Brainscape's Knowledge GenomeTM

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


See full index

Caries symposium 2 > Methods of caries management - the biological approach > Flashcards

Methods of caries management - the biological approach Flashcards

1
Q

what is detection of caries

A

determining the presence or absence of the disease

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

what is diagnosis of caries

A
  • determining the presence or absence of the disease

- knowing whether or not the disease is active or arrested such that, appropriate treatment can be planned

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

things handy for diagnosing caries?

A
  • plaque chart
  • full mouth prophylaxis
  • good lighting
  • inspect without drying for dentinal shadowing (best seen in wet conditions)
  • dry tooth with 3 in 1
  • use 2.5 x magnification
  • CPITN probe for gently removing debris from fissures/ determine consistency of carious dentine
  • good quality bitewings
  • temporary elective tooth separation (TETS)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

when should temporary elective tooth separation be performed

A

ALL lesions on the inner half of enamel and in the outer half of dentine

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

why should temporary elective tooth separation be performed

A

to confirm cavitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what special tests can you use

A
  • transillumination
  • FOTI
  • diagnodent
  • plaque PH
  • salivary flow rate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

how can we visually detect coronal caries

A

enamel discoloration +/- surface destruction

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

what does a caries score of 0,1,2,3 and 4 indicate?

A 
0 = no/slight change after drying
1 = opacity visible after drying (a little demineralisation in fissure but entirely limited to enamel)
2 = opacity visible without drying (minimal dentine involvement)
3 = localised enamel breakdown in opaque/ discoloured enamel +/- discolouration from underlying dentine (periphery of white around discolouration is indicitive of dentine caries)
4 = cavity in enamel exposing underlying dentine (significant dentinal caries)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

when do we use tactile assessment of dental caries

A

dentine caries

NOT for enamel caries

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

why do we not probe enamel caries?

A
  • breakdown of fragile surface zone preventing potential remineralisation
  • high incidence of false positives i.e. probe sticks in a sound fissure
  • occlusal caries often starts at the sides of a fissure rather than at the base
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what 3 things to look for when doing a direct visual assessment for caries

A
  • demineralisation
  • uptake of stain
  • cavitation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how do we carry out temporary elective tooth separation

A
  • interproximal caries only
  • orthodontic separator between teeth
  • review min 2 days later (can leave 1 week)
  • inspect surface for cavitation
  • put probe in and drag it back through
  • take a silicone impression of approximal surface
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

when the radiograph shows a radiolucent V which doesn’t make it to the adj, what does this mean

A

that the caries is only on the outer half of enamel and these are never cavitated so never need to operatively intervene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

when the radiograph shows a radiolucent V which is on the inner half of dentine, what does this mean

A

these are always cavitated and you always need to operatively intervene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

if the radioluecency is on the inner half of enamel, what does this mean

A

most of the time it isn’t cavitated but 10.5% of the time there is a cavity. Do TETS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

if the radioluecency is on the outer half of dentine, what does this mean

A

41% of the time there is a cavity. Do TETS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

most common causes of smooth surface/ root caries?

A
  • elderly
  • perio
  • reduced saliva flow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

how do you describe root caries

A
  • primary or secondary
  • surface of tooth affected e.g. buccal, proximal etc
  • active, arrested or remineralised
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

how do you diagnose root caries

A
  • clean teeth (can’t see caries under plaque)
  • tactile assessment (use a probe)
  • visual assessment (position in relation to gingival margin, dimensions of lesion, colour of root caries)
20
Q

if root caries is close to the gingival margin what does this indicate

A

it’s more likely to be active

21
Q

what indicators tell us about the activity of root caries

A
  1. texture
    soft lesions = more likely to be active
  2. colour
    lighter coloured = more likely to be active
  3. site
    <1mm from gingival margin = more likely to be active
  4. size
    larger lesions = more likely to be active
22
Q

what are indications for non-operative intervention of root surface caries

A
  • hard, dark-coloured lesion, >1mm from gingival margin
  • doesn’t trap plaque
  • not rapidly progressing
  • patient able to participate in non-operative management
23
Q

how does secondary caries tend to progress

A

tends to begin from the outside in so if margins of restoration are good and intact it should be find internally

24
Q

where is the most likely site for secondary caries

A

cervical margin

25
Q

what should prompt restoration replacement

A
  • wide ditches (will admit a periodontal probe)

- carious outer lesions

26
Q

what shouldn’t be used as a sole indicator for restoration replacement

A

colour change

27
Q

what are our options for non-operative management of dental caries?

A
  • dietary analysis
  • OH instruction
  • increase F exposure
28
Q

why do we do dietary analysis

A

to reduce the amount of simple carbohydrates (i.e. reduce substrate)

29
Q

why do we do OHI

A
  • to remove plaque regularly (i.e. reduce bacteria on teeth)

- tooth brushing and interdental cleaning

30
Q

why do we increase F exposure

A

to tip balance towards remineralisaTion

31
Q

what are the different ways to increase F exposure

A
  • high F toothpaste (2400-2800ppmF)
  • F varnish
  • chlorhexidine varnish
  • silver diamine Fluoride
  • CPP-ACP (based on anticaries effect of cheese, casein peptides dissolve into plaque and supersaturate calcium and phosphate ions from ACP thereby promoting remineralisaion)
  • fissure sealant (?) ICON?
32
Q

when are dental restorations indicated

A
  • when lesions have advanced to obvious cavitation and where remineralisaion techniques have reached their limits
  • should use least invasive solutions
  • restore significant loss of dental tissue
  • eliminate plaque retention/stagnantion
  • restore physiological masticatory function
  • minimise the risk of recurrent disease
  • restore aesthetics where appropriate
33
Q

how do we detect primary coronal caries

A

visual assessment

  • cavitated lesions
  • enamel discolouration +/- localised surface destruction
  • plaque trap area

tactile assessment
- cavitated lesions

34
Q

how do we detect secondary caries

A

visual assessment

  • frankly carious lesions
  • plaque trap area

tactile assessment
- ditches wide enough to admit a perio probe

35
Q

how do we detect root surface caries

A

visual assessment

  • pale-coloured or black lesion, <1mm from gingival margin
  • plaque trap
  • patient unable to participate in non-operative management

tactile assessment
- soft feel with sharp probe

36
Q

what situation might mean you don’t do anything

A

can see occlusal caries but what’s happened is enamel has fractured off so the area is self cleansing

37
Q

how can you starve the bacteria

A

fissure sealants

38
Q

when should fissure sealants be used

A

when occlusal caries is visible radiographically, the lesion extends into the middle third of dentine and is heavily infected

39
Q

what are our options for deeper carious lesions

A
  1. non-selective removal of carious tissue to hard dentine
  2. selective removal to firm dentine
  3. stepwise excavation treatment
  4. selective removal to soft dentine
40
Q

describe non-selective removal of carious tissue

A

using slow speed and removing all the caries (most likely to cause carious (pulp?) exposure)

41
Q

describe selective removal to firm dentine

A

take sharp probe and remove til it all feels scratchy and hard

42
Q

describe stepwise excavation treatment

A

Stepwise is done over 2 stages, remove most and leave soft dentine but then we go back in a few months later

43
Q

describe selective removal to soft dentine

A

Most conservatively - puncture into the lesion, create a peripheral seal and then leave soft dentine behind (better then removing all caries and causing pulp exposure, also easier to do).

44
Q

how does stepwise removal compare to selective removal to soft dentine

A

srsd had higher success rates compared to sw

45
Q

can we achieve remineralisation in cavitated lesions

A

yes, but need to do non-operative managment to arrest caries

46
Q

what are minimally invasive techniques

A
  • repair and refurbishment of restorations
  • preventative resin restoration
  • ultrasonic minimal preparation
  • bioactive linings
  • partial caries removal
  • stepwise caries excavation
47
Q

what are the general principles to keep when restoring carious lesions

A
  • as little tooth structure as possible should be remove to preserve the strength of the remaining tooth
  • take care to protect the adjacent tooth when preparing an approximal restoration
  • establish a contact point
  • the margins should fit, which is a challenge cervically
  • when deciding to replace a restoration, be very clear as to why this option has been chosen
  • always consider whether the tooth could be repaired, rather than replacing the restoration

Caries symposium 2 (7 decks)

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