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YR 3 - CCD > Treatment Planning > Flashcards

Treatment Planning Flashcards

1
Q

link of disease and deprived areas

A

positive correlation

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2
Q

what are the high risk groups for dental caries?

A

low socioeconomic groups
medical conditional
clinical - enamel defects

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3
Q

what are the 3 independent factors for caries.

A

diet
fluoride
oral hygiene

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4
Q

how many dental disease affect children

A
  • pain and infection - difficulties eating, sleeping, concentration at school
  • miss school
  • carers take time off work
  • extractions affect alignment of permanent teeth
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5
Q

what are the 5 steps of the Dental Care Philosophy

A
  1. gain trust and co-operation
  2. accurate diagnosis and appropriate treatment plan
  3. comprehensive preventative care
  4. deliver in a way the child finds acceptable
  5. techniques for effective and long-lasting result
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6
Q

what comes under history taking?

A

reason for attendance
any complains
past MH
past DH
SH

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7
Q

what comes under examination

A

extra oral

intra oral
- soft tissues
- gingivae
- dental charting
- occlusion

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8
Q

how many primary teeth are there?

A

20

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9
Q

when do the primary teeth erupt (in months)

A

maxillary
- central incisor = 7 month
- lateral incisor = 8 month
- canine = 18 month
- first molar = 14 month
- second molar = 24 month

7,8,18,14,24

mandibular
- central incisor = 6 month
- lateral incisor = 7 month
- canine = 16 month
- first molar = 12 month
- second molar = 20 month

6,7,16,12,20

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10
Q

when do the permanent teeth erupt (in years)

A

maxillary
- central incisor = 7-8
- lateral incisor = 8-9
- canine = 11-12
- first premolar = 10-11
- second premolar = 10-12
- first molar = 6-7
- second molar = 12-13
- third molar = 17-21

mandibular
- central incisor = 6-7
- lateral incisor = 7-8
- canine = 9-10
- first premolar = 10-12
- second premolar = 11-12
- first molar = 6-7
- second molar = 12-13
- third molar = 17-21

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11
Q

give 6 key things to look for in a developing dentition.

A
  • any delayed eruptions
  • abnormal eruptions
  • premature loss of primary canines
  • crossbites
  • prognosis of first permanent molars
  • palpate for permanent canines at 9 years old
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12
Q

what is a cross bite?

A

when teeth don’t line up properly when mouth is closed

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13
Q

what special tests can kids have?

A

radiographs
palpations
percussions
mobility tests

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14
Q

how often do children have radiographs and what type?

A

12-24 months
- frequency dictated by risks

  • every 6 month for high caries risk
  • routine bitewings
  • OPT only when clinically necessary
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15
Q

which special tests are not performed on children? why?

A

vitality tests
- ethyl chloride or EPT

they are not reliable

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16
Q

What should the diagnosis include? (7)

A
  • patients cooperation ability
  • dentition stage
  • oral hygiene and gingival status
  • dental caries
  • pulpal/perio pathology
  • developing dentition
  • any other defects
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17
Q

what are the 3 principle strategies for restorations

A
  1. prevention approach
  2. biological
  3. conventional
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18
Q

describe the preventative approach.

A

aim is to reduce the cariogenic potential of a lesion
- altering environment
- through OHI

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19
Q

what 4 tools are there for the preventative approach?

A

OHI
fluoride varnish
diet
fissure sealants

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20
Q

what case selections are ideal for the preventative approach?

A
  • asymptomatic - no pain
  • no evidence of sepsis
  • parental motivation and consent
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21
Q

for prevention, how often should fluoride varnish be applied to high caries risk children?

A

2 times a year

22
Q

generally, how much fluoride should 3-6 years be using?

A

more than 1000ppm

23
Q

how much fluoride should a child above 6 be using or if they are below this age and high caries risk?

A

1350-1500ppm

24
Q

for prevention, how much fluoride for 10+ years with active caries?

25
for prevention, how much fluoride for 16+ with active caries?
either 2800ppm or 5000ppm
26
how much does fluoride intervention reduce caries by in primary and permanent teeth?
primary - 37% permanent - 43%
27
what does diet advice communication need to be like? (3)
easy to deliver, retain and follow
28
what does diet advice entail? (7)
- restrict food and drink w/ sugar to 4 occasions in one day max - drink water or milk between meals - sugar-free snacks - no sweetened drinks in feeding bottles - no eat or drink after brushing at night - foods have hidden sugars - restrict fizzy, acidic drinks
29
what age should a child be supervised when brushing?
until at least 7 years old
30
by what percent do fissure sealants reduce the incidence of occlusal caries over 4 years?
50% reduction
31
what's the recall intervention for a child with high caries risk?
every 3 months until they move to a low caries risk
32
what discussions can you have with the parent?
- explain preventative approach - can delay decay progression - reasons why treatment is appropriate for child - importance of home care
33
what must be documented?
- discussions with the parents, including reasons for choosing approach - parental consent - parent understanding treamtne may be required in future - DNA's and cancellations
34
in which 2 cases would a preventative approach be successful?
- child with early lesions - older child with asymptomatic dental caries who can't cope with LA/conventional approach
35
describe the biological approach.
the aim is to completely seal a carious lesion from the oral environment - to slow or arrest caries progression
36
why may the biological approach be more suitable?
- if child struggles with LA - if it is possible to arrest the caries
37
what does the Hall Technique state?
- evidence for prevention approach = limited - evidence for biological approach = more robust - crowns are more effective than fillings for managing decay
38
what are the 3 advantages and 2 disadvantages of the biological approach?
pros - can be effective and is preferred to complete caries removal by all members - avoid use of LA and tooth prep - no iatrogenic damage risk cons - quality of seal must be good, otherwise caries persists - evidence needs to be more solid
39
what case selections are ideal for the biological approach?
- asymptomatic - no pain - no evidence of sepsis - child can sit in chair and follow instruction - parental consent
40
what are the steps in the biological approach?
assessment good OHI fissure sealant or hall technique crown
41
if you are to place a hall technique crown on a child, what is the criteria?
- must be able to manage bitewings - need to have a clear band of healthy dentine between caries and pulp - no history of nocturnal pain or infection - bitewings post-op to ensure full seating
42
what is the 'technique' of a hall technique crown lol
1. assess tooth shape, contact points and occlusion 2. protect airway - sit at 45 and gauze for the throat 3. size the crown 4. load with cement 5. fit the crown 6. remove excess cement, check fit 7. check occlusion
43
with the biological approach, when would you use fissure sealants?
- no cavitations - no radiolucency
44
describe the steps of applying fissure sealant.
- clean pits and fissure - isolate the tooth for moisture control - etch, wash and dry - bond and cure - sealant and cure - evaluate
45
with the biological approach, what must be discussed with parents?
- its is a new technique, with evidence to work - need good homecare for succession - need regular review and recall - future intervention may be required
46
when do you stop recall interventions with children?
- move to low caries risk - no new lesions on BWs - good plaque control - low cariogenic diet
47
describe the conventional approach.
the gold standard managing all caries and restore oral health - LA, RD, complete caries removal, restorations, extractions - GA/RA if required - lots of evidence for success
48
with the conventional approach, how is the treatment plan set out?
formulate the plan visit by visit - order will be simple to complex - preventative care runs parallel to restorative - behaviour management is integral
49
with the conventional approach, what is the order of care with the teeth? aka quadrant dentistry.
order of care: - upper posterior (2 visits) - lower posterior (2 visits) - upper anterior - lower anterior - prioritise the key teeth- permanent, Es, Ds
50
how can child behaviour be considered?
- go at a pace they can tolerate - set realistic goals
51
what material is used for occlusal cavities?
composite
52
what is the next option if LA is not possible?
general anaesthesia inhalation sedation - 5+yrs

YR 3 - CCD (16 decks)

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