Unit 315: Management of oral health diseases and dental procedures Flashcards
LO1: Know the types and causes of oral disease LO2: Understand prevention and management of oral diseases LO3: Restorative treatment LO4: Fixed and removable prostheses LO5: Orthodontics LO6: Non-surgical endodontic treatment LO7: Extractions and minor oral surgery
What is the name for the first visible signs of caries?
White spot lesion
What does the suffix “-itis” indicate?
Inflammation
Which term describes inflammation of the supporting structures of the tooth?
Periodontitis
Describe the progression of caries through tooth tissues
Enamel demineralised Caries in enamel Caries reaches ADJ Caries in dentine Caries reaches pulp
What is the significance of Streptococcus mutans?
Initial caries formation
Forms weak organic acids which cause enamel demineralisation
What type of sugar is considered to be most involved in caries formation?
Non-milk extrinsic sugars e.g. dextrose
What are NMEs?
Non-milk extrinsic sugars
Sugars which aren’t found naturally in food (like glucose or fructose) or in milk (lactose).
What term describes non-carious tooth tissue loss caused by bruxism?
Attrition
What role does plaque play in caries formation?
Plaque contains bacteria which form acids in the presence of dietary sugars. Acid demineralises the tooth structures, giving rise to caries
What role does plaque play in periodontal disease?
Bacteria in plaque produce toxins which cause inflammation in the gingival tissue (gingivitis). If this is not arrested, it will continue to break down the supporting structures of the tooth including the periodontal ligament and the alveolar bone.
Name three conditions which are directly linked to a worsening severity of periodontal disease
Diabetes
Stress
Vitamin C deficiency
What term describes a pathogenic microorganism in its non-infective state?
Spore
What term describes the condition where a tooth experiences pain from a caries attack that can be resolved by removing the caries and filling the cavity?
Reversible pulpitis
What does the term glossitis mean?
Inflammation of the tongue
What term describes inflammation of the operculum?
Pericoronitis
What term describes the flap of gum which may be found over the top of partially erupted third molars?
Operculum
What procedure may be carried out following repeated incidences of pericoronitis?
Operculectomy (cut off the flap of gum over the wisdom tooth)
Wisdom tooth extraction may also be carried out, particularly if the tooth is impacted.
Put these defence mechanism in order of their action in protecting the body:
Inflammatory response; mucous membranes; saliva; skin
Skin; mucous membranes; saliva; inflammatory response
Describe the difference between an acute and a chronic condition
Acute = quick onset, short term
Chronic = slow onset, long term
When does pulpitis become irreversible?
When caries reaches the pulp
What is name for the first layer formed on the tooth surface after brushing?
Salivary pellicle or acquired pellicle
What term describes the condition where pus spreads uncontrolled into surrounding tissues?
Cellulitis
What is meant by the term “gram-negative”?
Anaerobic, does not require oxygen
Which stagnation area is particularly associated with the development of periodontal disease?
Gingival crevice
Describe the development of periodontal disease
Bacteria produce toxins
Gingivitis - false pockets (gingiva inflamed)
Periodontitis - true pockets (periodontal ligament destroyed)
Sub-gingival calculus forms
Pockets deepen
Name the 5 signs/symptoms of inflammation
Heat, pain, redness, swelling, loss of function
What effect is commonly seen in the oral cavity of patients with epilepsy?
Gingival hyperplasia caused by medication E.g. epanutin
Leads to false pockets and more difficulty cleaning
What is the critical pH for enamel demineralisation?
pH 5.5
Name of feature of chronic periodontitis which is NOT a feature of chronic gingivitis
True pockets
What factors leading to caries formation are most easily controlled by the patient?
Diet - length and frequency of acid attacks
Controlling plaque - effective and regular tooth brushing
Increasing tooth resistance - fluoride in toothpaste and mouthwash
What type of microorganism is lactobacillus?
Anaerobic/gram-negative bacteria
What microorganism is most relevant to established caries?
Lactobacillus
What type of cell is responsible for dentine formation?
Odontoblasts
What do cementoblast cells do?
Form cementum
What cells form bone?
Osteoblasts
What type of cell is responsible for enamel formation?
Ameloblasts
Name three functions of dentures
Speech
Mastication (chewing)
Aesthetics
What can be done for patients with unbalanced occlusion? e.g. chewing on anterior teeth
Provide dentures or implants (move chewing forces to posterior teeth)
What term describes yellow-coloured, hard deposits that are often visible in the oral cavity of patients with a poor standard of oral hygiene?
Supragingival calculus
Subgingival calculus can’t be seen and is dark brown or black in colour
What term describes a slow growing abnormal sac of fluid within the body tissues?
Cyst
Name the three areas to consider when preventing caries formation
Control the build-up of plaque
Increase tooth resistance to acid attack
Modify the diet
Which toothpaste ingredient has the most effect in supressing the formation of plaque?
Triclosan
Why should patients be advised to spit and not rinse after tooth brushing?
To allow the teeth to bathe in fluoridated toothpaste and allow maximum fluoride absorption
What term describes buccal enamel loss due to mechanical trauma from toothbrushing?
Abrasion
What disease process presents as a localised swelling, often with pus present?
Infection
What ingredient may be added to mouthwash specifically to aid healing by eliminating anaerobic bacteria?
Hydrogen peroxide
What effect does fluoride have when absorbed by tooth tissues?
Converts hydroxyapatite crystals to fluorapatite crystals which are more resistant to acid attack
Name four methods of topical fluoride application
Toothpaste
Mouthwash
Varnish
Gel
Name three types of systemic fluoride
Water
Drops
Tablets
What periodontal condition may be caused by Treponema vincenti?
Acute necrotising ulcerative gingivitis
Place these interdental cleaning products is the least effective?
Floss; interdental brush; tape; wood stick
Wood stick
Which disease process presents as an overgrowth of tissue cells that invade their surroundings and often destroy surrounding tissues?
Tumour (malignant)
Why are carrots a good food to be eaten following a meal?
The crunchy nature of carrots will dislodge food debris, and it does not contain any non-milk extrinsic sugars
What does DMF stand for?
Decayed, missing and filled
What condition may lead to increased erosion of the teeth, particularly on the palatal/lingual surfaces of anterior teeth?
Bulimia
Acid reflux
Which toothpaste ingredient has the most effect on increasing the teeth’s resistance to caries?
Sodium fluoride
Why might patients who smoke have a delayed diagnosis of periodontal disease or gingivitis?
Smoking reduces the blood supply to the gingiva, preventing the detection of inflammation as there will be less bleeding on probing
What effect could puberty and pregnancy have in the oral cavity?
Increased gingivitis due to hormonal imbalances
What is abfraction?
Sudden loss of a section of a tooth from the cervical region due to shearing forces on the tooth
Which disease process presents as a break in the protective layer of a soft tissue, leaving a raw and often painful lesion that may bleed?
Ulcer
What toothpaste ingredient is added to remove some surface stains from the teeth?
Biological enzymes
Abrasives were added in the paste but were found to cause increased abrasion and tooth sensitivity
What is the ideal concentration of fluoride that is artificially added to water supplies in parts per million (ppm)?
1 ppm
What is the most effective method to ensure patients remember oral health advice given?
Give it in writing
Why is it important to consider body language during oral health instruction?
To ensure we make the patient feel we are listening to everything they are saying and giving them our full attention
What is the correct term to describe a dry mouth?
Xerostomia
What method of cavity preparation provides the most tactile response?
Excavator
What method of moisture control is most effective at preventing tooth contamination during endodontic treatment?
Rubber dam
What constituent of local anaesthetic cartridges maintains a neutral pH of 7 to prevent soft tissue irritation?
Buffer
Why is calcium hydroxide not suitable to be used as a temporary filling material in deciduous teeth?
It is not thick and bulky enough to be built up into a temporary filling (in any tooth)
What is the correct classification of a mesio-palatal cavity in the upper lateral incisor?
Class III
Not class IV as does not include incisal edge
What is the purpose of aspirating syringes during administration of local anaesthetic?
Avoids injection into a blood vessel
What is the purpose of a spoon excavator during dental procedures?
Remove softened dentine
What instrument is used specifically to remove interproximal calculus?
Push scaler
Name three functions of a mouth mirror
Aid vision
Retract soft tissues
Reflect light
What is a class V cavity?
Cavity involving the cervical margin of a tooth
What item is used to extirpate the pulp contents during endodontic treatment?
Barbed broach
What is the correct category of waste disposal for used local anaesthetic syringes?
Infectious hazardous waste - sharps
What shape of bur is used during inlay preparation to ensure no undercuts are produced?
Tapered fissure
What hand instrument is used to adapt a filling material to the cavity margins to avoid leakage under the set restoration?
Burnisher
What item from a rubber dam kit is used to hold the dam sheet in place around a tooth during dental procedures?
Clamp
What lining material is not suitable to be used under composite restorations?
Zinc oxide and eugenol
oils prevent composite from fully setting
What is the retention factor for full dentures?
Flange
Which constituent of local anaesthetic cartridges is present to allow a reasonable shelf life and period of use?
Preservative
What matrix system is most likely to be used when placing a composite filling in a class III cavity?
Celluloid (plastic)
What is a Willis bite gauge used for?
To measure the occlusal face height of the patient e.g. during denture bite stage
What metal forms the largest portion of amalgam alloy powder?
Silver
Which local anaesthetic technique involves depositing the anaesthetic solution beneath the mucous membrane and over the alveolar bone to anaesthetise the local nerve endings?
Infiltration
What item is used to make the margins of the tooth clearly visible before impressions of a crown preparation?
Retraction cord, may be soaked in astringent
Why should zinc phosphate be used with care as a lining or filling in deep cavities or deciduous teeth?
The liquid component is phosphoric acid with a pH of 2. The acidic quality may cause pulpal irritation.
What is a class III cavity?
Affects two or more surfaces of an anterior tooth, not including the incisal edge.
What are Adams pliers used for?
Adjusting Adams cribs.
May be on partial dentures, removable orthodontic appliances, functional appliances and removable retainers.
What type of impression should be used for fixed-prosthesis impressions? e.g. crown, bridge, inlay, onlay
Elastomer e.g. silicone
Alginate should not be used, it is not accurate enough and may tear
Name three ways that mercury may enter the body
Ingestion
Absorption through the skin
Inhalation of vapours
What type of local anaesthetic should be used for a patient with hypertension?
One without adrenaline
What acid and concentration is used in acid etchant?
33% Phosphoric acid
What is the specific advantage of calcium hydroxide as a lining material rather than other lining materials?
Promotes secondary dentine formation
What method of local aneasthetic injection involves injecting directly into the cancellous layer of the alveolar bone to anaesthetise the tooth roots?
Intra-osseous
What is the correct waste category for disposal of extracted teeth containing amalgam fillings?
Non-infectious (chemical)
How many millimetres can the curing light penetrate during placement of composite restorations?
2.0 mm
Describe the full decontamination process for alginate impressions before they can be sent to the lab?
Rinse under running water to remove debris.
Place in disinfectant bath and leave for required time.
Rinse off disinfectant and place into zip lock bag with a damp paper towel.
Attach date of disinfection and package for lab.
What device allows aspirated waste amalgam residue to be collected and safely disposed of by the dental team?
Amalgam trap
What constituent of local anaesthetic syringes prolongs the action of the anaesthetic?
Vasoconstrictor
What is the main advantage of glass ionomer over composites?
Glass ionomer releases fluoride
What is a class II cavity?
Involves two or more surfaces of a posterior tooth
What term describes the endodontic technique of removing contaminated pulp tissue from the pulp chamber only, leaving the root canal intact?
Pulpotomy
Why must alginate impressions be kept in a damp environment?
To prevent distortion through drying out
Which body organ is most affected by mercury poisoning?
Kidneys
What instrument may be used to remove sharp spicules of bone from the dental ridge during an extraction procedure?
Rongeurs
What is the MOST COST EFFECTIVE method of replacing missing teeth?
Acrylic denture
What is the MOST EFFECTIVE method of replacing missing teeth?
Implant
What two powders from a mercury spillage kit are mixed with water to make a paste used to contain a mercury spillage?
Flowers of sulphur
Calcium hydroxide
Which type of local anaesthetic administration requires the use of an aspirating syringe and appropriate cartridge, with a long 27 gauge needle?
Inferior dental nerve block
What instrument is used to widen the root canal by cleaning and debriding its walls?
Reamer
What type of dentures do not require a try-in stage?
Immediate dentures (fit after an extraction)
What must be placed before a filling can be placed in a class II cavity?
Matrix outfit
Why are deciduous teeth restored rather than extracted?
To maintain space in the dental arch for permanent teeth beneath
What material may be used for temporary crowns but not permanent crowns?
Acrylic
What technique may be used during the placement of an amalgam filling but not during an inlay preparation?
Undercuts
What is a Le Cron carver used for?
Fine adjustments to the wax during a denture try-in stage
What appliance may be used to close an anatomical defect of the oral cavity that has been left following surgery, such as following the removal of an oral cancer lesion?
Obturator
What technique may be carried out to prevent extraction of a tooth with irreversible pulpitis?
Pulpectomy
Why can pulpectomies not be carried out on deciduous teeth?
The roots cannot be filled as they need to be resorbed prior to exfoliation
Why might deep caries not be fully removed in deciduous teeth?
The pulp chamber is larger and closer to the surface in deciduous teeth. To avoid accidental exposure, some deep caries may be left and disinfected with medicaments (e.g. cresophene). The hope is that the tooth will remain pain-free and functional until it falls out naturally.
What is the usual retentive component present on a removable orthodontic appliance?
Adams crib
Which root canal treatment is not carried out on deciduous teeth?
Pulpectomy
What is the most common purpose of a veneer?
Mask discolouration
What term describes the branch of dentistry concerned with replacing missing teeth?
Prosthodontics
What is gerodontics?
A branch of dentistry concerned with the treatment of elderly patients and their teeth
What is paedodontics?
A branch of dentistry concerned with the dental treatment of children
What branch of dentistry is concerned with the treatment of malocclusions?
Orthodontics
What is the main advantage of using an implant rather than a bridge to replace a missing tooth?
Single tooth involvement (no extra stress on neighbouring teeth)
Which endodontic treatment requires the use of files during its completion?
Pulpectomy
What term describes the movement of teeth caused by fixed orthodontic appliances?
Bodily movement
What type is orthodontic appliance is usually required to derotate teeth?
Fixed orthodontic appliance
Why would a temporary bridge be fitted immediately after an extraction rather than a permanent bridge?
Allow bone resorption to occur
What term describes the method of bony retention achieved to hold an implant in place in the jaw bone?
Osseointegration
What type of orthodontic appliance cannot be used to correct the jaw relationship?
Removable appliance
(Worn in only one arch)
Fixed appliance can used elastics. Functional uses muscular forces.
Why should bleach not be used to clean dentures?
Will bleach the acrylic and teeth, making the denture look unnatural in the mouth
Place these stages of restoration treatment in the correct order:
caries removal; lining; filling; shaping
Caries removal
Shaping
Lining
Filling
What would be the main reason for placing a temporary crown on a root-filled molar tooth?
Maintain occlusion
