W3 Class III + Management of older persons

Question 1

Define a class III?

Answer 1

It is a smooth surface caries on the proximal surfaces of anterior teeth.

• Does not involve the incisal edge of tooth.
• Cavitation frequently commences at ginigval aspect of contact point.

Question 2

How to detect anterior lesion?

Answer 2

Exlorer/probe Radiographs Visual inspection - Cavitation - Shadowing Transillumination

Question 3

What are two tx options for a class III?

Answer 3

Dental caries. 1. Enamel only: incipient lesion - remineralise 2. Dentine involvement: remove carious tissue and restore

Question 4

What are considerations to remineralise a class III?

Answer 4

Topical fluoride (duraphat)/clinipro? - CCP-ACP tooth mousse - ↑ OH - F- toothpaste (neutrafluor 5000) - Interproximal cleaning - Enamel blast - ↑ F+ water - Diet!! Compliance at home, and control at home

Question 5

Define the cavity preperations for class III CR

Answer 5

• Outline form is determined by extent of carious lesion, as does depth and incisal-gingival dimensions. - It can have labial or palatal approach (accessing from palatal provide better aesthetics) depends on factors. - Incisal wall of cavity prep remains intact - Walls are smooth + internal line angles and roundd.

Question 6

What is this cavity prep class?

Answer 6

Class III

Question 7

What is the clinical procedure for class III?

Answer 7

Calcium hydroxide (if pulpal involvement). Liner - vitrebond Clear strip matrix and wedge Etch, prime, bond Placement of CR

Question 8

What are older patients more at risk of?

Answer 8

Lesions Oral cancers Candida Stomatitis Mucosa: atrophic changes

Question 9

What is this condition?

Answer 9

Oral Candidiasis: related to antibiotic, immune suppressant drugs, diabetes and hiv medications.

+ Xerostomnia

Question 10

What is this?

Answer 10

Ulceration

Question 11

What is this condition?

Answer 11

Angular Chellitis: fissuring at the angles of the mouth, with cracks and ulcerations. Can be secondary to candida infection

Question 12

What is this?

Answer 12

Glossitis (sore tongue): red and smooth, sore and swollen

Question 13

What is this?

Answer 13

Varicosities: deep, red or bluish nodular dilated vessels on either side of the midline on the ventral surface of the tongue.

Question 14

Are older patient more at risk of Xerostomnia?

Answer 14

Yes, due to systemic medications!

Question 15

What are (9) dental manifestations as a result of being older?

Answer 15

Dental caries Root caries Retained tooth roots Multiple restos Yellow in colour Pulp changes (shrinkage) NCTL Attrition Loss of vertical dimension

Question 16

What are common morbidities for older aged patients?

Answer 16

Arthritis Hypertension, Hearing loss Cardiovascular disease Osteoporosis

Question 17

What are dental considerations for older pateints?

Answer 17

Barriers to care: physical, financial, lack of perceived need, Barrier to OH: dexterity, dependence, residential status. Thorough history: medications, medical conditions

Question 18

What are some preventative care options for older patients?

Answer 18

Dentifrice selection Relief for xerostomia Motivation and instruction Dietry habits Denture hygiene Fluoride