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Clinical knowledge II > Manifestations of disease > Flashcards

Manifestations of disease Flashcards

1
Q

What determines a caries risk assessment?

A

Frequency of sugar.
Fluoride exposure.
Oral hygiene.
Medical conditions
Caries experience.
Medications
Family caries experience.

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2
Q

What clinical findings place someone in the high risk caries category?

A

White spot lesions.
Presence of active decay.
Amount of lesions.
Previous restorations/caries experience.
The extent of the carious lesions.
The presence of plaque.
Extractions.
Orthodontic appliances.

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3
Q

What parts of a person’s social history may affect their caries risk?

A

Social deprivation.
Caries in family.
Lack of knowledge surrounding dental disease.
Education.
Alcohol intake.
Diet.
Low dental aspirations

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4
Q

What systemic diseases cause xerostomia?

A

Diabetes
Rheumatoid arthritis
Sjrogren’s syndrome
HIV
Scleroderma
Lupus
Sleep apnoea.

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5
Q

What can cause acidic dental erosion?

A

GORD.
Alcohol.
Carbonated drinks.
Sugary drinks.
Bulimia.
Fruit juices.
Xerostomia due to lost buffering capapcity.

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6
Q

What advice would you give to someone with NCTSL?

A

Referral to a specialist if bulimia or GORD is suspected.
Saliva promoting gels, spray or tablets.
Diet advice to reduce acidic drinks.
Alcohol cessation.
Brush with 1350ppm-1500ppm fluoride toothpaste.
TBI - not brushing after eating/sick.

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7
Q

What makes a person high perio risk?

A

Presence of PRF.
Poorly controlled diabetes.
Smoking.
Smokeless tobacco use.
Family history of periodontitis.
Ethnicity.
Socio-economic status.
Plaque biofilm.
Occlusion

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8
Q

What are the clinical findings that make a patient high perio risk?

A

More than 30% BoP
More than 20% plaque
Plaque retentive factors.
BPE.
Recession
Bone loss on radiographs
Tooth mobility
Tooth loss.

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9
Q

What are the clinical presentation of a smoker?

A

Staining
Halitosis
Hairy black tongue.
Candidiasis.
Mobility
Tooth loss
Lack of BoP due to vasoconstrictor in nicotine.
Stomatitis
Gingival recession.

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10
Q

What makes a person high risk for developing oral cancer?

A

Tobacco and alcohol use.
HPV-16
Gender
Excess body weight.
Age.
Sun exposure
Poor nutrition.
Genetics.

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11
Q

How ca coeliac disease present orally?

A

Glossitis
Angular cheilitis
RAS
Enamel Hypoplasia

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12
Q

How can Crohn’s disease present orally?

A

Swelling of the lips
Mucosal tags
Oral Ulceration
Angular cheilitis
Lip fissures
Perioral erythema
Full width gingivitis

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13
Q

How can ulcerative colitis present orally?

A

Apthous ulcers
Angular cheilitis.

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14
Q

How does GORD present oraly?

A

Dental erosion on palatal aspects.
Antacids

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15
Q

How does hepatic disease present orally?

A

Intra-oral jaundice.
Impaired haemostasis.
Prolonged bleeding

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16
Q

Hoe does anaemia present orally?

A

Pallor
Glossitis
Oral candidosis
Axacerabtion of RAU.
Plummer-Vinson syndrome.

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17
Q

How can leukaemia present orally?

A

Gingival swelling
Oral ulceration
Leukaemic deposits.
Oral purpura.
Candida

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18
Q

How can platelet disorders present orally?

A

Purpura.
Petechial haemorrhages
Blood filled blisters on the oral mucosa.

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19
Q

What causes platelet disorders?

A

Idiopathic thrombocytopaenia
Connective tissue diseases
Acute leukaemias.
Drug associated
HIV

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20
Q

What should be avoided in patients with bleeding disorders?

A

IDB
Aspirin
NSAIDs

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21
Q

What are the oral manifestations of lupus?

A

Lichenoid.
Purpura
xerostomia

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22
Q

What are the oral associations with Rheumatoid arthritis?

A

Sjogren’s Syndrome
Limited opening
crepitus
Stiffness
Pain

23
Q

How may Sjogren’s syndorme present clinically?

A

Parchment like mucosa.
Lobulated depapillated tongue.

24
Q

What is the clinical presentation of scleroderma?

A

Restricted opening
Dysphagia
Widening of the periodontal ligament
Trismus

25
Why is COPD relevant to Treatment?
Periodontal susceptibility. Trigger airway problems Best treated upright Difficult for rubber dam. Smoking cessation
26
What is lichen planus?
Bilateral white striations, papules or plaques on the buccal mucosa.
27
What type of lichen planus is the most common?
Reticular.
28
What type of lichen planus is the most symptomatic?
Erosive.
29
What are the 4 types of epulides?
Pregnancy Fibrous Giant cell Carcinomas
30
How would you manage a pregnancy epulis?
OHI May regress after delivery. May need exision.
31
How do you assess the risk of pain or sepsis before exfoliation?
Extent of the lesion Site of the lesions Activity of the lesions Time until exfoliation Number of other lesions present Anticipated co-operation from the child. Anticipated co-operation from the parent. The range of procedures the clinician is able to provide. Medical status of the child.
32
What medical information would you gather to risk assess a child?
Medications Medical Conditions Allergies hospitalisation
33
What social information would you gather to risk assess a child?
Siblings School Distance travelled Attitude to dental health
34
What dental health information would you gather to risk assess a child?
Attendance Previous treatment (GA) Brushing habits Fluoride exposure Complaints Diet
35
What factors would influence your decision in a paediatric patient?
If the child is in pain. The extent of the lesion. Which tooth the lesion is present. Co-operation Time to exfoliation. IF the parent is there to consent.
36
In which order should treatment be carried out?
Pain prevention. Prevention Intervention
37
What is the significance of a BPE code 2?
The the black band is visible - less than 3.5mm. Sub/supra gingival plaque or calculus present. A screening tool that along with clinical examination will help to diagnose. BSP outlines treatment for code 2 as OHI, plaque and bleeding charts, PMPR, review at next appointment in 3-6 months.
38
How would you manage periodontal treatment with a patient who is nervous and has cerebral palsy?
Acclimatisation with short appointments. Starting with prevention unless the patient is in pain. NCTSL, periodontal disease, caries, drooling, xerostomia are common in patients with cerebral palsy. - Gaining appropriate consent. - Treatment modifications. (wheelchairs/hoists/stability aids/carer.) - Different motor skills determine OHI modifications. - Sedation or GA referral depending on patient anxiety for restorations.
39
How would you carry out treatment to a patient with cerebral palsy?
OHI – Brushing twice a day with a modified toothbrush, carers help, make sure to give advice to carer also. Using NaF toothpaste (prescription from dentist for NaF 5000ppm, 0.05% NaF MW to be used during the day). Plaque and bleeding indices. PMPR – May hand scale due to patient being nervous to gradually integrate them into the dental practice Longer appointments. Treating xerostomia with saliva promoting tablets. Fluoride varnish (2.26%) application twice a year. Diet advice – Limiting sugar to meal-times, nothing just before bed. Sugar free medication Restorations – Do one at a time, GI restorations. Maybe sedation or GA depending on co-operation.
40
What are the factors that increase risk caries prevalence amongst the aging population?
Xerostomia Polypharmacy Previous periodontal disease (Recession). Diet Lack of fluoride (less than 1350ppm) Root morphology Living in a residential home. Social deprivation Cariogenic medicines. Physical disability.
41
How would you manage a vaso-vagal syncope?
Prevention: - Raise patients legs above head. Management if they become unconscious: - Lay patient supine. Monitor pulse. Give oxygen if necessary. Once recovered may give glucose drink.
42
What would you find in the medical emergency kit?
Glyceryl trinitrate (GTN) spray (400micrograms) Salbutamol aerosol inhaler (100micrograms) Adrenaline injection (1:1000, 1mg/ml) Aspirin dispersible (300mg) Glucagon injection 1mg Oral glucose solution Midazolam 5mg/ml buccal Oxygen Oxygen face mask & tubing Basic set of oropharyngeal airways. Pocket mask with oxygen port Self-inflating bag and mask. Variety of well fitting adult and child facemasks. Portable suction Single use sterile syringes and needles Automated blood glucose measurement device NIBP / Pulse Oximeter Automated External Defibrillator
43
What is a dentoalveolar infection?
A pus producing infection associated with the teeth and supporting structures.
44
When are antimicrobials recommended?
As an adjunct to definitive treatment where there is an elevated temperature, evidence of systemic spread and local lymph involvement.
45
What is a periapical abscess?
An acute infection that are associated with the apex of the tooth. This can cause systemic effects.
46
What is deciduous pulpal involvement?
The soft irreversible dentine extends into the pulp causing irreversible changes before pulpl exposure.
47
What is a periodontal abscess?
Usually from trauma at the opening of the gingival pocket.
48
What is ANUG?
It is associated with poor oh, smoking and stress. Halitosis, ulceration, malaise. Treatment with PMPR.
49
What is periocoronitis?
Inflammation associated with the crown of a partially erupted tooth.
50
What is the herpes simplex virus?
Infectious until the crusting is complete. Advice aciclovir.
51
What are the predisposing factors to candida?
Age Pregnancy Trauma Diet Asthma Diabetes Malignancy AIDs/HIV Xerostomia Antibiotics Smoking
52
What are the differential diagnosis' to candida?
Geographical tongue Leukoplakia. Hairy tongue. Lichen planus HIV infection Oral cancers.
53
What are the clinical presentations of a squamous cell carcinoma?
White or red patch Non healing ulcer Earache Mostly Painless Dysphasia Enlarged lymph Lower lip

Clinical knowledge II (17 decks)

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