Dental review Flashcards
What initiates the breakdown of starch?
Salivary amylase
What breaks down triglycerides into fatty acids?
Lingual lipase
What structure is keratinized?
Hard palate
What structures are non-keratinized?
Soft palate
What is the crown of the tooth?
Visible region above the level of the gums
The neck of the tooth where cementum and enamel meet is called?
Cementumal Enamel Junction
What is the hardest substance in the body?
The enamel
The opening of the base of the root canal is called?
Apical Foramen
What passes through the apical foramen?
Blood vessels, lymphatic vessels and nerves
What is the ligament that attaches the cementum to the root?
Periodontal ligament
What is the alveolar process?
Tissue of the attachment apparatus which is the thickened ridge of bone that contains the tooth sockets (alveoli) on bones that hold teeth in the maxilla and mandible
What are the different types of teeth?
Incisors, canines, premolars, molars
What are the most posterior molars called?
Wisdom teeth
How many teeth do adults have?
32
The top of the mouth is called?
Maxillary arch
What is the only moveable skull bone?
Mandible
Which cranial nerve is most commonly dealt with for dental?
Trigeminal, CN V
Which anesthetic is used for dental anesthesia?
0.5% Bupivacaine/Marcaine
What is local infiltration?
Deposition of local anesthetic directly at or near a small terminal nerve ending in the immediate area of treatment
What is a regional block/tooth nerve block?
Deposition of local anesthetic near a major nerve trunk at a greater distance from the area of treatment which provides a wider area of anesthesia
When is an Inferior Alveolar (IA) block used?
- For anesthesia of entire hemi mandible
- For fracture repair, removal of teeth or pain control
What is the target site of IA block?
Lingula
Where do you place the barrel for IA blocks?
Commissure of mouth opposite to the injection site
What is concussion of a tooth?
Minor injury to the tooth supporting structures without abnormal loosening or displacement of the tooth
What is the treatment of concussion of a tooth?
No treatment required
What is subluxation of a tooth?
Traumatic injury that results in a tooth, to varying degrees, loose in the socket
What is the treatment of subluxation?
- Gentle manipulation into proper position
- Splint if necessary
What is tooth avulsion?
Traumatic injury where the tooth has been removed from the socket
How do you treat a tooth avulsion?
- Administer local anesthesia or regional intraoral block
- Reimplant tooth in socket or place tooth in Hank’s solution, milk, saline or saliva
A completely avulsed tooth maybe retained if placed in socket within what time frame?
30min - 1hour
What are the types of tooth fractures?
- only enamel
- expose dentin
- expose pulp
- include the root
Treatment of enamel fractures
- smooth edges
Sx of dental pulp fracture
Sensitivity to cold, air and water
Treatment of dental pulp fracture
- mild analgesic
- filling with crown
Treatment of mandibular fracture
Immobilize jaw with barton bandage
What is pulpitis?
Inflammation of dental pulp resulting from untreated caries, trauma or multiple restorations
Principle sx of pulpitis
Pain
Treatment of pulpitis
- remove decay
- restore damaged tooth, sometimes root canal
- extraction of tooth as last line of treatment
Sx of reversible pulpitis
Pain with cold or sweets, pain ceases within 1-2 seconds
Sx of irreversible pulpitis
Pain that lingers minutes after stimulus
Treatment of reversible pulpitis
Drill and fill
Treatment of irreversible pulpitis
Root canal then crown
Apical periodontitis and osteomyelitis can lead to?
Ludwig’s angina
What is periapical abscess?
Collection of pus at the apex of a tooth, usually caused by an infection that has spread from the apical foramen of a tooth with irreversible pulpitis to surrounding tissues
What is the sequelae of periapical perionditis?
Periapical abscess
What is a periodontal abscess?
Collection of pus that occurs alongside of a tooth
Abscesses may spread to where?
Cheeks
Treatment of abscesses
Drainage via I&D
What is gingivitis?
Inflammation of gingiva with swelling, redness, exudate and discomfort
What is the gingiva?
Firm, tightly adapted to the teeth, and contoured with pink stippled tissue
What is the most common cause of gingivitis?
Poor oral hygiene
Why does poor oral hygiene cause gingivitis?
Pockets of bacteria may cause gingivitis and root carries
Xerostomia may also play a role
What could chronic gingivitis evolve into?
Periodontitis
What is primary herpetic gingivostomatitis
Mild, self limiting, viral infection
Sx of primary herpetic gingivostomatitis
- fever, cervical lymphadenopathy, malaise
- numerous pin head vesicles which rupture and ulcer on the perioral skin
- severe painful gingivitis while eating
Treatment of primary herpetic gingivostomatitis
- self limiting, heals within 7-14 days
- acyclovir 200-800mg 5x per day
- magic mouth wash
Which part of magic mouth wash provides anesthetic relief?
2% viscous lidocaine
What is recurrent herpes simplex?
Mild, self limiting re-manifestation of herpes simplex
How is herpes simplex differentiated?
Intraoral herpes simplex and herpes labialis
What is herpes labialis commonly called?
“cold sores”“fever blisters”
Prodromal sx of intraoral herpes simplex
Pain, burning, tingling and itching where vesicles develop
Treatment of herpes simplex
- self limiting
- acyclovir 200-800mg 5x per day
Where is herpes labialis primarily found?
Vermillion border and/or commissure of lips
Treatment of herpes labialis
Topical AAA at first sign of prodrome or lesion
What is necrotizing ulcerative gingivitis?
Common, severe, non contagious bacterial infection of the gums with sudden onset
What is NUG commonly called?
” trench mouth” “vincent’s angina”
What causes NUG?
Opportunistic Fusobacteria and spirochetes as a result of immunosuppression
Dx of NUG
- punched out appearance with grey pseudo membrance
- foul breath
- rapid onset malaise or fever
Treatment of NUG
- magic mouthwash
- after 24-48 hours of improve, gentle debridge
What is oral candidiasis?
Opportunistic fungal overgrowth of the lining of the mouth
Dx of oral candidiasis
- white curdled milk or cottage cheese buildup
Treatment of oral candidiasis
Fluconazole 100mg x 7days
What is another name for oral candidiasis?
Thrush
What are aphthous ulcers?
Recurrent aphthous stomatitis or canker sores
Dx of aphthous ulcers
- prodrome burning or itching
- 1/4to 6mm round ulcerations with yellow-gray fibrinoid with erythemix halos
Treatment of aphthous ulcers
- self healing, 10-14 days
- topical corticosteroids
What is temporomandibular disorders?
Umbrella term for conditions producing dysfunction of the jaw joint or pain in the jaw and face
What can cause temporomandibular disorders?
Arthritis
What are some temporomandibular disorders?
- internal joint derangement
- infectious arthritis
- condylar hyperplasia
- condylar hypoplasia
Treatment of temporomandibular disorders?
NSAIDs, splint if necessary, refer to dental
What is geographic tongue?
Benign migratory glossitis from changing patterns on dorsum and edges of tongue
What does geographic tongue resemble?
Map, may migrate over time
Dx of geographic tongue
- usually on dorsal surface of tongue
- asymptomatic but associated with burning when eating spicy or acidic food
What is hairy tongue?
Dark, elongated filiform papillae stained with chromeogenic microorganisms giving the appearance of hair
What causes hairy tongue to be black
Smoking and coffee
Dx of hairy tongue
Black hairy appearance on dorsum of tongue
Treatment of hairy tongue
Good oral hygiene including scrubbing tongue
What is mucocele?
Mucus retention cyst
How does mucocele form?
As a result of ruptured or obstructed salivary gland
Where is mucocele commonly found?
Inner surface of lower lip
What are carries?
Cavities
What is the most common cause of dental pain?
Carries
Focal erythema, swelling and fluctuance with possible sinus tract suggests which condition?
Periapical/Periodontal abscess
Where does pericoronitis commonly occur?
3rd molar
What is the primary treatment of dental carries?
Drill n fill
For very deep cavities, how long may a temporary filling be left in place?
6-10weeks
What is the most common material for fillings and how long does it last?
Silver amalgam, lasts 14 years on average
If used with rubber dam, how long can an amalgam filling last?
Over 40 years
What happens to composite resins when it hardens?
Shrinks
What are glass ionomers?
Same aesthetic as composite but without shrinkage and slowly releases fluoride
Characteristics of Intermediate restorative materials
- contains eugenol to relieve pain
- easy to remove or re contour
- not good for rebuilding fractured teeth
Glass ionomer characteristics
- good for rebuilding teeth
- good for bonding splints
What is tempbond/dycal good for?
Temporarily re-bond prosthetic
What training should IDCs promote?
Oral hygiene
Dental class 2 characteristics
- routine treatment needs that can be delayed for 12 months
- world wide deployable
Is dental class 3 worldwide deployable?
Nope
What effects does tobacco have on the oral cavity?
Yellow intrinsic staining
Black/brown extrinsic teeth staining
Xerostomia or lack of saliva production which leads to higher carries
Vasoconstrictions which leads to gingival recession and eventual tooth loss
Throat, mouth and lip cancer
Which instruction is for Tobacco Cessation?
BUMEDINST 6200.12A
What is calculus?
Tartar, hardened form of dental plaque
How long does it take for calculus to form?
Little as 24 hours
What can excessive calculus cause?
Migrates subgingivally and assist in periodontitis
What can cause intrinsic staining?
Necrotic pulp, certain medications or high fever, long term smoking or coffee drinking
What can cause extrinsic staining?
Plaque and calculus from coffee, wine, tobacco and certain beans
What is halitosis?
Bad breath
What underlying medical conditions can cause halitosis?
Liver failure and ketoacidosis
How can halitosis be reverse?
Oral hygiene including flossing
