Risk Assessment Flashcards

1
Q

What are the factors necessary for caries?

A

tooth
substrate (carbohydrate)
plaque (bacteria)

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2
Q

Which child patients are at higher risk of dental caries?

A
  • children presenting with tooth decay
  • children who have had dental caries in their primary dentition and first permanent molars
  • been admitted to hospital for removal of their teeth;
  • certain children who are medically compromised or have a disability.
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3
Q

Which adult patients are at a higher risk of dental caries?

A

people with medically compromising conditions or disabilities

older adults, particularly as they become physically or cognitively impaired

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4
Q

Why does risk identification based on a single risk or protective factor have limitations?

A

due to the multifactorial nature of caries

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5
Q

What are general caries risk factors?

A

social
general health

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6
Q

What are the local caries risk factors?

A

Oral Hygiene
Diet
Fluoride Experience
Past Caries Experience
Orthodontic Treatment

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7
Q

What is caries risk assessment?

A

individually tailored
basis of case management & treatment planning in the short & long term
ongoing re-assessment

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8
Q

What are the 7 elements of caries risk determination?

A

Clinical Evidence
Dietary Habits
Social History
Fluoride use
Plaque control
Saliva
Medical History

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9
Q

What is the role of diet in caries development?

A

> 3 sugar intakes per day

High frequency more of an issue than volume of sugar

Highly processed/refined carbohydrate more cariogenic than natural sugars (e.g. sucrose more cariogenic than glucose and fructose)

Natural sugars still cause harm e.g lactose in Early Childhood Caries

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10
Q

What should be used to analysed diet?

A

four day diet diary including one/two days at the weekend

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11
Q

What examination provides clinical evidence?

A

physical

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12
Q

What are clinical factors that increase risk of caries?

A

Caries Experience
dmft > 5 (primary dentition), DMFT > 5 (permanent dentition)
caries in 6’s at 6 years
3 year caries increment > year

Orthodontics
Fixed appliance therapy

Prosthetics
Fixed or removable

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13
Q

What are the social history factors that could impact caries risk?

A

SIMD category (social index multiple depravation)
Education
Unemployment
Work stressors
Single parent families
Violence
Inequalities and access to healthcare
Dependents

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14
Q

What is the role of fluroide in caries development?

A

Infrequent use of F- toothpaste
No F- in Water supply

Professionally applied fluoride

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15
Q

What does fluoride do?

A

forms caries resistant flurorapitite

antimicrobial effect

reduces ability of bacteria to stick to the surface of the teeth

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16
Q

What is the role of plaque control in caries development?

A
  • Poor technique
  • Irregular brushing
  • Unassisted (very young/very old, those with manual dexterity issues)
  • Access to toothbrush/toothpaste
  • Difficulty due to changes (mixed dentition/orthodontics/gaps/recession)
17
Q

What is the role of saliva in caires development?

A

Amount
Flow
Buffering Capacity
pH
Viscosity

18
Q

What is the role of medication on caries development?

A

Xerostomia (desired effect/side effect e.g. scopolamine patches/asthma inhalers)

Other drug side effects making OH difficult e.g.Mucositits

Free sugars to make medicine more palatable (lactulose)

Frequency of sugar containing medicine

Recreational drug use/rehabilitation from
drug addiction

Social convention of how we act towards people who are ill- bring them sweets!

19
Q

What are the social factors that impact child caries?

A

Mother’s education secondary only

Poor dental attender

Family Unit: single parent, social class, unemployment

20
Q

What are the health factors that impact child caries?

A

Poor health/chronic sick
Sugar-based medications

21
Q

What are social/behaviourial factors that affect infant caries?

A

mother’s caries rate
prolonged nursing habits
bottle/ pacifier at bedtime
cariogenic snacking
No tooth cleaning
Little Fluoride exposure

22
Q

When should you start brushing infant teeth?

A

as soon as they erupt

23
Q

What are factors associated with a typical high risk adult?

A

Level of education
Attends only when they identify a problem
Social difficulties
“Sweet tooth” with poor OH
Secondary caries
Medication that impacts oral health

24
Q

What are the eight elements of the preventative program?

A

Radiographs
Toothbrushing instruction
Strength of F in toothpaste
F varnish
F supplementation
Diet advice
Fissure sealants
Sugar free medicine