HMCS Dental review Flashcards
What are the two line of defenses?
-Salivary amylase initiates the breakdown of starch.
-Lingual lipase breaks down triglycerides into fatty acids.
Is the hard palate keratinized or non-keratinized?
Keratinized
What are examples of non-keratinized areas of the mouth?
-Soft palate
-Floor of mouth
-Cheeks (buccal)
What are the three regions of the tooth?
-Crown
-Neck
-Root
What is the most visible region of the tooth?
-The crown
What is the area on the neck of the tooth where the enamel and cementum meet?
-Cementumal Enamel Junction (CEJ)
What is the hard white outer layer of the tooth?
-Enamel
What part of the tooth gives it basic shape and rigidity?
-Dentin
The pulp contains what?
-Connective tissue containing blood vessels, nerves, and lymphatic vessels
What is contained within the Attachment Apparatus?
-Cementum
-Periodontal ligaments
-The alveolar process
How many different types of teeth do we have and what are they?
-1.Incisors
-2.Canines
-3.Premolars
-4.Molars
What are the most posterior molars called?
-Wisdom teeth
How many teeth does an adult with all their teeth have?
-32
Most people in the military have how many teeth?
28
What tooth is tooth number one?
-Maxillary right third molar
What tooth is tooth number seventeen?
-Mandibular left third molar
What tooth is tooth number thirty-two?
-Mandibular right third molar
What is the only movable skull bone?
-Mandible
What is the only nerve associated with dental?
-Cranial Nerve V: Trigeminal
The cranial nerve comprises of what?
The lingual nerve
What does medial mean?
-Towards the midline
What does distal mean?
-Away from the midline
What anesthetic do you use for someone in pain on the ship and why?
-0.5% Bupivacaine /Marcaine because it lasts longer
Local infiltration is deposited where?
-At or near small terminal nerve endings in the immediate area of treatment. (The tooth that affected)
A regional block is deposited where?
-Near a major nerve trunk at a greater distance from the area of treatment, which provides wider areas of anesthesia.
Why do you use the tooth block (oral nerve block)?
-It reduces the need for oral analgesics
What are indications for an IA block?
-Fracture repair
-Removal of teeth
-Pain control
-NOT POSTOPERATIVE CARE
When you’re giving an IA block your target site is called what?
Lingula (a small bony bump about halfway back on the inner ramus of the mandible, where the inferior alveolar nerve enters the jaw)
When placing the barrel you place it opposite of what?
-Place barrel of syringe in commissure of mouth opposite to the site of injection. (Over the bicuspid on the opposite side)
What is the treatment for a tooth concussion?
Usually no treatment is required.
What is the most common cause of subluxation?
-Trauma
What is subluxation?
-Loose tooth
What is the treatment for subluxation?
-Gentle manipulation to make sure tooth is all the way in socket.
-Splint if necessary
Pt complains of pain and mobility after playing basketball, no visible displacement, what is the diagnosis?
-Subluxation
Avulsion is what?
-A traumatic injury where the tooth has been removed from the socket
What is the time frame to replace a tooth back in the socket?
-30 minutes to 1 hour
If re-implantation is unsuccessful what do you place the tooth in?
-Hank’s solution, milk, saline, or saliva (the patient’s mouth)
What do you not want to put a tooth in?
-Water
If your patient has an avulsed tooth what are you going to do for the patient?
Give them an IA (intraoral nerve block)
What anesthetic is used for an IA?
Bupivacaine /Marcaine
What are indications for an intraoral nerve block?
-Whenever anesthesia is desired in a fairly small anatomic area
-For laceration repair
-For incision and draining
-For oral pain management
-For repositioning/inserting traumatized teeth
-For teeth extraction
What are the different types of tooth fractures?
-Affect only the enamel (superficial)
-Expose the dentin
-Expose the pulp
-Include the root
If the fracture involves only the enamel what does the patient notice? What do you do for the patient?
-Patients notice rough or sharp edges but are asymptomatic.
-Treatment involves smoothing out the edges
If dentin is exposed but not the dental pulp, patients usually exhibit sensitivity to what?
-Cold air and water
What it the treatment for exposed dentin?
Drill and fill. Treatment consists of restoration of the tooth by a composite (white filling) or, if the fracture is extensive, a dental crown, to cover the exposed dentin
Is SIQ required for a dentin fracture?
-No
How can you tell if the pulp is exposed?
-Bleeding from the tooth
What is the treatment for pulp exposure?
-Root canal
Is SIQ needed for any tooth fractures?
-No
What do you do for a mandibular fracture?
Immobilize jaw and refer to dental
Inflammation of the dental pulp is called what?
-Pulpitis
What is pulpitis caused by?
-Carries/cavities not taken care of or carries/cavities redone multiple times (multiple restorations)
-Trauma
What is the treatment for pulpitis?
-Removing the decay
-Restoring the damaged tooth
-Sometimes performing root canal therapy or extracting tooth (last resort)
What is the primary symptom of pulpitis?
-Pain
In reversible pulpitis, pain occurs when what is applied to the tooth?
-Cold, sweets, or percussion
In reversible pulpitis when stimulus is removed how long does it take pain to cease?
he pain ceases within 1 to 2 seconds.
If the pain is longer than 1 to 2 seconds after stimulus is removed what is it?
-Irreversible pulpitis
-The pain may then cease for several days because of pulpal necrosis.
In irreversible pulpitis the tooth is sensitive to what?
-As infection develops and extends through the apical foramen, the tooth becomes exquisitely sensitive to pressure and percussion.