Unit 304 - oral health assessment/diagnosis Flashcards

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1
Q

What are the 2 main purposes of carrying out the oral health assessment?

A

-prevention of disease by regular opportunities to reinforce oral health and general health messages.
-early detection and diagnosis when disease is already present.

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2
Q

What are the 3 main diseases that dentist look for during an assessment?

A

caries, gingivitis, periodontal disease

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3
Q

Within oral health assessments what are dentist there to do?

A

make the initial diagnosis, treatment plan and carry out treatments.

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4
Q

Within oral health assessments what are hygienist there to do?

A

works directly with patients or under the perscription from a dentist, maintain oral health and prevent it from worsening.

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5
Q

Within oral health assessments what are therapist there to do?

A

works directly with patients or under the perscription of a dentist to carry out certain treatments if necessary

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6
Q

Within oral health assessments what are dental nurses there to do?

A

assist the dentist, providing clinical and other support during the assessment/treatment, reinforce all oral hygiene messages given to the patient.

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7
Q

Why are vitality tests preformed?

A

Help to determine whether a tooth is vital or non - vital

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8
Q

Examples of materials/instruments the dentist will use to preform a vitality test- hot, cold and electrical.

A

Hot - greenstick compound - type of GP (vaseline should be applied to the tooth prior to prevent further pain)
Cold - ethyl chloride - produce ice crystals in room temperature
Electric - electric pulp tester

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9
Q

In regards to vitality testing what response would inidicate a healthy pulp?

A

Normal

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10
Q

In regards to vitality testing what response would inidicate early pulpitis?

A

increased response

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11
Q

In regards to vitality testing what response would inidicate that the pulp is dying?

A

reduced response

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12
Q

In regards to vitality testing what response would inidicate that the pulp tissue has died?

A

no response

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13
Q

Why is it necessary sometimes for a dentist to take study models?

A

consider a patients occlusion before deciding on any treatments.

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14
Q

What cases are study models useful?

A

occlusal analysis, ortho cases, tooth surface loss is present due to grinding/erosion so the dentist can monitor this, unwanted tooth movement is suspected.

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15
Q

Why are photographs taken during an oral health assessment?

A

record aspects of the dentition/soft tissues
- soft tissue lesions to aid diagnosis
-injury following trauma
-before and afters

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16
Q

How are photographs taken , what with?

A

conventional cameras, digital cameras or specialist intraoral digital cameras.

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17
Q

Where are extraoral soft tissues?

A

those outside the mouth

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18
Q

When a dentist is checking extraoral soft tissues, what will they be looking for with the external face signs?

A

skin colour, facial symmetry, presence of blemishes - moles/coldsores.

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19
Q

When a dentist is checking extraoral soft tissues, what will they be looking for with the lips?

A

change in colour or size, presence of blemishes and palpating for any abnormalities

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20
Q

When a dentist is checking extraoral soft tissues, what will they be looking for with the lymph nodes?

A

any swelling or abnormalities - indicate infection or a more sinister lesion.

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21
Q

Where are the lymph nodes located?

A

under the mandible and in the neck

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22
Q

If a patients skin colour was to change from pinky to pale/clammy what may this inidcate?

A

patient may faint

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23
Q

Why is checking facial asymmetry so important?

A

indicate the presence of swelling, issues with the nerve supply or muscular control.

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24
Q

What type of cancer is skin cancer?

A

Melanoma

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25
Q

Why is it important that the lips are examined?

A

to check for blemishes e.g. cold sores (herpes simplex type 1) or the presence of mucoceles.

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26
Q

What are mucoceles?

A

Minor salivary gland cysts

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27
Q

What colour lips indicate chronic heart failure?

A

tinged bluish-purple

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28
Q

Enlargement of lymph nodes could indicate:

A

the body is fighting infection or some other disease process

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29
Q

When a dentist is checking intraoral soft tissues, what will they be looking for with the labial, buccal and sulcus mucosa?

A

colour and texture, presence of any white patches (especially buccal) and moisture level

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30
Q

When a dentist is checking intraoral soft tissues, what will they be looking for with the palatal mucosa?

A

hard and soft palates, the oropharynx and tonsils

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31
Q

When a dentist is checking intraoral soft tissues, what will they be looking for with the tongue?

A

colour and texture, shape and movement, level of mobility.

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32
Q

Where is the most common place within the oral cavity for oral carcinoma to develop?

A

beneath the tongue

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33
Q

When a dentist is checking intraoral soft tissues, what will they be looking for with the floor of the mouth?

A

colour and texture, presence of any white or red patches and swellings.

34
Q

Low moisture levels in the mouth can indicate what?

A

problems with the functioning of the salivary glands - age related or medication.

35
Q

What are the 2 known risk factors of oral cancer?

A

smoking and alcohol

36
Q

If a sinister lesion was suspected on a patient where would they be referred to?

A

local hospital maxillofacial department

37
Q

what is teeth charting?

A

style “dental shorthand”
quickly and accurately record a patients dentition as it appears at the time of the oral health assessment

38
Q

What is the palmer notation used to chart?

A

tooth charting

39
Q

What is the international dental federation notation (FDI) used to chart?

A

tooth charting

40
Q

What is the basic periodontal examination (BPE) used to chart?

A

periodontal charting

41
Q

In what country is the univeral charting system mainly used?

A

USA
Numbers from UR8 as 1 to UL8 as 16 to LL8 as 17 to LR8 as 32

42
Q

What system is used when charting the dentition of an actual patient?

A

Two-grid system - forensic notation
this seperates the current dental status from any treatment required.

43
Q

Explain the two grid system - forensic notation
Outer grid and inner grid:

A

Inner grid - current dental status + restorations present
Outer grid - Dental treatment that needs to be carried out

44
Q

With the forensic notation - 2 grid system a fractured tooth, can range from not needing treatment to needing treatment - only exception.

A
45
Q

How is the palmer notation incorportating alphanumeric system shown?

A

All the 4 quadrants: UR UL LL LR
Letters - deciduous dentition
Numbers - permanent dentition

46
Q

What does the two digit FDI notation replace?

A

quadrant symbol or use of UR etc, with a quadrant number as well as a tooth number.

47
Q

How can we work out two digit FDI notation with permanent teeth:

A

UR1 11 - UR8 18
UL1 21 - UL8 28
LL1 31 - LL8 38
LR1 41 - LR8 48

48
Q

How can we work out two digit FDI notation with deciduous teeth:

A

URA 51 - URE 55
ULA 61 - ULE 65
LLA 71 - LLE 75
LRA 81 - LRE 85

49
Q

What 4 instruments are used during an oral health assessment?

A

Mirror
angled probe - detect soft tooth surfaces, margins on existing restorations
Tweezers
Briault probe - detect interproximal caries

50
Q

What does the term occlusion mean?

A

Situation when the mouth is closed and the teeth of both jaws interlock together so that their occlusal surfaces are in contact.

51
Q

What is a normal occlusion?

A

no crowding, no protuding teeth, no prominence of chin.

52
Q

What is an overbite?

A

Vertical overlap - Upper arch covers the bottom arch

53
Q

What is an overjet?

A

Horizontal overlap- distance between the upper and lower teeth

54
Q

Class 1 occlusion =

A

normal bite
overjet between 2-4mm
overbite is 50%

55
Q

Class II div 1 =

A

increased overjet more than 4mm
upper teeth protrude between their lips - open lip posture
mandible is too far behind its normal position - not because of the maxilla

56
Q

Class II div 2 =

A

decreased overjet and increased overbite
Upper incisors become trapped behind the lower lip causing the teeth to erupt upright or pulled back = retroclined
mandible is not so far posterior

57
Q

What does malloclusion mean?

A

normal occlusion is not present

58
Q

What is crowding caused by?

A

insufficient room for all of the teeth to erupt in line and it also occurs in jaws which are too small to accomodate 32 permanent teeth.

59
Q

Class III malloclusion:

A

Chin is prominent - lower jaw pertrudes forward
lowers infront of uppers

60
Q

What are the main causes of malocclusion?

A

Genetic, inheritance of an abnormal jaw, or supernumerary teeth and missing teeth.
Common cause is early loss of teeth and thumb sucking habits

61
Q

What is angles classification based on?

A

the relationship of the first molars to each other.
Incisor relationship can determine the classification

62
Q

What is a supernumerary tooth?

A

An extra tooth
occurs mainly in the midline of the upper incisor region as a “mesiodens”, could prevent an incisor from erupting or make it erupt in an abnormal position.

63
Q

What is congenitally missing teeth?

A

Absence of one or more permanent teeth
Upper lateral incisors are often missing - instead they can develop as tiny conical teeth = peg laterals.
Third molars and second pre molars are also common.

64
Q

What is the correct word to use when several teeth are missing from a dentition?

A

Hypodontia - rare

65
Q

What can thumb sucking cause?

A

displacement of anterior teeth = decreased overbite and increased overjet

66
Q

How does a cross bite develop?

A

suction action causes excess pressure on the cheeks, so the upper buccal teeth are forced to develop inside the arch of the lowers.

67
Q

What do periodontal tissues act as?

A

supporting tissues around the tooth

68
Q

What are periodontal pockets?

A

presence and depth of any unnatural spaces down the side of the teeth.

69
Q

What do healthy periodontal tissues look like?

A

Pink, firmly attached to the tooth with gingival crevice no deeper than 3mm, do not bleed.

70
Q

What probe is used to record the BPE score?

A

BPE probe

71
Q

What does code 0 mean?

A

healthy periodontal tissues, no bleeding, no calc or overhangs

72
Q

What does code 1 mean?

A

pocket no more than 3.5mm, bleeding on probing, no calc or overhangs

73
Q

What does code 2 mean?

A

pocket no more than 3.5mm, sub or supragingival calc present

74
Q

What does code 3 mean?

A

pocket present up to 5.5mm deep

75
Q

what does code 4 mean?

A

pocket present deeper than 5.5mm

76
Q

what does code * mean?

A

furcation present

77
Q

What does grade 1 mobility mean?

A

side to side tooth movement less than 2mm

78
Q

What does grade 2 mobility mean?

A

side to side movement more than 2mm

79
Q

What does grade 3 mobility mean?

A

vertical movement present

80
Q

The standard of oral hygiene is graded as what during oral health assessments?

A

excellent, good, fair or poor

81
Q

When code 3 is recorded on a BPE what should be done?

A

radiographs to check bone levels and oral hygiene instructions given and scale, 3 month recall

82
Q

When greater than code 3 is recorded on BPE what should be done?

A

radiographs and full pocket depth recorded 6PPC, FULL debridement, 3 month check up