How to Intervene Flashcards
What are the dependant factors of caries? (9)
- Tooth surface (enamel, dentine, root caries – all have different processes)
- Occlusal surface (fissures, pits, smooth)
- Time
- Diet
- Demineralisation
- Plaque retentive factors (more susceptible sites)
- Rate of progression
- Primary, secondary or residual caries
- Caries because of failed restorations
If a patient presents with new caries, what are the signs and symptoms? (6)
- The patient may present with initial symptoms
- They could be asymptomatic
- They may have sensitivity
- They may have a dull achy feeling
- Initial signs may be on visual inspection by the dentist
- These would allow you to investigate further
If a patient presents with new caries, what history and examination do you carry out? (2)
- Take a through history to see if there is any medication/medical issues/other factors that my increase the patients susceptibility to developing caries
- Do a visual exam and inspection
If a patient presents with new caries, what do you investigate? (2)
- If you think there may be caries, take radiographs to confirm
- If the caries might have spread to the pulp, take vitality tests to see if the pulp is still vital
After seeing the radiographs you have taken and carrying out a pulp vitality test, what do you do next? (1)
- Make a diagnosis
If a patient presents with new caries, what options do you have after you make a diagnosis? (6)
- Prevention of further disease (fluoride, dietary advice, cleaning) MOST IMPORTANT
- Watching to see progression
- Restore
- Filling without drilling
- Surgical intervention
- Refer if necessary
How do restorations fail? (3)
- Recurrent caries due to current restorations
- Iatrogenic factors
- Tooth fracture
Note: The patient’s perception of failure is if they are in pain. But the dentist’s perception of failure may be due to something which is asymptomatic. The most important thing is that you relieve the patient from this pain.
What are the causes of tooth wear? (3)
There are multiple causes of tooth wear:
- EROSION
- ATTRITION – patient would be complaining of sharpness, aesthetics
- ABRASION
How do the causes of tooth wear become a problem? (2)
It becomes a problem if:
- Patient is young
- Progressing quickly
List the different types of trauma your patient may present with? (3)
Your patient may come in with the following;
- Head injuries – if your patient presents with this, refer immediately as it could be brain related
- Soft tissue injuries
- Dental trauma – surgical treatment considered
What does Endodontology mean and why is it important? (5)
- Literally means ‘from within the tooth’
- Pulpal disease presents as an emergency procedure
- Management of endodontics is key in successful dentistry
- This may involve reversible pulpitis, irreversible pulpitis, pulpal necrosis
- Periradicular periodontitis
What is Post Pulp Necrosis? (3)
- Patient could develop an acute abscess
- On surgical treatment, the filling has been taken out and the dead pulp has been converted into an abscess with puss coming out of it
- The pressure in this is very high and can be very painful for the patient
When should you ask for help / Refer the patient? (4)
- When a dental problem has been presented beyond your level of clinical ability
- When there is difficulty reaching a diagnosis
- As a dental student (clinical tutors)
- When qualified (other colleagues, specialists, hospitals)
