W6 - mouthguard tx diagnosis

Question 1

What are common injuries that can develop without a mouthguard?

Answer 1

• Lacerations of gingiva, cheels, lips and tongue
• Chipped/broken/fracture teeth
• Jaw fractures
• Avulsion

Question 2

What are risk factors for dental trauma

Answer 2

Class II division 1 malocclusion
- Overjet
3-6mm- 2x risk
>6mm - 3x risk
- Contact sports
- Not wearing mouthguard

Question 3

What do mouth guards do?

Answer 3

They provide protection and can reduce the extent of injuries, absorbs and distributes forces.
Can reduce severity of TMJ injuries.

Protecting of hard tissues

• Tooth of crown
• Root fracture
• Avulsion
• Luxation
• Jaw fracture.

Protection of soft tissues:

• protects lips and intraoral tissues from bruising
• lacerations.

Question 4

What are the properties of an ideal mouthguard?

Answer 4

High-power absorption
Comfortable
Retentive
Allows wearer to breath and speak easily
Durable
Odourless and tasteless
Cleansible

Question 5

What are the types of mouthguards?

Answer 5

Stock
Boil and bite
Custom made

Question 6

What are the advantages of stock mouth guards?

Answer 6

Cost

Question 7

What are the disadvantages of stock mouth guards?

Answer 7

Retention
Comfort
Difficulty breathing and speaking
Less protective
Limitied sizes, not recommended

Question 8

What are the advantages of boil and bite mouthguards?

Answer 8

Cost effective?

Question 9

What are the disadvantages of boil and bite mouthguards?

Answer 9

Retention
Risk of thermal injury
Reduced cushioning effect in comparison to custom made
Technique sensitive
Reduces comfort

Question 10

What is a custom- made mouthguard?

Answer 10

Fabricated on a model of the patients mouth and fitted by a dental professional. Importance should be reinforced to patients.

Question 11

What are the advantages of custom made mouthguards?

Answer 11

Improved retention
Improved fit
Improved comfort
Reduced difficulties in breathing and speaking
Slow deterioration
Greater protection

Question 12

What are the disadvantages custom made mouthguards?

Answer 12

Cost

Time

Question 13

What are custom made mouth guards fabricated from and how?

Answer 13

Sheet of material - EVA (ethyl-vinyl-acetate) commonly used.
Technique:
- Vaccum-forming
- Heat pressure lamination

Question 14

What is a diagnosis?

Answer 14

Synthesis of all the information obtained from comprehensive examination, risk assessment. Identification of disease and determining nature of that disease.

Question 15

What is a definitive diagnosis?

Answer 15

A final diagnosis that is made after receiving the outcomes of all tests and after evaluating the patients response to tx.

Question 16

What is a provisional diagnosis?

Answer 16

The initial diagnosis we make after the comprehensive examination

Question 17

What is a presumptive diagnosis?

Answer 17

Limited information based on presumption that clinical finding would support it.

Question 18

What is differential diagnosis?

Answer 18

Disease present distinguishing between diseases

Question 19

What are diagnosis examples?

Answer 19

Dental caries: acute, chroninc, incipient, recurrent, root caries, arrested
Non-carious tooth loss:
Attrition, abrasion, abfraction, erosion
Pulp diagnosis
Reversible pulpitis, irreversible pulpitits, pulp necrosis
plaque induced gingivitis: with or without local contributing factor, modified by systemic disease
Non plaque induced gingivitis.
Chronic periodontitis: generalised, localised
Aggressive periodontitis

Question 20

What is a prognosis?

Answer 20

The prediction of the duration, course and termination of the disease and it’s response to treatment.
Questions to ask:
Should tx be undertaken?
Is treatment likely to succeed?

Question 21

What is the prognosis of an individual tooth/teeth?

Answer 21

% of bone loss clinical attachment loss
Recession
Distribution of bone loss
Furcation
Mobility
Crown root ratio
Extent of crown break down
Pulpal involvement
Pathology
Tooth position and occusal relationship
Patients risk status
Parafunctional habits

Good, Fair, Poor, Questionable, Hopeless

Question 22

Define treatment planning?

Answer 22

To resolve a dental problem in our scope of practice.
Present future dental problems
Promote good oral health
Be suitable and acceptable to pt.
Be comprehensive, individualised and pt focused. Understand when to refer

Question 23

What are treatment plan objectives?

Answer 23

Review all of the likely risk/aetiological factors that you have discovered that are contributing to the diagnosis. State clearly how you plan to address them. Be specific so that any practitioner could follow this plan.

Question 24

What is the preliminary phase?

Answer 24

Treatment goals:
resolution of acute problems. Stabalisation of active disease.
Emergency care
Lab tests
Extraction/referral/ monitoring teeth with hopeless prognosis
Temporisation of large lesions
Plaque control
Initial periodontal therapy to aid in effective plaque control at home.

Question 25

What are the treatment goals in Phase 1?

Answer 25

``` Maintain dental health Regeneration of secondary dentine Remineralisation of white spot lesion Remove local contributing factors Maintenance of gingival and perio health Arrest/stabalize periodontal disease progression Restoration of aesthetic function ```

Question 26

In phase 1 what are some restorative considerations?

Answer 26

Restorations for smaller carious lesions may be treatment planned first to prevent progression to larger lesion. Fissure sealants/protection may proceed restorative therapy. If patient has a large lesion that is close to progressing to pulp, these may be prioritized.

Question 27

In phase 1 what are the considerations for periodontal therapy?

Answer 27

During this phase the order of appointments are arranged/ sequenced to prevent futher destruction of the periodontium and to make facilitate plaque removal. S/c and debridement tx to the most diseased area.

Question 28

What are things might be introduce in phase 1?

Answer 28

Preventative care/ OH, smoking cessation? dietary counselling. Start small and build at each appointment. Ask before educate/demonstrate "have you been shown how to floss before?

Question 29

Describe re-evaluation phase

Answer 29

Evaluation if treatment goals have been met. Evaluation of active disease sites. Caries risk status and re-evaluation of periodontal status and host response. Plaque control and OH behaviours Gingival contours/health.

Question 30

Describe Phase 2

Answer 30

Surgical phase: pt may or may not be referred.

Question 31

Describe Phase 3

Answer 31

Restorative phase: Advanced restorative care/final management of dental caries Aesthetic restorative considerations Fixed/removable prosthetics

Question 32

Descirbe Phase 4

Answer 32

Managment goals: Disease free long term maintenance Maintenance of gingival/perio health Overall pt well-being Short term: review and reassessment Longer term: recall, reassessment and maintenance program

Question 33

What do you do during patient consultation?

Answer 33

Presentation and discussion of diagnosis and treatment plan with pt. Clinician provides adequate info. Practitioner may present a number of treatment options. Do nothing is an option, discuss the pros and cons of each Fees, quotes for tx options

Question 34

Describe informed consent?

Answer 34

The patients consent, the clinician must assist patients to make well-informed decisions about tx procedures. For complex procedure, expressed consent, verbal or written is required. Risks and consequences must be provided. The patient must understand what they are consenting too and must be legally okay. Specific language, cultural and communication needs of patients

Question 35

Describe the informed consent process

Answer 35

Provide information in a format patients can understand. All option provided to patients Risks and benefits of all option discussed. Patient is provided the opportunity to ask the practitioner questions and have these answered. Opportunity to discuss treatment externally.

Question 36

What are the consequences of not obtaining informed consent?

Answer 36

Cause of action against the dental practitioner in assault/battery Negligence claim Professional misconduct complaint

Question 37

How would be record informed consent?

Answer 37

Must be recorded in patient records + consent forms