Oral health conditions

Question 1

What is enamel?

Answer 1

White hard covering over crown of tooth, resistant to acid attack from micro orgs

Question 2

What is dentine?

Answer 2

cream/yellow coloured material that makes up bulk of tooth

Question 3

What is pulp?

Answer 3

contains all nerves and blood vessels, forms dentine

Question 4

What is peridontium?

Answer 4

Allows tooth to stay in mouth, tissue that holds tooth in place

Question 5

What is plaque, how is it formed?

Answer 5

Pellicle formation, 1-2 mins after brushing –> adhere to tooth surface

Removed using brushing

Question 6

What is dental calculus?

Answer 6

Mineralised plaque, removed by scaling

Question 7

What are occlusal carries?

Answer 7

cavity on chewing surface

Question 8

What are interproximal carries?

Answer 8

cavity between teeth

Question 9

What are root surface carries?

Answer 9

cavity on root surface

Question 10

Discuss dental carries

Answer 10

Multifactorial disease = bacteria, diet, susceptible tooth surface, time

Spreads quickly, prevention rather than cure

Signs/Symptoms = associated pain, sensitivity (Sweet/hot/cold), swelling

Question 11

Discuss gingivitis

Answer 11

Inflammation of gingiva, non-destructive disease that does not extend in to underlying alveolar bone, periodontal ligament or cementum

reversible

Process = plaque build up > gum inflammation

symptoms = gums swell, bleed on touch

Question 12

Discuss acute necrotising Ulcerative gingivitis

Answer 12

Trench mouth, lack of oral hygiene and psychological stress

Question 13

Which drugs cause drug-mediated gingivitis?

Answer 13

anticonvulsants, CCB, cyclosporin, erythromycin

Question 14

What products are available for gingivitis treatmen?

Answer 14

Chlorhexidine mouth wash –> reduce plaque

Cetylpyridinium chloride mouthwash –> inhibit/reduce plaque build up, less effective than chlorhexidine

Essential oils mouth wash –> less effective than chlorhexidine

Question 15

Discuss peridontitis

Answer 15

Preceded by gingivitis, irreversible

Loss of attachment of periodontal ligament and alveolar bone = tooth no longer attached to bone

Symptoms = bleeding, pain, tenderness, bad breath, bone breakdown (plaque bacteria)

Question 16

What is the most common type of mouth ulcer?

Answer 16

Apthous ulcer = periodic or recurring

Mucous membrane inside mouth

Question 17

What are the signs/symptoms of mouth ulcers?

Answer 17

Clearly defined red margin, round or oval shaped sores/lesions

Yellow-grey centred, re/swollen edges

localised pain/burning, single or cluster (1-6)

Usually small

Seen on: lips, buccal mucosa, floor of mouth, sides/lower surface of tongue

Question 18

Discuss the management of mouth ulcers

Answer 18

Health by themselves with no treatment, medicine reduces discomfort/healing time

Barriers (orthodontic wax) prevent ulcers

Question 19

What medicines can be used to treat mouth ulcers?

Answer 19

Chlorhexidine = mouth wash –> encourage healing/reduce pain

Choline salicylate = topical analgesic (gel)

Lignocaine/benzocaine = local anaesthetic (gel/liquid)

Triamcinolone (S3) = corticosteroid

Question 20

Discuss some mouth ulcer self-care advice

Answer 20

Clean teeth three times a day w/ soft-bristled toothbrush

Avoid irritant foods = spicy/salty, caffeine, chocolate, citrus

Use straw to drink, avoid stress, use relaxation, exercise

Dental advice with dentures

Vitamin and mineral supplements

Question 21

When should mouth ulcers be referred?

Answer 21

Ulcer w/ uneven colouring, no discomfort/pain

Present >14 days, >1cm diameter

Other medications, ulcer occurs often

Signs of illness (e.g. fever, sore throat)

Question 22

Signs and symptoms of HSV-1 (herpes)

Answer 22

prodromal stage = itching, burning, pain, tingling (hrs - days)

infectious stage = Lesion appears as vesicle and blisters, these rupture/weep

Lesions curst over after 24 hrs, itch

Spontaneous healing 7-10 days, no scar

Total outbreak <14 days

Question 23

What triggers a HSV-1 episode?

Answer 23

stress, cold weather, UV light (sunburn), illness/fever, fatigue, menstruation

Question 24

What is pharm treatment for HSV-1?

Answer 24

1) topical antiviral (aciclovir 5%+ hydrocortisone 1%) (S2)= as soon as symptoms present, shortens duration

1) S3 famciclovir (1500mg) single dose = administered at onset of prodromal symptoms for infrequent severe cases, reduce healing time

2) Povidone-iodine ointment = reduce risk of infection

2) hydrocolloid patch = for mild uncomplicated sores, minimise secondary bact infection, promote wound healing

Question 25

What are some non-pharm treatments of HSV-1?

Answer 25

Ice pack = help swelling

Question 26

What are some alternative treatments for HSV-1?

Answer 26

Lysine = reduce symptom severity (prevention = 1-3g/day, treatment = 3g/day)

Zinc = topical preparation, reduces recurrence, resolves symptoms

Question 27

Discuss oral candidiasis

Answer 27

Presents = creamy, white soft elevated patches, common in very young/old

Symptoms = pain, soreness, altered taste, burning tongue

Question 28

What are the S3 drug treatments for oral candidiasis?

Answer 28

Micondazole gel (Daktrain)= use 4x a day after food, 7-14 days

Nystatin oral suspension (Nistat, Mycostatin) = topically in mouth then swallow, 4 times a day after food 7-14 days

Question 29

What S4 are used for oral candidiasis treatment?

Answer 29

Amphotericin lozenges (funglin) = suck then swallow, 4 times daily after food for 7-14 days