Orthodontic Prevention

Question 1

List 6 risks of orthodontic treatment

Answer 1

demineralisation
root resorption
pulp damage
gingivitis/periodontal problems
soft tissue damage
other factors e.g TMD, burns

Question 2

define demineralisation

Answer 2

early stage of caries

loss of tooth substance

Question 3

what causes demineralisation

Answer 3

plaque bacteria metabolise dietary sugars

acid produced which attack tooth surface

Question 4

what is the critical pH of enamel and dentine

Answer 4

enamel- 5.5

dentine- 6.5

Question 5

what is the appearance of demineralised enamel

Answer 5

brown/white staining

Question 6

what are the 4 requirements for demineralisation/caries

Answer 6

plaque bacteria
carbohydrate/substrate
susceptible tooth surface
time in contact with tooth surface

Question 7

why may GI cement be used on bands?

Answer 7

F- release

prevent demineralisation?

Question 8

how long can it take for non cavitated lesions to remineralise?

Answer 8

6-12 week post de bond

Question 9

what is contraindicated for remineralisation and why

Answer 9

high F-

stops remineralisation process

Question 10

define micro abrasion

Answer 10

mechanical removal of a small amount of tooth structure to eliminate superficial enamel discoloration defects not removed by bleaching techniques

Question 11

name a common abrasive used in micro abrasion

Answer 11

pumice

HCL acid

Question 12

define root resorption

Answer 12

progressive loss of dentine and cementum by osteoclasts

Question 13

how much root length is lost on average during treatment

Answer 13

1-2 mm

Question 14

3 risk factors for root resorption

Answer 14

family history
previous trauma
resorption pre-treatment

Question 15

what prevention steps would you take for root resorption

Answer 15

radiographs to assess pre-treatment lengths
light forces during treatment
if pt at risk- radiographs 6 qmonths into treatment

Question 16

what can previously traumatised teeth be at risk of and what should be done ?

Answer 16

pulp damage/pulpitis so monitor pulp vitality

Question 17

2 ways pulp vitality can be measured

Answer 17

thermal or electical pulp testing

Question 18

How can rotary instruments (composite removing etc) affect the pulp

Answer 18

can damage due to overheating so take care when using

Question 19

how can risk of pulp damage be managed

Answer 19

little can be done
warn patients can last 2-7 days after appliance fitted
analgesic for pain

Question 20

what should patient with heavily restored dentition be warned about

Answer 20

periapical abscess

Question 21

why can gingival inflammation increase during orthodontic treatment

Answer 21

as reduced access for cleaning

Question 22

what periodontal problems can occur during ortho treatment?

Answer 22

increased gingival inflammation due to reduced access to cleaning
apical migration of periodontal attachment and bony support

Question 23

what does poor gingival health prior to treatment indicate

Answer 23

pt is unsuitable for ortho treamment

Question 24

define periodontal drift

Answer 24

tooth drifting due to periodontitis

Question 25

what can removeable appaliances be associated with?

Answer 25

gingival inflammation particularly of palatal tissues

Question 26

what is the management for periodontal problems

Answer 26

OHI
periodontal monitoring
3/12 s+p

Question 27

what is required after treatment for patients with periodontal problems

Answer 27

permanent retention due to altered ST balance

Question 28

name 4 types of soft tissue that can occue

Answer 28

traumatic ulcerations
friction against components of applainces
archwire ends lacerating- cut this
clumsy instrumentation- careful

Question 29

why can headgear be considered a risk

Answer 29

headgear bow can be displaced during sleep etc
bow is sharp and if eye is penetrated can cause an eye infection and eventual loss of eye
=sympathetic opthalmitis

Question 30

what is the risk with TADs

Answer 30

risk of perforation/infection

Question 31

name 2 possible allergic reactions

Answer 31

latex

nickel

Question 32

name 6 ‘other risk factors’

Answer 32

TMD
relapse
burns
allergic reactions
anchorage- headgear, TADs
prolonged treatment