week five - comp exams, tx planning, informed consent

Question 1

list and distinguish the FOUR types of diagnosis’

Answer 1

1. differential
   - involves listing all possible diseases assoc w the clinical signs/symptoms
2. presumptive
   - made w limited info and we presume other clinical findings would support it
3. provisional
   - initial dx made after comp exam
   - may change after reviewing pts response to tx over time
4. definitive
   - final dx mafe after receiving outcomes of all tests and evaluating pt response to tx

Question 2

list EIGHT factors that impact prognosis

Answer 2

1. recession
2. mobility
3. pathology
4. CAL - % bone loss
5. pt risk status
6. paragunctional habits
7. pt motivation
8. SES

Question 3

list and describe the FIVE phases in the Stefanic Guide to Treatment Planning

Answer 3

1. Systemic
   - goal = ensuring pt safety before tx
   - incl: stress/fear management, special positioning, consulting w pt physician, necessary tx considerations for systemic disease
2. Acute
   - goal = resolve urgent problems [pain aspriority]
   - a = emergency tx for pain/infection eg: missing restos, swellingm acute perio infection
   - b = tx of urgent chief complaint eg: chewing discomfort, food packing causing pain, sharp tooth surface, sharp brokwn ortho wire
3. Disease control
   - goal = control disease, aeasthetic and occlusal deterioration
   - eg caries removal, extraction of hopeless/problematic teeth, perio disease control, endo, pulpotomy
4. Definitive treatment
   - goal = rehab, returning function and aesthetics
   - often involves other specialists eg orthodontist, prosthodontist, oral surgeon
5. Maintenance
   - goal = maintain healthy oral cavity
   - prevent tx relapse, positive reinforcement of good OH, good dietary/lifestyle choices

Question 4

who can provide informed consent and when can patients not provide informed consent

Answer 4

age for consent in VIC is 16yo - can be lower if pt seem competent enough

unable to provide consent if:
- pt unable to understand relevant info
- retain info
- weigh info as part of decision making process
- communicate their decision
- eg young child, unconscious, mental impairement

Question 5

describe the alginate setting reaction

Answer 5

water + powder = sodium alginate + calcium suphate –> soldium sulphate calcium alginate

1. elastic gel forms and material solidifies due to cross linking of long chain alginic acid molecules w one another
2. reaction = v rapid - therefore calcium sulphate retarder is added to slow to reaction and allow adequate working time
3. once retarder is exhausted = setting complete

Question 6

list risk factors for dental trauma and the function + ideal properties of mouthguards

Answer 6

• class II div I malocclusion [overjet] –> 3-6mm = 2x risk
• contact sports - ~ 31% orofacial injuries due to sport-induced trauma
• not wearing mouthguard

mouthguard func
- absorbs + distributes forces = provides protection and reduces extent of injuries
- can help reduce severity of TMJ injuries
- protects hard + soft tx

ideal properties
- comfortable + retentive
- allowd wearer to breath/speak easily
- odourless and tastelss
- cleansable
- high power absoprtion and distribution of forces

Question 7

describe the characterstics of custom made mouthguards + THREE considerations

Answer 7

• usually maxillary arch and covers to first molars
• to protect root –> covers as much vestibulum as possible
• EVA [ethyl-vinyl-acetate] commonly used
• some studies suggest ~4mm thickness

considerations
1. mixed dentition
2. ortho
3. erupting teeth