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4th Yr - CAD > Third Molar Assessment > Flashcards

Third Molar Assessment Flashcards

1
Q

what are some common things that can happen with third molar?

A

impaction: against adjacent tooth, bone or soft tissue
- food packing
- caries
- abnormal path eg. cuts

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2
Q

what type of impaction is this ?

A

mesio-angular impaction

  • food trap causing inflammation
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3
Q

what are the different types of impaction can you get on mandibular third molar teeth ?

A
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4
Q

what are the different types of impaction can you get on maxillary third molar teeth?

A
  • vertical
  • disto- angular (most common)
  • mesio angular
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5
Q

what are the signs and symptoms

A
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6
Q

what can happen to third molars and why are they a problem ?

A

Pericoronitis (can get with any tooth)
Infection
Caries
Pathology (cysts / tumours)
Resorption (internal / external)
Trauma
Orthognathic surgery

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7
Q

what is pericoronitits?

A

An infection of the soft tissue around the crown of a partially
erupted tooth.
Usually cased by normal oral flora.
Common.

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8
Q

what are the causes of pericoronitits ?

A
  • Compromised host defences eg. diabetes or meds
  • Poor oral hygiene
  • ‘Trauma’ – often from opposing dentition
  • Food trapping under the operculum
  • Bacterial infection
  • Prevotella intermedia
  • Fusobacterium species
  • Anaerobic streptococci
  • Poor oral hygiene
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9
Q

what are the local symptoms of pericoronitis?

A

Pain
Halitosis
Swelling
Erythema
Bad taste

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10
Q

what are the systemic symptoms of pericoronitis ?

A

Trismus
Pyrexia
Lymphadenopathy
Malasie
Dysphagia

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11
Q

when should we be concerned if a pt has periocoronitis?

A

if infection spreads to submandibular or submental region making it difficult to swallow

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12
Q

how do we locally manage periocornitis ?

A

Irrigation with saline
Oral analgesia (paractemol / NSAIDs if no C/I)
Oral rinse warm salt water / CXD m/w – check sensitivities

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13
Q

how do we manage pericoronitis systemically ?

A

ABCDE to check if theres any life threatening signs
Irrigation with saline
Oral analgesia (paractemol / NSAIDs if no C/I)
Oral rinse warm salt water / CXD m/w – check sensitivities
PLUS
Broad spectrum antibiotic for 5/7
Amoxicillin 500mg TDS
Penicillin V 500mg QDS
Metronidazole 400mg TDS

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14
Q

how do we asses pts with third molar problems ?

A
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15
Q

when we asses third molars what are the the 3 factors we need to consider?

A
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16
Q

why is age important?

A

Increased morbidity with age
physiological changes
co-morbidities
recovery period
polypharmacy

17
Q

why is social history important>?

A

Smoking
Vaping
Alcohol
Diet
Occupation – “If you can’t bite you can’t fight”
= we remove third molars before hand for ppl who can’t access dental care to prevent problems in the long run eg. armed forces
Access to care
Post-operative Care

18
Q

why is drug history important ?

A

Steroids
Bisphphosphonates
Biologics / Immunomodulators
Antiplatelets / Anticoagulants

19
Q

why is BMI important?

A

increased can lead to issues like: diabetes, hypertension, cardiovascular diseases and small mouth and difficulty with access

20
Q

why is ethnicity important ?

A

dense bones from afrocarribean

21
Q

why is capacity important?

A

need this for consent

22
Q

why is anxiety important?

A
  • use MDAS
23
Q

why is the tooth itself important ?

A

how does it appear?
Fully erupted
Partially erupted
Presence abscence of disease / infection

24
Q

what are the 2 nerves we need to be mindful about when extracting ?

A

IAN
lingual

25
Q

descrie IAN ? innervation?

A
  • enters mandibel thru mandibular foramen
  • this nerves runs thru mandible and then crosses mandible then goes from lingual to buccal
  • provide sensation to lower teeth, gums, lip skin of chin
26
Q

describe lingual nerve ? innervation?

A
  • runs alongside IAN but is more superficial
  • innervates tongue
27
Q

what runs alongside IAN?

A
28
Q

what is important about the apices of the upper molars ?

A

run next to maxillary antrum

29
Q

how do we assess abnormal x rays

A
30
Q

what are some red flags in xrays

A
31
Q

what are we looking at then looking at xrays ?

A
32
Q

what are we looking at when assessing third molar xrays ?

A
  • Relationship to vital structures
    ➢ Configuration of roots
    ➢ Condition of the surrouding bone
    ➢ Apical
33
Q

when would we consider a CBCT?

A
34
Q

why is surrounding bone important when imaging?

A
35
Q

what is the depth of impaction?

A
  • where we would place instrument
36
Q

who are at risk of third molar complications?

A

Underlying systemic disease
Increased age
Infection
Anatomical position of tooth / root morphology
Local anatomical relations
Status of adjacent teeth
Reduced access
Dense bone
Lack of PDL space – ankylosis
Pathology
Poor patient cooperation / compliance

4th Yr - CAD (11 decks)

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