INTEGRATED CLINIC & CARIOLOGY

Question 1

Briefly discuss the 4 sequences of treatment planning

Answer 1

Control phase - control pain and disease
- OH, FS, referrals, emergency tx, impressions

Conservation phase
- perio, endo, resto, surgery, TMJ, ortho & assessment of patient for reconstruction

Restorative Phase - enhancing function and aesthetics
- crowns, posts, dentures, splints, simplants

Maintenance Phase - review and maintain good practices
- recalls

Question 2

What does SOCRATES stand for

Answer 2

mnemonic for pain history

Site
Onset
Character
Radiation/Referal
Associations
Time Course
Exaccerbating/Relieving Factors
Severity

Question 3

What does an ICDAS score of 3 indicate

Answer 3

There is a white/brown spot when the tooth is wet and upon drying there is noted enamel breakdown

Question 4

A tooth with a grey shadow from the dentine would be an ICDAS score of?

Answer 4

4

Question 5

Which of the following is an ICDAS score of 2

A. normal appearance when wet and a WSL evident when dried
B. white/brown spot when wet and enamel break down when dried
C. grey dentine shadow
D. white/brown spot when wet that does not change when dried

Answer 5

D

A - this is a code 1
B - this is a code 3
C - this is a code 4

Question 6

Discuss what the radiographic codes C1-C5 represent

Answer 6

C1 - radiolucency in the outer 1/2 of enamel
C2 - radiolucency in the inner 1/2 of enamel
C3 - radiolucency just into dentine
C4 - radiolucency in the outer 1/3 of dentine
C5- radiolucency in the inner 2/3 of dentine

Question 7

What does a plaque index score of 1 mean?

Answer 7

1 - there is no visible plaque, but there is a small amount of plaque removed with a probe

Question 8

you can see thick visible plaque on the patients teeth, what is the plaque score?

Answer 8

3

Question 9

What are the recomended fluoride doses in tooth paste for

0-18months of age
18 months - <6yrs
6yrs - adulthood

Answer 9

0-18months of age: none
18 months - <6yrs: 400-550ppm
6yrs - adulthood: 1000ppm

Question 10

A patient in your chair has evidence of fluorosis, their teeth appear to be moderately affected >80% and the entire surface is white and flecked

what is the fluorosis index?

Answer 10

3

Question 11

What does a fluorosis index of 0, 0.5 and 1 indicate

Answer 11

0 - normal
0.5 - questionable, milky
1 - mild 1-25% affected

Question 12

What percentage of the tooth/teeth are affected in a fluoride index of 2?

Answer 12

mild 26-50%

Question 13

What is the definition of dental caries

Answer 13

A non-communicable bacterial and lifestyle mediated disease

Biofilm mediated, sugar driven, multifactorial, dynamic disease that results in phases of demineralisation and remineralisation of dental hard tissues

Question 14

Cariogenic bacteria alone cause carious lesions

True/False

Answer 14

False

Caries requires cariogenic bacteria, bacterial plaque/biofilm, stagnation, a succeptible surface and time

Question 15

What are the 4 primary risk factors for caries

Answer 15

1. Fluoride
2. Biofilm/Plaque
3. Saliva
4. Diet

Question 16

What is the single most important factor for managing biofilm diseases?

Answer 16

Home care

Question 17

Which of the following protocols would you recomend for a high caries risk patient

A. Twice daily brushing with 5000ppm toothpaste and a 0.2% CHX rinse
B. Twice daily brushing with 1000ppm toothpaste and a 0.05% NaF mouth rinse
C. Twice daily brushing with 5000ppm toothpaste
D. Twice daily brushing with 1000ppm toothpaste

Answer 17

C

A - this is for very high risk (hyposalivation, active lesions on smooth surfaces)
B - this is for medium risk
D - this is for low risk

Question 18

A patient is in your chair and you have classified their caries risk as medium - what kind of professional fluoride applications would you do?

Answer 18

Medium risk

1. apply varnish (duraphat 5% naF) or GIC to newly erupted WT
2. apply varnish (duraphat 5% naF) to all lesions at each tx session
3. Then 6 month varnish applications of these lesions until patient moves into low risk

Question 19

A new patient attends your clinic, they have no frank cavitations but they do have some sticky pits and fissures, their radiographs show radiolucencies = C4

What is their caries risk level?

Answer 19

Medium

Question 20

A recall patient is at your clinic for their 12 month exam and they are presenting with 2 new lesions

What caries risk are they?

Answer 20

High

Question 21

You have a patient with an ICDAS code of 3 on their 46, the radiograph shows the lesion to be a C3.

What treatment do you do?

Answer 21

ICDAS 3-4 are ONLY restored is the radiolucency is >C4

Review in 6 months

Question 22

When would you recall a high caries risk patient and what would be done at the recall appointment?

Answer 22

3 month recalls following completion of tx
6 monthly BW’s

3 month recalls maintained UNITL OH improved and lesion progression has arrested
- a patient cannot be moved from high to medium in <12 months

Question 23

Your colleague has requested you see their patient for a recall, they have asked you to do this recall at 6 months after initial tx was completed and to take BW at these 6 monthly recalls

what caries risk classification is this patient?

Answer 23

Medium risk