SCR Dental Conditions Flashcards

1
Q

What would you expect to find in a patient pain history of an acute periodontal abscess?

Clinical observation?

Type of pain?

Onset?

Exacerbating factors?

A

Localised swelling

Throbbing pain, dull ache and tenderness. Well localised

A few days onset may be recurrent.

Exacerbated by biting and pressure

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2
Q

What are the findings on clinical examination for an acute periodontal abscess?

A

Intra-oral swelling adjacent to the tooth at gingival margin level Increased mobility

Increased periodontal pocketing

Lymphadenopathy

Bleeding and pus released on probing of pocket

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3
Q

What are the findings on percussion for an acute periodontal abscess

A

Slight TTP in a lateral direction

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4
Q

What are potential radiographic findings of an acute periodontal abscess?

A

Alveolar bone loss, vertical or horizontal

Apical radiolucency in perio-endo lesion

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5
Q

What is the management of an acute periodontal abscess?

A

If FOM is raised then send to A&E

RSD with irrigation of the pocket

XLA

Antibiotics if systemic or patient is immunocompromised

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6
Q

What is the management of an acute periodontal abscess where the FOM is raised?

A

If FOM is raised then send to A&E

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7
Q

Give a description of a typical patient that presents with necrotising ulcerative gingivitis

A

Commonly young adult Smoker
Poor oral hygiene
Stressed

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8
Q

What would you expect to find in a patient pain history of necrotising ulcerative gingivitis?

A

Pain
Bleeding
Swelling from gingivae
Halitosis

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9
Q

What are the findings on clinical examination for a patient with necrotising ulcerative gingivitis?

A
Necrosis and ulceration of  gingival tissues 
Blunted interdental papillae
Loss of attachment 
Oral hygiene poor 
Increased bleeding on probing 
Tender gingivae 
Lymphadenopathy
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10
Q

What are potential radiographic findings of necrotising ulcerative gingivitis?

A

Potential bone loss

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11
Q

What is the management of necrotising ulcerative gingivitis?

A

OHI
Smoking cessation advice
Antibiotics
Chlorhexidine mouthwash

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12
Q

What would you expect to find in a patient pain history of dentine hypersensitivity?

Pain stimuli?

Type of pain?

Does pain linger after the removal of stimuli?

A

Pain with hot, cold and sweet

Short sharp pain

Pain relieved by removal of stimulus

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13
Q

What treatment could potentially lead to dentine hypersensitivity?

A

May have had recent scaling or tooth whitening

Potential ongoing periodontal treatment

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14
Q

What are the findings on clinical examination for a patient with dentine hypersensitivity?

A

Root surface exposure due to gingival recession

Failed restorations

Potential caries

Sensitive to cold air stream

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15
Q

What are the findings on percussion for dentine hypersensitivity?

A

Not TTP

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16
Q

What evidence from a radiograph could potentially help diagnose dentine hypersensitivity?

A

Caries may be present

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17
Q

What is the management of dentine hypersensitivity?

A

Advise to use desensitising toothpaste

Avoid extreme temperature & acidic food

Apply topical fluoride varnish, dentine bonding agents, or cover exposed dentine with suitable restorative material

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18
Q

What would you expect to find in a patient pain history of food packing?

A

Pain after eating fibrous food

Recent large filling

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19
Q

What are the findings on clinical examination for a patient with food packing?

A

Lost or broken contact point

Gingival inflammation

Overhang

Food debris in contact point

No resistance to floss passing through contact point

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20
Q

What are the findings on percussion for food packing?

A

Potential lateral TTP

21
Q

What are potential radiographic findings of food packing?

A

Open contact point

22
Q

What is the management of food packing?

A

Scaling

OHI with tepe

Consider replacing restoration or improve contact point

23
Q

What would you expect to find in a patient pain history of cracked tooth syndrome?

A

Sound tooth gives sharp pain on biting and with hot and cold fluids
Pain on release of pressure

24
Q

What are the findings on clinical examination for a patient with cracked tooth syndrome?

What may you use in your clinical examination to check for this? What would the result be?

What could there be evidence of in the mouth to suggest it caused cracked tooth syndrome?

A

A crack or fracture may be evident
Existing restoration present

Pain on the release of pressure as checked with tooth sleuth

Evidence of parafunction

25
What are the findings on percussion for cracked tooth syndrome?
Potentially TTP
26
What will you see when you sensibility test a tooth with cracked tooth syndrome?
Positive response with an exaggerated response
27
What is the management of cracked tooth syndrome if there are symptoms of reversible pulpitis?
Cement orthodontic band to prevent cusps from being wedged apart Tooth will require cuspal coverage restoration
28
What is the management of cracked tooth syndrome if there is a vertical crack into root surface?
XLA
29
What would you expect to find in a patient pain history of reversible pulpitis?
Short sharp pain Poorly localised pain Mainly cold stimuli Pain goes if stimuli removed
30
What are the findings on clinical examination for a patient with reversible pulpitis?
Recent or failed restoration Tooth wear Recession Caries into dentine
31
What are the findings on percussion for reversible pulpitis?
Not TTP
32
What will you see when you sensibility test a tooth with reversible pulpitis?
Positive or hypersensitive
33
What are potential radiographic findings for reversible pulpitis?
Caries into dentine Lamina dura seen No periapical change
34
What is the management of reversible pulpitis?
Removal of caries and if pulp is nit exposed place a temporary ZOE dressing
35
What would you expect to find in a patient pain history of irreversible pulpitis?
``` Rapid onset or spontaneous pain Poorly localised pain Constant or lingering dull/sharp/stabbing pain Disturbed sleep Pain persists after stimulus is removed Exacerbated by hot ```
36
Comment on how analgesics help control both reversible and irreversible pulpitis?
Reversible can be controlled with analgesics Irreversible cannot be controlled with analgesics
37
What are the findings on clinical examination for a patient with irreversible pulpitis?
Extensive caries into dentine or pulp | Recent or failed restoration
38
What are the findings on percussion for irreversible pulpitis?
Not TTP
39
What will you see when you sensibility test a tooth with irreversible pulpitis?
Negative or painful delayed response
40
What are potential radiographic findings for irreversible pulpitis?
Caries or large restoration near or into pulp Widening of PDL No periapical change
41
What is the management of irreversible pulpitis?
Assess restorability If unrestorable XLA If restorable extirpation
42
What would you expect to find in a patient pain history of acute apical periodontitis?
Spontaneous onset Constant lingering pain especially on biting Well localised pain
43
What are the findings on clinical examination for a patient with acute apical periodontitis?
Swelling is palpable but localised to tooth Tooth may be carious or discoloured May have had a previous RCT Lymphadenopathy
44
What are the findings on percussion for acute apical periodontitis?
TTP
45
What will you see when you sensibility test a tooth with acute apical periodontitis?
Negative
46
What are the findings on percussion for acute apical abscess?
TTP
47
What will you see when you sensibility test a tooth with an acute apical abscess?
Negative
48
What are potential radiographic findings for an acute apical abscess?
Widening of PDL to large apical radiolucency | Root filled may be present
49
What are potential radiographic findings for an acute apical periodontitis?
Widening of PDL to large apical radiolucency | Root filled may be present