Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

3b. BDS3 CDS Caries Symposium Part II > L15. Methods of Caries Management - The Biological Approach > Flashcards

L15. Methods of Caries Management - The Biological Approach Flashcards

1
Q

What are the 4 main factors involved with the development and progression of caries?

A
  • Tooth tissue;
  • Bacteria;
  • Sugar;
  • Time.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the ultimate aim of all caries treatment?

A

Promoting an environment that favours remineralisation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the difference between detection and diagnosis of caries?

A
  • Detection is determining the presence of disease;

- Diagnoses confirm the activity of the disease (i.e. is it active or arrested).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the process of examination for caries?

A
  • Plaque chart;
  • Clean teeth (can’t see caries under plaque);
  • Inspect without drying for dentinal shadowing;
  • Dry tooth;
  • Inspect for caries.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What can be used to help confirm the presence of caries?

A
  • Use of CPITN probe to see if any catching occurs;
  • Bitewing radiographs;
  • Temporary elective tooth separation (TETS);
  • Transillumination;
  • FOTI;
  • Plaque pH;
  • Salivary flow rate.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the stages of visual detection of coronal caries?

A
  • Normal enamel translucency after drying;
  • Enamel opacity after drying;
  • Enamel opacity without drying;
  • Enamel opacity with local surface destruction;
  • Enamel discolouration +/- surface destruction;
  • Surface breakdown opaque enamel;
  • Surface breakdown discoloured/ opaque enamel;
  • Enamel cavity into dentine.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Why should tactile assessment (use of a probe), never be used for enamel caries?

A

This can cause cavitation, cavitation is the point of no return (i.e. requires operative tx and prevents potential remineralisation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What type of caries are bitewing radiographs typically used to confirm?

A

Interproximal (sometimes pick up unexpected occlusal caries)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Sometimes dark staining in fissures can look like caries, what is usually present if this is caries?

A

A white periphery - without this it is typically exogenous staining

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When may you decide to use TETS?

A

Suspected interproximal caries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How is TETS carried out?

A
  • Orthodontic separator between teeth;
  • As band contracts, teeth pushed apart;
  • Leave for 2-5 days;
  • Review;
  • Inspect surface for cavitation;
  • Can use probe and or silicone impression on surface in question.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is included in a diagnosis of root caries?

A
  • Primary or secondary;
  • According to tooth surface (e.g. buccal, proximal etc.);
  • Active, arrested or remineralised.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are two important factors to assess when examining root caries?

A
  • Position relative to gingival margin (+/- 1mm?);
  • Dimension of lesion (small or large);
  • Colour (light or dark).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

In terms of bacterial load, how does this typically correlate to texture and colour of a root caries lesion?

A
  • Soft lesions have higher bacterial load (probably the best indicator);
  • Lighter lesions have higher bacterial load.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the indications for non-operative intervention of root caries?

A
  • Hard, dark-coloured lesion;
  • > 1mm from gingival margin;
  • Does not trap plaque;
  • Not rapidly progressing;
  • Pt able to participate in non-operative management.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

In terms of a secondary caries lesion, what is the order of progression surrounding the restoration?

A

Outer to inner (an outer lesion does not always mean there are secondary caries under the restoration)

17
Q

Criteria for tx of secondary caries is quite uncertain, what indications suggest intervention?

A
  • Wide ditches (which admit a probe);
  • Very carious outer lesions;
  • Colour changes alone are not a good predictor.
18
Q

What is ‘non-operative management’ of caries?

A

The intervention of caries progression/ risk by means of modification to the factors required for caries development (tooth, host, bacteria, [time])

19
Q

What might be involved in non-operative management of caries?

A
  • Dietary analysis (sweet episodes: how many and how much?);
  • OHI;
  • Increased fluoride exposure.
20
Q

How has high fluoride toothpaste been seen to act on root caries?

A
  • Significantly harder;
  • Significantly further from gingival margin;
  • Significantly fewer bacteria.
21
Q

What is the issue surrounding evidence to support use of fluoride varnish application?

A
  • Where the benefit in caries reduction comes from;

- Is this from the education on OH, increased/ correct brushing or from the varnish itself?

22
Q

When might the use of silver diamine fluoride (SDF) be ideal?

A

Good for patients with littler cooperation but high caries risk

23
Q

What is the main issue with SDF treatment?

A

The effected tooth tissue turns black

24
Q

How does ICON work?

A
  • Resin infiltration of the lesion;
  • Etch lesion;
  • Dry off with ethanol (withdraws moisture);
  • Apply resin;
  • This is ‘absorbed’ and infiltrates the demineralised lesion;
  • Improves appearance.
25
Q

What is the main criteria for assessing patients for caries intervention?

A
  • What risk is the patient?;
  • Low: no intervention;
  • Mod-high: intervention to address and change their caries risk.
26
Q

What are the aims of restorative treatment?

A
  • Restore significant loss of dental tissue;
  • Eliminate plaque retention;
  • Restore masticatory function;
  • Minimise the risk of recurrent disease;
  • Restore aesthetics where appropriate.
27
Q

What indicators are there for operative intervention of primary coronal caries?

A
  • Cavitated lesions (probe catches on tactile assessment);
  • Enamel discolouration +/- localised surface destruction;
  • Plaque trap area;
  • Can’t be cleansed.
28
Q

What indicators are there for operative intervention of secondary caries?

A
  • Frankly carious;
  • Plaque trap area;
  • Ditches wide enough to admit a periodontal probe.
29
Q

What indicators are there for operative intervention of root surface caries?

A
  • Pale coloured or black lesion, < 1mm from gingival margin;
  • Plaque trap;
  • Pt unable to participate in non-operative management;
  • Feel soft with sharp probe.
30
Q

How do fissure sealants work to treat caries?

A
  • Acid etch decreases the viable bacteria;

- Sealant seals and starves them.

31
Q

What are the options for treating deep, carious lesions?

A
  • Non-selective removal of carious tissue to hard dentine;
  • Selective removal to firm dentine (SRFD);
  • Stepwise excavation treatment (SW);
  • Selective removal to soft dentine.
32
Q

What is the main risk with SRFD?

A
  • Pulp exposure;

- Poor prognosis for tooth vitality in long term, even with pulp cap.

33
Q

Does the risk of pulp exposure increase or decrease with stepwise excavation, from SRFD?

A

Decreases (less tissue removal at first step so less chance of exposing pulp)

34
Q

Does the risk of pulp exposure increase or decrease with SRSD, from SW?

A

Decreases (however, study shows a high number of patients who didn’t go back for second SW tx so tx incomplete)

35
Q

What are the non-operative options for treatment of caries?

A
  • Non-operative;
  • Non-operative management;
  • Topical application.
36
Q

What is involved with non-operative management of caries?

A
  • Patient education (of caries/ their caries risk);
  • Dietary modification (3-day diet diary and assessment to reduce sugar intake);
  • OHI (brushing and interdental cleaning);
  • Professional prophylaxis (the more they’re seen, the more the risk of caries decreases).
37
Q

What topical application options are there for treatment of caries?

A
  • Topical fluoride (twice a day: 1450, 2800 or 5000ppm);
  • Fluoride varnish;
  • CPP-APC;
  • Chlorhexidine (for root caries);
  • Silver diamine fluoride (SDF).
38
Q

What other non-operative options are there for treatment of caries?

A
  • Active management;
  • Sealing in occlusal caries;
  • Resin infiltration;
  • Ensuring areas are self-cleansing.
39
Q

What are the general principles to consider when restoring a tooth?

A
  • Minimally invasive (remove as little tooth structure as possible);
  • Prevent iatrogenic damage;
  • Establish a contact point;
  • Correct margin fittings;
  • Justifying replacing existing restorations (new caries or a technical failure);
  • Always consider repairing rather than replacing.

3b. BDS3 CDS Caries Symposium Part II (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions