Dental Review Flashcards
What are included in the first line of defense in the digestion in the mouth?
Teeth
Salivary Amylase
Lingual lipase
What does salivary amylase breakdown?
Starch
What does lingual lipase breakdown?
Triglycerides into fatty acids
What areas of the mouth are non-keratinized?
Cheeks
Soft Palate
Floor of the mouth
What areas are covered by keratinized mucous membrane?
Hard palate
Dorsal Tongue
What is the visible region of the tooth above the gums?
Crown or coronal
What is region that contains the CEJ and encompasses the junction of the crown and root?
Neck or cervical
What does CEJ stand for?
Cementumal Enamel Junction
What is the region of the tooth that is embedded in the socket?
Root or radicular
What is the hard, white, outer tissue layer that covers the crown?
Enamel
The enamel primarily consists of what two materials?
Calcium phosphate and calcium carbonate
What is the tissue that form the majority of the tooth and gives shape and rigidity?
Dentin
What is the connective tissue that contains blood vessels, nerves and lymphatic vessels?
Pulp
What does the attachment apparatus consist of?
Cementum
Periodontal ligaments
Alveolar process
How many types of teeth are there?
4
What are the four types of teeth?
Incisors
Canines
Premolars
Molars
What teeth have a chisel-shape and are for cutting into food?
incisors
What teeth have a pointed surface and are used to shred and tear?
canine
What teeth have two cusps and are used for crushing and grinding?
premolars
What teeth are posterior, multiple cusps and roots, used for crushing and grinding?
Molars
What are the most posterior molars referred to as?
Wisdom teeth
How many teeth does an adult have?
32
Superior right most posterior molar is what number?
1
Top-left posterior molar is number?
16
The bottom left most posterior molar is numbered?
17
The bottom right most posterior molar is number?
32
What CN is contained in the maxilla and branches off?
CN V, trigeminal
What is the only moveable skull bone?
Mandible
What is an IA nerve block?
Inferior Alveolar
Mesial refers to what?
Towards the midline
Lingual means?
toward the tongue
Interproximal means?
in between
Occlusal means?
biting surface of molar and premolar
Incisal means?
biting surface of laterals and canines
What is the long lasting anesthetic preferred for medical evacuations?
0.5% Bupivacaine/ Marcaine
What is the half life of bupivacaine?
3.5h
What type of block would be near a major nerve trunk and provide a wider area of anesthesia?
Regional Block
What are indications for an Inferior Alveolar block?
Anesthesia of entire hemi-mandible
Fracture repair, removal of teeth and pain control
What can be performed to reduce the need or reliance of analgesics?
Anestheisa
What is the target for an inferior alveolar block?
lingula, a small bony bump about halfway back on the inner ramus of the mandible where the inferior alveolar nerve enters the jaw
When giving an IA block the barrel of the syringe should be located where?
in the commissure of the mouth opposite of the injection site over the bicuspid
The penetration depth of an IA injection is how far?
2-3 cm
What is a tooth concussion and treatment?
- minor injury to supporting structures without abnormal loosening or displacement
- usually no treatment require
What is subluxation of a tooth?
traumatic injury to loosens a tooth in the socket without displacement
Tooth subluxation should be treated how?
Gentle manipulation of the tooth into its proper position and splinted
Tooth avulsion is defined as what?
traumatic injury that removes tooth from the socket
Treatment of an avulsion is?
Rinse tooth with saline, do not scrub
administer nerve block and reimplant
If re-implantation of an avulsion tooth is unsuccessful store in what solutions?
isotonic media
- Hanks solution
- milk
- saline
- patients saliva
What should be done post initial care after a patient has suffered a tooth avulsion?
immediate consult to dental
A completely avulsed tooth may be retained if replaced in the socket within what time?
30 mins to 1 hour
A tooth fractures is defined as?
A portion of the tooth or bones has been cracked or separated from itself
An enamel fracture affects what area?
only the enamel is fractured
Treatment of an enamel fracture is what?
Smoothing edges
Dentin fractures are what and are identified how?
Fracture of the dentin, exposed w/o dental pulp
sensitivity to cold air and water
Treatment of a dentin fractures consist of what?
Mild analgesic
Restoration of the tooth with composite or amalgam filling
Referral to the dentist
A pulp fracture is considered urgent and identified how?
Bleeding from the tooth or mobile
Treatment involves what for a pulp fracture
root canal
Mandibular fractures treatment consists of what actions?
Immobilize jaw via Barton bandage and refer to dental
Pulpitis is defined as what?
inflammation of the dental pulp
What causes pulpitis?
untreated caries
trauma
multiple restorations
The principle symptom of pulpitis is what?
pain
Treatment of pulpitis includes?
Remove decay
restore damage tooth
Root canal (irreversible)
What are the pain stimulus for reversible pulpitis?
cold
sweets
pressure
Pain subsides within what time frame with reversible pulpitis?
1-2 seconds
Pain occurs how in irreversible pulpitis?
spontaneously
lingers for minutes after stimulus
exquisitely sensitive to pressure and percussion
What may cause pain to cease for multiple days in irreversible pulpitis?
pulpal necrosis
A periapical abscess that may elevate the tooth from it’s socket is also known as an?
apical abscess
infectious sequelae of pulpitis include what?
apical periodontitis
periapical abscess
cellulitis
osteomyelitis of the jaw
An infected molar at the floor of the mouth may cause what?
Ludwig’s angina
Treatment of reversible pulpitis is what?
caries removal and restoration
Irreversible pulpitis treatment consists of?
Root canal (crown post RC) extraction
This is known as an?
Abscess or gum boil
What is known as a collection of pus at the apex of a tooth and may affect surrounding tissues including the cheek?
Periapical abscess
Treatment of a periodontal abscess includes?
systemic pain relief
drainage
antibiotics
Treatment of a periapical abscess or apical abscess consists of what?
Systemic pain relief Drainage Antibiotics Refer to dental for: -Root canal -Extraction (last resort)
Gingivitis is described as what? How is it identified?
Inflammation of the gingiva (gums)
bleeding, swelling, redness and discomfort
The most common cause of gingivitis is what?
poor oral hygiene
Periodontal pockets contain bacteria that can cause?
gingivitis and root caries
What play a secondary role in gingivitis?
faulty dental restorations and xerostomia (lack of saliva)
Chronic gingivitis may evolve into what?
periodontitis
Primary herpetic gingivostomatitis is described as?
Common
mild
self-limiting
Viral infection of the mouth
Prodromal symptoms of primary herpetic gingivostomatitis are
fever
cervical lymphadenopathy
malaise
What may be seen with primary herpetic gingivostomatitis?
numerous pin-head vesicles which rupture and ulcer on the perioral skin, lips and oral mucosa
scabbing may present
What may be a complaint from the patient with primary herpetic gingivostomatitis?
severe and painful gingivitis with difficulty eating
What is the treatment for primary herpetic gingivostomatitis?
Usually self limiting, heal 7-14 days
Acyclovir 200-800mg x5/day for 7-14 days
Magic mouthwash
What is the anesthetic ingredient of magic mouthwash?
2% viscous lidocaine
Recurrent herpes simplex is defined as what? What may it also be known as?
common, self-limiting re-manifestation of of HSV
known as cold sores or fever blisters
what are prodromal symptoms of recurrent herpes simplex?
pain, burning, or tingling where vesicles develop
Treatment of intraoral herpes simplex includes?
Topical antiviral AAA
-5% Acyclovir cream
Necrotizing ulcerative gingivitis is described as what? What are other names for NUG?
common, severe, non-contagious bacterial infection of the gums with sudden onset
trench mouth or Vincent’s Angina
What is a main cause of NUG
immunosuppression
What is a presentation of NUG?
punched out appearance and a grey pseudo membrane over papilli
What is a treatment of NUG?
Gentle debridement
Oral candidiasis is defined as what? What is another term?
Opportunistic fungal overgrown of the lining of the mouth from yeast/fungus
Thrush
What is the treatment for thrush?
Fluconazole 100mg x 7 days
An aphthous ulcer is known as what?
canker sore
What will be seen on an exam with a patient with an aphthous ulcer?
burning or itching
1/4 to 6mm round yellow-grey ulcer surrounded by erythemic halo
Treatment of a canker consists of?
Self healing 10-14 days
Topical corticosteroid
Temporomandibular Dysfunction is an umbrella term used for
Issues with the jaw joint
What are some disorders that can be captured under temporomandibular dysfunctions?
internal joint derangement
infectious arthritis
condylar hyperplasia
Treatment of a temporomandibular dysfunction includes?
splinting, NSAIDs, referral to dental
Geographic tongue is formally known as?
benign migratory glossitis
How is geographic tongue described?
changing patters of hyperkeratosis and erythema on the dorsum and edges of the tongue
What symptoms may be seen with benign migratory glossitis?
burning when eating spicy or acidic foods
Hairy tongue can be identified by
dark, elongated filiform papillae that have been stained by chromeogenic microorganisms
Dental caries are also known as
cavities
Dental carries may form into?
Pulpitis
Pulpitis from dental caries would present as?
Focal erythema, swelling, with possible sinus tract
An abscess would be identified by
Visible fluctuant swelling
Fistula or sinus tract
Present with “high tooth” (periapical)
Pericoronitis from dental caries is treated by
operculectomy or extraction
Post operative bleeding from a tooth extraction should initially be treated with?
Direct pressure
Treatment of a dental caries is?
Refer to dental for drill and fill
The focus of any emergency dental exam should be
exam painful area
Temporary filling of a cavity may be left in place for?
6-10 weeks
What is the most common filling of occlusal surfaces of posterior teeth?
Silver amalgam
Silver amalgam lasts how long on average? If placed with a rubber dam?
14 years
>40 years
Composite resins that shrink when hardened also respond to what more than other filling materials?
heat and cold
What provides the same aesthetics as composites without shrinkage and slowly release fluoride into the tooth?
Glass ionomers
What materials resemble enamel?
porcelain or gold inlay or onlay
What does IRM stand for?
intermediate Restorative Material
What are some advantages of using IRM?
Contains eugenol to relieve pain
Easy to remove or re-contour
A responsibility of the IDC is to?
promote oral hygiene through training
What are some effects of tobacco on the oral cavity?
Yellow intrinsic teeth staining
Xerostomia (lack of saliva)
Vasoconstriction
Throat, mouth and lip cancer
What is a major factor leading to higher chance of dental caries?
Xerostomia or lack of saliva
What is the instruction for tobacco cessation?
BUMEDINST 6200.12A
Intrinsic staining can result from?
necrotic pulp
use of medications
high fevers while teeth are developing
Most halitosis can be reversed by what? What time frame?
Good oral hygiene
- flossing
- mouth rinse
- sugar-free gum
48hrs
If you have a patient with white sores, redness for 2 weeks and wont scrape off. Smoked 1 pack a day for last 20 years. Single white non-tender demarcation. Your treatment plan is to?
Refer
