Tutorials Flashcards
name 3 potential triggers of asthma
allergies
exercise
smoke
infections
aetiological factors of MIH
perinatal hypoxia
genetic predisposition
childhood illness e.g measles, rubella
how does the pattern of MIH differ from fluorosis
MIH has an asymmetrical pattern
Fluorosis is diffuse linear patches with clear boundaries in a symmetrical pattern
what teeth are most commonly involved in MIH
one to four FPMs, at least one must be affected for MIH diagnosis
permanent incisors also commonly affected
Other teeth may also present defects
describe the demarcated opacities seen in MIH
only defects more than 1mm should be considered
clearly demarcated opacities presenting with an alteration in the translucency of enamel. Can vary in size, shape and colour - white, creamy or yellow/brown
why is post eruptive enamel breakdown seen on MIH teeth
due to masticatory forces on the weakened enamel, breaks down over time
Loss is often associated with a pre existing demarcated opacity
what shape does dens in dente appear as on a radiograph
white ‘m’ shape
what teeth is most commonly affected by dens in dente
maxillary lateral incisors
difference between MIH and amelogenesis imperfecta
amelogenesis - generally all teeth affected
MIH - not all teeth affected, most commonly just FPM(s) +/- incisors
what is contained within some fluoride varnishes that may trigger asthma
colophony (sticky agent)
treatment option for MIH posterior teeth with no post eruptive breakdown
(child)
fissure sealants
treatment for MIH posterior teeth with post eruptive breakdown
(child)
composite - ideally with no prep
no crowns or veneers in children
FS is insufficient for teeth that have experienced PEB
non invasive treatment option for MIH anterior teeth
microabrasion
resin infiltration
in what circumstances may microabrasion be considered for treating MIH teeth
anterior teeth where aesthetics important
most useful on yellow/ brownish demarcations
superficial lesions
what is used for carrying out microabrasion
18% hydrochloric acid
when may resin infiltration be a useful treatment for MIH
anterior teeth where aesthetics important
deeper lesions that cant be fixed with microabrasion
(resin infil brand is ICON)
why might patients with MIH not cope with resin glass ionomer fissure sealant and a GI FS be more suitable
due to sensitivity - think cold air, cold water
For normal glass ionomer can dry with cotton wool rather than cold air
discuss tooth mousse
Tooth mousse can be used to help relieve sensitivity
helps block dentinal tubules and also contains fluoride to aid remineraisation.
Can be applied after brushing with finger
Takes time to have effect - needs build up
comes in variety of flavours
Can be expensive
what patients cant use tooth mousse and why
those with milk allergy or vegans
contains casein which is a milk protein
why might MIH teeth be difficult to anaesthitise
due to chronic pupal inflammation from sensitivity
articaine may be better than lidocaine for infiltrations
how is an asthma attack treated
mild/moderate attack - 2 puffs salbutamol
severe/acute attack - 10x puffs salbutamol into spacer then breathe for 2 mins then oxygen - repeat if required
short acting vs long acting beta agonists
short e.g salbutamol - treating bronchoconstriction
long - prevention of bronchoconstriction
what do inhaled corticosteroids do
reduce inflammation in bronchial walls
why might asthma patients be at increased risk of candida
if they use corticosteroid inhalers
