pain dysfunction syndrome (TMJ) causes, diagnosis, treatment (3)
- 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
Best imaging study for mandibular fractures
Panorex
How to differentiate between oral thrush and leukoplakia
Oral thrush can be removed manually and has red spot underneath, leukoplakia cannot
Familial Adenomatous polyposis (FAP) (what study is required immediately upon diagnosis)
Growth of multiple torus (slow growing bone on palate or mandible) that require immediate colonoscopy as cancer will develop
Most common risk factor for leukoplakia
Tobacco use
Erythroplakia
Red flat worn away area with possible erosion, more ominous sign of oral squamous cell carcinoma
Squamous cell carcinoma of the mouth treatment and prognosis
Treated with primary surgery, good chance of 5 year survival but need careful followup
Most significant risk factor for HPV leading to oral cancer is ___, HPV serotype ___ is the most common type to cause oral cancer
Oral intercourse, 16