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GI > Oral and dental health > Flashcards

Oral and dental health Flashcards

1
Q

What are th symptoms of assymptomatic oral cancers?

A 
Granular (50%) or smooth surface (33%) texture
Elevation in 20% of cases
No ulceration 
No bleeding
 and Not indurated (soft on palpation)
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2
Q

Is incidence of oral cancer increasing or decreasing?

A

Increasing

there has been a 4 fold increase in the last 30 years

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3
Q

Where in the UK is oral cancer incidence the greatest?

A

Scotland.

Incidence in scotland is 2.5 times greater than england

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4
Q

Oral cancer is more common in men or women?

A

Much more common in men 2:1 ratio

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5
Q

What type of oral cancer has the greatest and worst 5 year survival?

A

Lip has a very good 5 year survival and hypopharynx has the worst

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6
Q

What is the average 5 year survival for oral cancer?

A

50%. The further back in the mouth the worse the prognosis

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7
Q

Where are the most common locations for oral cancer in the UK?

A

Tongue and floor of mouth

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8
Q

Where is the most common site for oral cancer in India?

A

Buccal mucosa of the cheek

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9
Q

Is deprivation a risk factor for oral cancer?

A

Yes. More evident in males than females

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10
Q

Most oral cancer occurs in people over 50 but incidence in younger people is increasing T or F?

A

True

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11
Q

What are the causes of oral cancers?

A

Tobacco
Alcohol
Tobacco and alcohol
Diet deffieient in nutrients
HPV is a rising cause of oropharngeal cancer
Candida is often present alongside oral cancers
Drugs used to treat syphilis may cause oral cancer

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12
Q

What are some of the most common carcingoegens found in cigarettes (there are over 4000)

A

Carbon monoxide, arsnic, formaldehyde, cyanide, benzene, toluene and acrolein

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13
Q

Are you at a greater risk of oral cancer if you roll your own cigarettes?

A

Probably as you don’t use a filter and it is becoming more common and economical to roll your own

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14
Q

Do eCigs carry the same risk of oral cancer as smoking tocacco?

A

No- there are far fewer carcinogens but the research is not long term

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15
Q

What is Hookah?

A

Smoking mainly in Arab world but also in London bars. Can be combined with sugar.
Inhaled deeper but toxins are not dissolved in the water

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16
Q

Which ethnic groups chew tobacco and what are the risks?

A

Bangladeshi

Sub mucus fibrosis which increases risk of mouth cancer

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17
Q

Alcohol guidelines?

A

14 units per week for men and women

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18
Q

What is considered binge drinking?

A

Consumption of >8 units at once for men and 6 units for women

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19
Q

Smoking 20 a day will increase your risk of oral cancer by 10% but what if you drink as well?

A

Increases risk by 24%

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20
Q

Are alcohol mouth washes safe?

A

Yes probably but the evidence is mixed

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21
Q

What dietary factors can increase your risk of oral cancer and why?

A

Low in Vitamin A, C and Iron.

This causes atrophy of the oral mucosa and therefore it becomes more susceptible to local carcinogens

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22
Q

Does oral sex increase your risk of oral cancer?

A

Yes- HPV virus
Prevalence increases with age and the number of sexual partners.
Should we vaccinate guys? Would the vaccine prevent oral infection.

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23
Q

What are the signs of oral cancer?

A 
Any subtle change.
Especially red and white colour changes.
Swelling and ulcerated areas.
Exposed areas of necrotic bone 
Atrophy
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24
Q

How long should mouth trauma take to heal?

A

~10-14 days

If it has not healed after this then something is wrong and it should be referred

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25
Q

Where should you refer to if you suspect oral cancer?

A

Max fax unit

Dental hospital

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26
Q

What are the most common type of cancers in the mouth?

A

Squamous cell carcinomas

27
Q

What is Lichen Planus?

A

Skin condition which can affect the mouth. Can last for years. Non infectious. 2.5% of people with Lichen Planus will develop oral cancer

28
Q

What are the high risk and rare sites for oral cancer in the UK?

A 
High risk
Soft (non keratinizing) sites 
Ventral tongue, floor of mouth, lateral tongue.
Rare sites
Dorsal tongue, hard palate
29
Q

What are the potentially malignant lesions found in the mouth?

A

Erthroplakia (redness on mucosa)
Erythroleukoplakia (White and red patches)
Leukoplakia (whiteness)
Erosive lichen planus (skin condition in the mouth)
Submucosa fibrosis
Dyskeratosis congenita (rare progressive and congenital cause of whiteness on oral mucosa, also with increased skin pigmentation and nail dystrophy)
Sideropenic dysphagia (rare disease characterized by difficulty in swallowing, iron-deficiency anemia, glossitis, cheilosis and esophageal webs.)

30
Q

Is recurrence of oral cancer common?

A

Yes, especially within 2 years

31
Q

Melanomas are extremely rare in the mouth. T or F?

A

True

32
Q

What are the warning signs for oral cancer?

A

Colour changes (red/white)
Ulcer (exclude trauma, infection, drug causes)
Numb feeling in lips or face
Unexplained pain in the mouth or neck (late manifestation of oral cancer)
CHange in vioce
Dysphagia

33
Q

What are the other orofacial manifestations of cancer?

A 
Drooping of eyelid or facial palsey
Fracture of mandible
Double vision 
Blocked or bleeding from nose
Facial swelling
34
Q

4 key oral cancer questions?

A

1) How long has it been there? Mouth trauma heals within 10-14 days.
2) Is it painful (trauma or infective will be painful but pain is a late manifestation of oral cancer
3) Risk factors? Smoking/drinking
4) What colour is the lesion? Red/ white

35
Q

What are the 3 main oral public health diseases?

A

1) Tooth decay
2) Gum disease
3) Oral cancer

36
Q

Why are oral diseases important?

A

Commonest reasons of elective hospital admission of children for GA in Scotland
Tooth decay is the most prevalent condition worldwide
Very expensive to treat- 5-10% of the health budget is used to treat dental diseases

37
Q

Untreated caries in permanent teeth is the disease with the greatest global prevalence. What is the burden in terms of DALYs?

A

80th

Doesn’t lead to shortening of life but it is common and does have a significant effect on peoples lives

38
Q

How does oral health impact on physical health, social health and psychological health?

A

Physical health: Healthy diet/nutrition, healthy dentition
Social health: Eating, smiling , kissing
Psychological health: Self esteem, dental anxiety, communication

39
Q

What are the greatest risk factors for poor oral health?

A

Diet (sugar), tobacco and alcohol

40
Q

What are dental caries?

A

Dynamic process involving the exchange of calcium and phosphate ions between tooth structure and saliva (plaque fluid), in the presence of acids produced by the fermentation of carbohydrates by oral micro-organisms

41
Q

What 3 things are required for dental caries?

A

Teeth, bacteria and sugar

42
Q

What is the current public health target for sugar consumption?

A

Sugar should not make up more than 5% of total energy intake. Currently between 10 and 15%

43
Q

What are the stages of tooth decay?

A

1) Sub clinical decay
2) Initial decay- intact surfaces and cavities limited to enamal
3) Moderate decay- Cavities in the enamal and in dentine
4) Extensive decay- Lesions in dentine and into the pulp of the tooth

44
Q

What is used by public health to measure dental caries?

A 
DMF index
Sum of 
Decayed
Missing 
Filled teeth or surfaces
45
Q

What are some of the disadvantages to DMF teeth method?

A

Not all teeth are lost through caries (orthodontist, trauma)
A tooth can only be in one condition
DMF is irreversible and not good for measuring beneficial interventions
The components are unequal in impact (an extracted tooth is not equivalent to a filled tooth for a person)

46
Q

What is def and DMFS?

A 
def is a count of all primary/ baby teeth that are decayed, missing or filled
DMFS is a count of all decayed, missing or filled tooth surfaces
47
Q

Where in the UK has the most caries in 5 year olds?

A

Wales is worst, then scotland, then england.

Scotland is getting better where Wales and England are staying the same.

48
Q

What is the national Dental Inspection Programme in Scotland?

A

Two level programme:

1) Basic examination: All P1 and P7 children
2) Detailed examination: representative smale of P1 or P7 children inspect in alternate years.

Helps to montor the effectiveness of PH interventions

49
Q

What is the target for children and tooth decay?

A

60% of all P1 and P7 children to be free of obvious tooth decay

50
Q

There has been a worldwide reduction in dental caries in children over the last 40 years. Why is this?

A

Availability of fluoride tooth paste

51
Q

What factor accounts for the uneven distribution of dental caries?

A

Deprivation and socioeconomic status.

Although the equality gap is narrowing there is still a 25% difference

52
Q

Where are dental caries most commonly found in the mouth?

A

Back teeth. Molars and premolars

53
Q

The proportion of people who have lost all their own teeth is decreasing. When do people lose their teeth?

A

Older age

54
Q

Why do adults fro m deprived areas have fewer of their own teeth?

A

Cost of treatment is often greater then the cost of tooth extraction

55
Q

What is periodontal disease?

A

Group of related conditions, both acute and chronic, characterised by inflammation fo the periodontal tissues in response to the presence of dental plaque. (Gum disease)

56
Q

Give examples of periodontal conditions?

A 
Gingivitis 
Chronic periodontitis 
Necrotising Ulcerative gingivitis 
periodontal abscess
Perio-endo lesion
Gingival enlargement
57
Q

What other medical conditions are associated with periodontal disease?

A 
Atherosclerosis, stroke, MI
Adverse pregnancy outcomes 
Diabetes
Respiratory infections 
Rheumatoid arthritis and osteoporosis
Obesity
58
Q

How are the stages of periodontal disease measured?

A

BPE= basic periodontal exmination. Measured on a 0-4 scale.
Using a special tool with mm measurements on it
<3.5mm is normal. (Score 0-2)
Periodontal disease, if not managed can attack the bones which are holding the teeth

59
Q

What is the treatment for periodontal disease?

A 
Oral hygiene 
Stop smoking 
Scaling and root planing (dental hygienist)
Surgery
Extraction
60
Q

Is the incidence of periodontal disease increasing or decreasing?

A

Decreasing but has a large impact of QoL

61
Q

What is Childsmile?

A

National programme to improve the oral health of children in Scotland and reduce inequalities both in dental health and access to dental services.
Started as a trial in 2005. Mainstream since 2012

62
Q

What are the 3 branches of the Childsmile programme?

A

1) Core tooth brushing in preschools
2) Preventative dental care in nursery and primary school using fluoride painting as a preventative measure
3) Community support and oral health promotion and clinical caries prevention by dental health teams

63
Q

Who delivers Childsmile?

A

Dental Health support workers
Extended duty dental nurses (apply fluoride varnish)
Dental practice staff
Health visitor and public health nurses can refer into the programme

64
Q

Childsmile has been very effective in rimproving oral health in children and meeting its targets. True or false?

A

True

GI (48 decks)

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