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BDS3 Lawrence > Endo - Diagnosis > Flashcards

Endo - Diagnosis Flashcards

1
Q

What does SOCRATES stand for?

A 
Site 
Onset 
Character 
Radiate
Associated symptoms 
Time 
Exacerbating factors 
Severity
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2
Q

What question might you ask to gain more of an understanding of the site of the pain?

A

Where is the pain?

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3
Q

What question might you ask to gain more of an understanding of the Onset of the pain?

A

What were you doing when it started? was it spontaneous or not?

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4
Q

What question might you ask to gain more of an understanding of the character of the pain?

A

What does the pain feel like? Sharp? dull?

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5
Q

What question might you ask to gain more of an understanding of how the pain Radiates?

A

Do you feel it anywhere else?

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6
Q

What question might you ask to gain more of an understanding of the Associated symptoms of the pain?

A

Do you have a fever/ feel nauseous or vomit?

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7
Q

What question might you ask to gain more of an understanding of the Time/duration of the pain?

A

How long does the pain last?

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8
Q

What question might you ask to gain more of an understanding of the Exacerbating factors of the pain?

A

Does anything make it worse?

Postural changes etc?

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9
Q

What question might you ask to gain more of an understanding of the severity of the pain?

A

Create and establish a pain scale

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10
Q

What is the scientific name for a toothache?

A 
Odontogenic pain (tooth pain)
non-odontogenic pain (from the gingivae)
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11
Q

What type of fibres gives sharp shooting pain?

A

A-delta fibres

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12
Q

What type of fibre gives dull, aching and burning pain?

A

C fibres

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13
Q

Which fibres are responsible for referred pain and where does it usually rate to?

A

C fibres as the radiating pain is dull and achy.

Radiates to the ipsilateral side. (same side)

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14
Q

What is involved in a full endodontic examination?

A 
after the C/O, HPC, PMH, PDH, SH
E/O
I/O
Soft tissues and intraoral swellings 
Sinus tracts 
Palpation 
Percussion (TTP)
Mobility 
Periodontal exam BPE
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15
Q

What type of fibres is an EPT testing?

A

A-delta fibres

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16
Q

How would you carry out an EPT?

A

Dry the tooth and isolate.
Test on a healthy tooth first for a baseline feeling.
Then place toothpaste on the tooth and place the wand on the tooth. Ask the patient to hold (completing the circuit).
Slowing increase power till response and then repeat for adjacent teeth.

17
Q

What results are reliable for an EPT?

A

Negative results are a good indication of dead pulp.

18
Q

When is EPT not reliable?

A

In open apex teeth

In telling if the pulp condition is irreversible or reversible

19
Q

What is good about sinus tract-tracing?

A

Common in chronic apical abscesses and allow you to tract straight to the source of infection.

20
Q

Describe how you would identify a normal pulp?

A

The pulp would be symptom-free
Have no apical pathology or radiolucency
Responses to sensibility tests

21
Q

Describe reversible pulpitis?

A

There is inflammation of the pulp but it should resolve after appropriate management.

22
Q

What are some possible causes of the symptoms of reversible pulpitis?

A

Dentine hypersensitivity mimics the symptoms
Caries
Large restorations

23
Q

If a patient came to you, in practice with reversible pulpitis, how would they describe their symptoms?

A

They would describe to you, pain/sensitivity upon the stimulus of cold or hot drinks.
That pain then wouldn’t last long after

24
Q

What is symptomatic irreversible pulpitis?

A

This is inflammation of the pulp that cannot be fixed and RCT is needed to prevent spread.

25
Q

If a patient came to you, in practice with irreversible pulpitis, how would they describe their symptoms?

A

They would have SPAWNTANEOUS PAIN
Upon stimulus, the sharp pain would last a lot longer (linger for 30s or more)
OTC analgesia wouldn’t help
Postural changes would make it worse and referred pain is also indicated.

26
Q

What are some common aetiologies of irreversible pulpitis

A

Deep caries
large restorations
Pulpal exposures
Root fractures

27
Q

What are the two main clinical ways of diagnosing pulpal issues?

A

Dental history
Thermal tests
As inflammation hasn’t quite reached the apical tissues, therefore, there is no TTP.

28
Q

For asymptomatic irreversible pulpitis, how do you diagnose?

A

As the pulp responds normally to tests and doesn’t display any clinical symptoms this can be difficult. However, the tooth usually has large amounts of caries or a deep restoration which if removed would result in a pulpal exposure.

29
Q

What is pulpal necrosis closely associated with?

A

Apical periodontitis

30
Q

What is are the symptoms of pulpal necrosis?

A

As the pulp is now dead it doesn’t respond to thermal or EPT tests.
As it comes with apical periodontitis, this means its TTP and has radiolucency in the apical region (osseous breakdown)

31
Q

Diagnosis of normal apical tissues?

A

Healthy bone levels all the apices.
Lamina dura intact
No TTP
No radiolucency

32
Q

Symptoms of Symptomatic apical periodontitis?

A

Inflammation has spread to the apical region of the tooth.
SEVERE pain to TTP, biting and palpation
May or may not be associated with radiographic changes (depending on the stage of disease)

33
Q

Symptoms of Asymptomatic apical periodontitis?

A

Inflammation of the apical tissues but is not TTP or palpation
However, can see radiographic changes.

34
Q

Describe how a chronic apical abscess presents?

A

It has a gradual onset
Little to no discomfort with an intermittent discharge of pus through a sinus tract
Radiographic signs of osseous destruction

35
Q

What is a chronic apical abscess a result of?

A

Pulpal necrosis

36
Q

If a patient came into your practice with a swelling containing pus on the gum, extreme tenderness to palpation and percussion. As well as radiographic changes.
What would be your initial diagnosis?

A

acute apical abscess

They have rapid onset and are also spontaneous to pain

37
Q

What are some other systemic symptoms associated with an acute apical abscess?

A

Fever
Malaise
Lymphadenopathy

38
Q

What in condensing osteitis?

A

Inflammation causes the deposition of bone at the apices as a result of infection.
Most common on pre-molars

39
Q

What are the treatment options for endodontic cases?

A 
RCT 
Re-RCT
Ex 
leave and monitor 
Surgical intervention

BDS3 Lawrence (39 decks)

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