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Dental Public Health > DPH Handout - MI Dentistry > Flashcards

DPH Handout - MI Dentistry Flashcards

1
Q

(FDI) 5 underlying factors for minimal intervention in dental caries management

A
  1. modifying oral flora
  2. educating patients
  3. remineralizing non-cavitated lesions of enamel and dentin
  4. undertaking minimal operative intervention of cavitated lesions
  5. repairing defective restorations
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2
Q

MI dentistry definition

A

minimal intervention dentistry

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3
Q

2 sides of MI dentistry

A
  1. maximal interception of disease
  2. minimal invasion
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4
Q

earlier concepts of MI

A

“microdentistry”, “smaller cavity preparations”

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5
Q

(November 2009) definition of MI

A
  • philosophy for whole of life management of oral environment
  • comprehensive, personalized approach to diagnosis and management of oral disease and the factors which influence those diseases
  • means for empowering patient with knowledge and skills to reduce their ongoing burden of disease
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6
Q

ICDAS

A

International Caries Detection and Assessment System

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7
Q

the ‘D’ in ICDAS stands for

A

detection of dental caries according to:
1. stage of carious process
2. topography of lesion
3. anatomy
4. restoration or sealant status

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8
Q

ICDAS: topography of lesion

A

pit-and-fissure vs smooth surfaces

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9
Q

ICDAS: anatomy

A

crown vs roots

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10
Q

the ‘A’ in ICDAS stands for

A

assessment of caries process by:
1. stage
2. activity

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11
Q

ICDAS: stage

A

non-cavitated vs cavitated

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12
Q

ICDAS: activity

A

active vs arrested

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13
Q

ICDAS: 6 stages in the carious process

A

Code 0 = sound
Code 1 = first visual change in enamel
Code 2 = distinct visual change in enamel
Code 3 = localized enamel breakdown
Code 4 = underlying dark shadow from dentin
Code 5 = distinct cavity with visible dentin
Code 6 = extensive distinct cavity with visible dentin

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14
Q

ICDAS: Code 0

A

sound tooth

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15
Q

ICDAS: Code 1

A

first visual change in enamel (seen after prolonged air drying)

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16
Q

ICDAS: Code 2

A

distinct visual change in enamel

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17
Q

ICDAS: Code 3

A

localized enamel breakdown

18
Q

ICDAS: Code 4

A

underlying dark shadow from dentin

19
Q

ICDAS: Code 5

A

distinct cavity with visible dentin

20
Q

ICDAS: Code 6

A

extensive distinct cavity with visible dentin

21
Q

ICDAS: targets for modern remineralizing therapies

A

Code 1-3

22
Q

focus of minimal intervention dentistry philosophy

A
  • disease prevention
  • diagnosis at earliest timepoint
23
Q

levels of prevention: primary

A

prevent initiation of disease by addressing causal factors

24
Q

levels of prevention: secondary

A

find disease early and arrest its progression

25
Q

levels of prevention: tertiary

A

limit disability; repair diseased tissue and replace lost, missing or diseased tissue

26
Q

primary prevention: dental caries

A
  • mechanical plaque control
  • diet modification
  • lifestyle changes
  • systemic and topical fluorides
  • chlorhexidine
  • xylitol and sugar substitutes
  • sealants
  • pH elevation using bicarbonate
  • culture-based tests for cariogenic bacteria
27
Q

secondary prevention: dental caries

A
  • clinical examination for dental caries (blunt probes, magnification)
  • intra-oral cameras
  • bitewing radiographs
  • drying teeth to identify early carious lesions (ICDAS)
28
Q

tertiary prevention: dental caries

A
  • tooth restoration
  • atraumatic restorative technique, air abrasion, chemomechanical caries removal, lasers, ultrasonics, and micro-preparation burs
  • ozone
  • photo-activated disinfection
29
Q

primary prevention: dental erosion

A
  • dentally safe drinks
  • diet modification
  • lifestyle changes
  • fluoride
  • recaldent
30
Q

secondary prevention: dental erosion

A
  • clinical assessment of erosive tooth wear and sensitivity related to dental erosion
  • in-office and at-home application of remineralizing and desensitizing agents
31
Q

tertiary prevention: dental erosion

A
  • tooth restoration with conservative adhesive
  • intracoronal or extracoronal restorations
32
Q

sample methods for modifying dental plaque biofilm

A
  • Recaldent
  • xylitol
  • chlorhexidine
  • pH elevation using urea or bicarbonate
33
Q

enhancements to conventional radiography

A
  • automated image analysis
  • subtraction radiography
  • use of contrast media to enhance detection of proximal cavitations
34
Q

current & emerging technologies - primary prevention: dental caries

A
  • tooth surface protection
  • plaque fermentation tests
  • salivary tests for physico-chemical properties
  • salivary tests for cariogenic bacteria
  • Recaldent
  • light-activated fluoride
  • biofilm modification using ecological therapies
35
Q

current & emerging technologies - secondary prevention: dental caries

A
  • subtraction radiography
  • digital image analysis
  • contrast-enhanced radiography for proximal cavitations
  • light-induced fluorescence (QLF) assessment of surface mineral changes
  • laser fluorescence detection of incipient and occult occlusal and proximal lesions
  • fiber optical transillumination
  • optical coherence tomography
  • impedance detection of mineral loss
  • biologically active tooth coatings
  • internal remineraliation
  • lesion reversal using Recaldent
36
Q

current & emerging technologies - primary prevention: dental erosion

A
  • saliva testing
  • modification of erosive foods and drinks
  • therapeutic sugar-free chewing gums
  • light-activated fluoride treatments
  • surface-coatings of teeth to increase acid resistance using adhesive resin or laser deposited or laser-sintered technologies
37
Q

current & emerging technologies - secondary prevention: dental erosion

A
  • physical methods for assessing tooth wear and mineral loss at chairside (i.e. smart sensor coatings indicating mineral loss or gain)
  • light-induced fluorescence (QLF) assessment of surface mineral changes
  • rapidly acting desensitizing and remineralizing agents
  • sacrificial surface coatings for at risk tooth surfaces
38
Q

natural progression of proximal caries

A
  1. molar and premolar regions
  2. maxillary anterior teeth
  3. mandibular anterior teeth
39
Q

can be used to track mineral loss and mineral gain

A

light-induced fluorescence

40
Q

methods of digitally enhanced optical imaging

A
  • digitally enhanced fiber optical transillumination (DiFOTI)
  • optical coherence tomography (OCT)
41
Q

chemical conversion of apatities to fluoroapatites if fluoride is present at the same time as laser or other intense light is applied

A

photonic conversion

42
Q

combined with Recaldent in more recent developments for rapid reversal of white spot of lesions

A

fluoride

Dental Public Health (4 decks)

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