Plaque related diseases - caries Flashcards
what is dental caries?
a disease of the mineralised tissues caused by action of microorganisms on fermentable carbohydrates
1st - demineralisation of the mineralised portion
2nd - disintegration of organic material
what factors contribute to caries?
plaque - smutans and lactobacilli
carbohydrates
time
susceptible tooth
when do you treat caries operatively?
visible cavitation
caries close to EDJ
what is NDIP 2003?
national dental inspection programme
p1/7 children have a basic inspection annually and detailed inspection biannually
at what age do bitewings start?
start at 5 years
lateral obliques if no co operation
what are rampant caries?
caries involving several teeth and occur rapidly
how does caries progress?
episodically
enamel has a dynamic surface - constant remineralisation and demineralisation
what happens when caries reaches dentine?
pulp dentine complex reacts to initiate protection of tooth vitality
- bacterial toxins through tubules = inflammatory reaction in the pulp
= reactionary dentine and sclerosis, reduced permeability of tubules and the pulp retreats
what is the aim of a restoration?
remove the bacterial infection before carious exposure
what does pain indicate?
a pulpal inflammation
what does reversible pulpitis require?
remove infection and restore
what does irriversible pulpitis require?
leads to pulpal necrosis - xla,rct
what happens when toxins go through the root apex?
perriradicular periodontitis = abscess, swelling/sinus
what is cellulitis?
soft tissue swelling
what is ludwigs angina?
progresison from severe cellulitis
fom swelling and elevated tongue - difficulty swallowing, eating and breathing
risk of death by asphyxiation
what is primary root surafce caries?
below cej, no enamel involvement/restorations
what is secodary root surface caries?>
adjacent to restoration
what are root surface caries influenced by?
saliva fluoride oh diet chx
what are NME’s
caries epidemic cause
sucrose, glucose, fructose
what are milk sugars?
intrinsic sugars?
lactose
in fruit and veg
what does pre eruptive F cause?
wider fissures
more rounded cusps
thinner enamel and denitne
what is post eruptive F effects?
if f present = fluoroapatite = remineralises
fluoroapatite less soluble than HA
increases enamel mineralisation
increases resistance of enamel to demineralisation
reduced acidity of plaque
what is the conc of F in water?
1ppmF /1mg F per litre
what is duraphat?
5% sodium fluoride
22600ppmF
what is combined fluoride therapy?
gives best results
1 systemic and 1 topical
what is fluorosis?
enamel hypoplasia
white chalky spots/brown staining and pitting of teeth
increased f affects the enamel matrix formation and impairs ameloblastic function
bilateral symmetrical distribution
what is the tx of fluorosis?
microabrasion
bleaching
resin restoration
veneers
what is toothbrush abrasion?
abnromal loss of tooth structure bc non masticatory physical action - repetitive mechanical habit
what is chlorhexidine?
0.2% chlorhexidine gluconate
antiseptic/antimicrobial action
bacteriocidal and bacteriostatic
= adsorbed onto teeth and mucosal surfaces and releases bacteriostatic concentrations over a period of time
how much saliva is secreted daily and what is its function?
0.5-0.6 litres/day
protective, digestive, enamel stabilisation
buffers and neutralises acids
what is xerostomia?
reduced salivary production meds - diuretics, antihistamines, antidepressants radiation s.gland surgery systemic disease - sjogrens syndrome
how does xerostomia look in the mouth?
dry glossy atrophic mucosa
fungal bacterial infections common
angular chelitis
what is the tx of a disabled pt with caries?
superbrush
modified handle
sponges with chx and chx gel
what is moisture control used to eliminate?
saliva
gcf
bleeding
pus etc
what is a PRR?
min pit and fissure caries
restores caries and seals rest of fissure pattern
what problems does NCTSL cause?
sensitivity cupping lesion pulp exposure loss of vitality proud restorations reduced height of crowns aesthetic problems
what is erosion?
chemical dissolution of hard tissues not including bacteria
what is attrition?
loss of structure bc mechanical action of mastication
what is abrasion?
friction
what is abfraction?
tensile/compressive forces during tooth flexure = loss of tooth surface