EXAM I Acquired Tooth Disease Flashcards
___ is the most common reason a child misses school
a toothache
what is the caries prevalence of children under 4 in the US?
38-49%
children under what age with dental caries often go untreated?
3 years old
___ is caused by gastric acid and acid regurgitations due to medical or psychological issues (acid reflux, anorexia, bulimia)
intrinsic erosion
___ occurs when dietary acids (sugar, diet sodas, fruit drinks, etc.) contribute to the mouth’s being in a very acidic state
extrinsic erosion
tooth enamel begins to demineralize at pH levels below ___; soda has an average pH of ___
- 5.5
- 2.5
how many grams are in a teaspoon?
4
if there are 38 grams of sugar in a 12oz can of soda, how many teaspoons is that?
there are 4g in a teaspoon
38g divided by 4g/tsp = 9.5tsp of sugar in a 12oz can of soda
when enamel wears down, what can occur?
- teeth become discolored
- edges of front teeth may look transparent
- sensitivity
- restorations fall out
what is the most common cause of root resorption of permanent teeth? what are 3 other causes?
- orthodontics is the most common cause
- trauma
- ectopic teeth erupting in the path of the root
- chronic inflammation
what type of root resorption is described as the crown of one tooth coming close to or in contact with the root of another tooth, causing resorption?
ectopic root resorption
___ is an unusual condition where the dentin and pulpal walls begin to resorb centrally within the root canal
internal root resorption
what are some possible causes of internal root resorption?
trauma, but often there is no known etiology
can also be the result of materials and methods used in pulpotomies in primary teeth (don’t use a fill with a calcium hydroxide base)
how is trauma of primary teeth different from that of permanent teeth?
primary teeth tend to move within bone as opposed to fracturing, because the bone structure surrounding primary teeth isn’t as thick and dense as around permanent teeth, which tend to fracture
___ is a chemical bacterial and mechanical irritation but usually due to bacterial invasion from death of pulp tissue
acute alveolar abscess
what are some signs and symptoms of acute alveolar abscess?
- tenderness of the tooth
- throbbing severe pain with swelling of the overlying soft tissue
- if the swelling becomes extensive, it can result in cellulitis which can change the patient’s facial appearance
___ is a diffuse infection of the soft tissues that occurs more frequently in younger children
cellulitis
in terms of its relationship with dentistry, what is cellulitis caused by?
primary or permanent pulpal necrosis
___ is characterized by considerable swelling of the face or neck due to collateral edema and a spreading fascial infection
cellulitis
children with cellulitis appear acutely ill, and may have a high fever with ___ and ___
- malaise
- lethargy
___ is due to a long standing, low grade infection of the periradicular bone
chronic alveolar abscess
what are the signs and symptoms of chronic alveolar abscess?
generally, there are no outward signs and symptoms with chronic alveolar abscess; the child doesn’t complain of pain
there may be a discharge from sinus opening
in the early stage of gingivitis, bacteria in ___ build up, causing the gingiva to become inflamed and easily bleed during tooth brushing
plaque
how are the teeth affected in gingivitis in terms of mobility? what irreversible damage occurs in gingivitis?
- teeth are still firmly planted in their sockets
- no irreversible bone or other tissue damage has occurred as this stage
___ is a chronic inflammatory disease that destroys bone and gingival tissues that support the teeth
periodontal disease
___ affects nearly 75% of americans and is the major cause of adult tooth loss
periodontal disease
what type of lesions are described as follows:
firm, nontender, fixed to the surface, rough or cauliflower surface; overlying mucosa is normal unless traumatized, usually well-circumscribed, asymptomatic, slow-growing
benign lesions (benign epithelial tumors)
what are some examples of benign lesions?
- papilloma
- verruca vulgaris
- fibroma
- irritation fibroma
- epulis fissuratum
___ and ___ make up >50% of all childhood cancers
leukemias and brain cancers
leukemias make up approximately what fraction of all childhood cancers? what is the most common type in children?
- 1/3
- acute lymphoblastic leukemia
___ are the most common solid type tumors
brain tumors
what are the two types of brain tumors?
gliomas and medulloblastomas
what are some less common solid tumors (other than brain tumors)?
- neuroblastomas
- wilms tumor
- sarcomas
- rhabdomyosarcomas
- osteosarcoma
___ are a developmental anomoly of teeth, and are composed of mature enamel, dentin, and pulp tissue; because of their slow growth and well-differentiation, theya re generally considered to represent hamartomas rather than true neoplasms
odontomas
___ are the most common odontogenic tumors
odontomas
what are the two types of odontomas?
compound and complex
which type of odontoma is a collection of small radiopaque masses, some or all may look like teeth (denticles); occur most frequently in the anterior region of the maxilla and usually associated with the crown of an unerupted canine; usually asymptomatic and discovered during routine radiograph exam when there is a delayed eruption of permanent tooth
compound odontoma
which type of odontoma is composed of hapharzadly arranged dental hard and soft tissue; no resemblence of a normal tooth; tends to occur in the posterior region of the mandible; there might be a missing tooth if it arises from a normal tooth follicle
complex odontoma
what is the treatment of odontomas?
- simple local excision
- excellent prognosis
- they don’t recur and are not invasive
what is the difference between gemination, fusion, and concrescence?
- gemination - attempted division of a single tooth germ, appears as a bifid crown on a single root
- fusion - represents the union of two independently developing primary or permanent teeth
- concrescence - fusion of teeth involving only the cementum
what is dens invaginatus?
tooth within a tooth (dens in dente)
what is the treatment of dens invaginatus?
common presentation is pulp necrosis and dental abscess
cover with sealant or restoration
what are the dental-related problems associated with cherubism?
- primary teeth may exfoliate early due to loss of alveolar bone support or resorption
- permanent teeth are usually ectopic being displaced by the growing lesion
what are the 3 stages of amelogenesis?
- enamel matrix is secreted by ameloblasts
- tooth undergoes calcification
- enamel maturation, with crystal growth and removal of water and protein, continues until eruption
what nutritional deficiencies are associated with hypoplasia?
- deficiencies in vit A, C, and D, calcium, and phosphorus
what are some possible causes of molar-incisor hypomineralization?
asthma, pneumonia, upper respiratory tract infections, otitis media, antibiotics (amox), dioxins in mothers milk, tonsillitis, exanthematous fevers of childhood
when considering the development of dental fluorosis, what is the critical time when central and lateral incisors and first molars are calcifying?
between birth to 4-5 years of age
___ are defects on the crowns of developing permanent teeth that are evident radiographically, even though no infection of the primary tooth or surrounding area is present
pre-eruptive “caries”
how are pre-eruptive “caries” treated?
- often resembles caries when it is observed clinically, and the destructive lesion progresses if it is not restored
- as soon as the lesion is reasonably accessible, it should be restored
___ is characterized by a tendency for the body of the tooth to enlarge at the expense of the roots; the pulp chamber is elongated and extends deeply into the region of the roots
taurodontism
the clinical significance of taurodontism becomes apparent only if ___ or ___ is necessary
vital pulp therapy or root canal therapy
the following is the clinical appearance of what inherited defect of dentin?
the teeth have a variable blue-gray to yellow-brown discoloration due to defective, abnormally colored dentin shining through the transclucent enamel; enamel frequently fractures; difficult to treat
dentinogenesis imperfecta
which dentinogenesis imperfecta type is characterized by the following:
- dentin defect along with osteogenesis imperfecta
- primary dentition more severely affected than permanent
- great variability within a family
- fragile bones, blue sclera, pre-senile deafness, macrocephaly, triangular skull
- postnatal growth deficiency
- roots are thin and tapered-pulp canal ribbon like
type I
which dentinogenesis imperfecta type is characterized by the following:
- one of the most common inherited defects (AD) in man - 1:8,000
- involves both dentitions equally, correlation of severity, color, and attrition high within a family
- treatment is complicated by the lack of proper root structures for support of crowns and fixed appliances
- implants are possible since the facial bones are not involved in this type
type II
which dentinogenesis imperfecta type is characterized by the following:
- brandywine type - AD inheritence
- opalescent color of the teeth
- both dentitions are involved
- bell shaped appearance of teeth
- shell tooth appearance on xray - hollow appearanceI
type III
which type of dentin dysplasia is radicular dentin dysplasia?
- AD trait
- primary and permanent teeth affected
- root canal and pulp chambers are absent except for chevron-shaped remnant of the crown
- color is either normal or slightly opalescent or blue-brown
type I
which type of dentin dysplasia is coronal dentin dysplasia?
- AD trait
- primary dentition appears opalescent with obliterated pulp chambers
- permanent dentition has normal color with thistle-tube pulp configuration with pulp stones
type II
___ is a developmental defect with a heterogenous etiology that affects the enamel of both primary and permanent teeth; has 4 broad types
amelogenesis imperfecta
___ type of amelogenesis imperfecta is the most common type, 60% have open bite, soft enamel with normal thickness, pitted surface, moth eaten appearance
hypocalcified type
___ type of amelogenesis imperfecta has hard thin enamel, small teeth, occasionally tapered, possible systemic causes associated with many different syndrome, sometimes from infections, trauma, primary over-retention, fluorosis, cerebral palsy, sturge weber syndrome
hypoplastic type
___ type of amelogenesis imperfecta has normal enamel thickness but with low radiodensity and quite soft, fractures and flakes away, brown color due to porous surface, snow capped teeth, radiographically hard to tell enamel from dentin
hypomaturation type
what are the most common teeth to be missing in hypodontia?
maxillary lateral incisors and mandibular second premolars
what syndromes are associated with oligodontia (more than 6 teeth missing)?
ectodermal dysplasia and down syndrome
of unerupted canines, ___% will be impacted, and ___% will be displaced bucally
- 85%
- 15%
ectodermal dysplasia commonly affects what 4 tissues, and how are they affected?
- hair - tricodysplasia
- teeth - hypodontia
- nails - onchodysplasia
- sweat glands/skin - dyshidrosis
the following are characteristics of what disorder?
- multiple missing teeth, most common oral finding
- all teeth may be missing
- conical and peg shaped teeth, especially canines and incisors
- lack of development of the alveolar process
ectodermal dysplasia
what are the permanent teeth most commonly missing in ectodermal dysplasia?
mandibular incisors and premolars, and maxillary premolars
what are the permanent teeth most commonly present in ectodermal dysplasia?
maxillary central incisors and canines, all molars
in ectodermal dysplasia, how many teeth are commonly present? and which arch typically has more teeth?
- 4-14 teeth present
- more in the maxilla
the following are factors that can cause what in teeth?
- blood-borne pigment
- blood decomposition within the pulp often caused by trauma or drugs used during procedures
- ZOE and composite
intrinsic discoloration of teeth
what does hyperbilirubinemia do to teeth?
it can cause intrinsic staining
___ is a result of transplacental passage of maternal antibodies against red blood cell antigens of the infant, which leads to increased rate of RBC destruction. the fetus develops anemia witha resultant increase in the bilirubin content of the amniotic fluid
erythroblastosis fetalis
what do primary teeth look like in patients affected by erythroblastosis fetalis?
they may have a blue-green or brown stain, which may fade with time
___ is a rare liver disease which allows bilirubin to build up in blood, causing a staining of teeth
biliary atresia
___ is an inherited, chronic, multisystem, life-shortening disorder characterized primarily by poor digestion and obstruction and infection of the airways
cystic fibrosis
what is tooth discoloration in cystic fibrosis patients a result of?
either the disease alone or therapeutic agents (like tetracycline), or a combination of both
what medication is deposited in the dentin, and to a lesser extent in enamel, of teeth that are calcifying during the time the drug is administered?
tetracycline
what color does tetracycline stain developing teeth?
brown/gray/black
what are some causes of macroglossia?
- hypothyroidism
- down syndrome
- allergic reaction
- injury
what two conditions is fissured tongue commonly seen in?
down syndrome and hypothyroidism
what is the most common tongue lesion?
geographic tongue (benign migratory glossitis)
in geographic tongue, the smooth, red areas that appear on the dorsum of the tongue are devoid ___
filiform papilla
white strawberry tongue has been observed in cases of ___ and ___ in young children
scarlet fever and kawasaki disease
a white coating of the tongue is usually associated with ___ factors; what is the amount of coating on the tongue related to?
- local
- varies with time of day and is related to oral hygiene and diet
what does the coating consist of in white coated tongue?
- food debris
- microorganisms
- keratinized epithelium
- found on and around the filiform papillae
a white coated tongue that can be scraped and bleeds underneath is a symptom of ___
candida yeast infection
___ is rarely seen in children, but occurs in young adults and has been related to the oral and systemic intake of antibiotics, smoking, and excessive ingestion of dark drinks such as coffee and tea
black hairy tongue
___ are markings caused by the tongue’s position against the lingual surfaces of the mandibular teeth
crenation
how can you test whether a labial frenum is normal vs abnormal? when should you perform this test?
- if a heavy band of tissue that goes between the incisors causes blanching of the palatine papilla, it is safe to predict that the frenum is abnormal
- this should be tested during the late mixed dentition stage
what are some issues that an abnormal labial frenum can cause?
toothbrush problems, interferes with movement of the lip, and may interfere with speech
what are some possible complications of tongue piercings?
- tooth chipping
- dental abrasion
- gingival recession
- swollen infected tongue
