TOOTH CONS & CARIOLOGY Flashcards
Explain the 5 additional questions/investigations required for caries risk determination following a provisional diagnosis?
- 24 Hour Snacking Questionnaire
- Plaque Index
- ICDAS
- Stimulated Saliva
- Modifying factors
o B/W
o Medical history & medications
o Fluoride history
o Diet and oral hygiene
o Past caries experience
o Social factors (education, income, smoking, alcohol, family Hx, stress, etc)
o Local factors: overhanging resto, Fractured resto, anatomical variations, rotated tooth, exposed root, ill fitting denture etc
Which teeth are used for the plaque score?
Total of 6 teeth - 16, 11, 26, 36, 41 and 46 (on plaque report form)
• 0 = Follow air drying, plaque is not visible and cannot be picked up by explorer
• 1 = Following air drying, plaque is not visible and can be picked up by explorer
• 2 = Plaque is visible (no air drying or probe required)
• 3 = Thick plaque is visible
On clinical examination, a tooth appears sound in wet conditions but upon drying, you notice a WSL - what is the ICDAS score?
1
On clinical examination, a tooth has a brown spot lesion in wet conditions and upon drying, you notice some enamel loss - what is the ICDAS score?
3
After finalising the caries risk for a patient, briefly explain the next steps involved in managing the patient?
- Case presentation: Explain what info has been gathered
- Informed consent on treatment plan
- Behaviour management and coaching: OH re-education and at home fluoride care
- Monitoring - recall as appropriate
What are the three tests for resting saliva?
- Flow rate: Dry bottom lip and time when hydration beads begin to form.
60s = Low
30 – 60s = Normal
< 30s = High - Viscosity: Visual inspection of general viscosity.
- Water and clear = Normal
- Frothy and bubbly = ↑ Viscosity
- Sticky and frothy = ↑↑ Viscosity - pH: Use pH paper dipped into patient’s saliva and compare with indicator.
Which is correct treatment of root caries?
A) Superficial soft lesion - Twice daily brushing with 1000ppm
B) Minimal cavitation and soft lesion - Twice daily brushing with 5000ppm and GIC restoration
C) Superficial hard lesion - Twice daily brushing with 5000ppm
D) Minimal cavitation and hard lesion - Twice daily brushing with 1000ppm
D)
What is the concentration for NaF rinse:
A) Weekly/fortnightly
B) Daily
When is it indicated?
Who should it NOT be used on?
• Weekly or fortnightly rinse – 0.2% (900-910 ppm)
• Daily rinse = 0.05% (220-227ppm)
• Indications:
o Undergoing orthodontic treatment
o Unable to perform adequate tooth brushing
o Post-irradiation hyposalivation
Note: 0.05% rinse recommended once daily at separate time from brushing (1 minute) for medium risk patients
• Should NOT be used for children < 6 years
Which type of fluoride gel is commonly used and at what concentration. Which group of patients is this recommended for inchair?
APF 1.23% (12,300ppm)
Recommended for low risk patients at recall appointments to maintain lesion arrest.
Relate ICDAS and bitewing scores to measures of intervention:
- Preventive/preservative
- Grey - Restore or not restore? Require further considerations
- Invasive treatment
ICDAS:
1, 2 = Preventive/preservative
3, 4 = Grey
5, 6 = Invasive
BW score:
1, 2, 3 = Preventive/preservative
4 = Grey
5 = Invasive
Which is false about sivler diamine fluoride?
A) It has pH 9-10
B) Disadvantage of black/brown discolouration of carious dentine
C) Reserved for approximal caries
D) 38% solution is most effective
C) This is referring to resin infiltration procedure
Which of the following is NOT a risk factor for erosion?
A) Acidic diet
B) Parafunction
C) GORD
D) Swimming
B) Referring to attrition
Distinguish attrition vs abrasion.
Attrition = Loss of wear of tooth substance or restoration caused by contact between occluding or approximal surfaces
Abrasion = Loss of wear of tooth substance or restoration caused by factors other than tooth contact
What are the five types of cracked tooth diagnosis?
Enamel craze lines
Fractured cusp
Cracked tooth (incomplete crown-root fracture)
Split tooth
Root fracture
What type of caries removal is indicated for
- Deep caries
- Extremely deep caries
Deep caries = C5 (inner 2/3 of dentine
- Selective removal to firm dentine –> Therapeutic agent, base liner and restoration
Extremely deep caries = >C5 (inner 1/4 of dentine) - pulp exposure is unavoidable
- Selective removal to soft dentine –> Therapetuci agent, base liner and restoration
- Stepwise caries removal:
1. First visit = As above
2. Second visit = Reenter 6-12months and remove further leathery dentine
*NOTE: Both cases need to have peripheral walls on hard/sound dentine
