2 deciduous caries pattern and diagnosis

Question 1

why can caries be arrested in early stages?

Answer 1

it is possible for remineralisation to happen

Question 2

what is caries?

Answer 2

disease of mineralised tissues (enamel, dentine, cementum) caused by action of micro-organisms on fermentable carbohydrates

Question 3

what does decalcification look like?

Answer 3

white/brown spot lesions

white- chalky

Question 4

describe active caries?

Answer 4

light brown soft mushy probe will sink

Question 5

what else will be affected in interproximal caries?

Answer 5

adjacent tooth

Question 6

what teeth are affected by nursing bottle (early childhood) caries?

Answer 6

upper incisors, 1st molars, lower canines

Question 7

what causes nursing bottle caries?

Answer 7

bed with bottle not water
milk only safe during the day
may sleep without swallowing
less saliva

Question 8

appearance of secondary caries

Answer 8

ditched margins, cracked

Question 9

describe arrested caries

Answer 9

hard shiny glassy tough

Question 10

what are rampant caries?

Answer 10

10 or more new lesions in a year

commonly lower anteriors

Question 11

describe primary dentition caries pattern

Answer 11

molars, upper anteriors
rare in lower anteriors, buccal and lingual surfaces
no interproximal caries as no contacts occlusal caries in 1st primary molars

Question 12

describe mixed dentition caries pattern?

Answer 12

lower 6s > upper 6s
cingulum pits of lateral incisors
incisors uncrontrolled caries
pits/grooves in palatal upper 6s and laterals, buccal lower 6s

Question 13

describe caries pattern in early permanent dentition

Answer 13

second molars erupting
host factors
-reduced salivary rate
-high mutans count

Question 14

what makes caries management difficult in children?

Answer 14

parental involvement
patient development
dealing with two dentitions

Question 15

caries risk assessment

Answer 15

parent/patient management
symptoms
HOPC
PDH
-tx experience 
-oral hygiene habits, family history, dietary habits
medical history
social history

Question 16

describe a caries exam

Answer 16

extra oral
intra-oral
-soft tissues
-oral hygiene, swellings, sinuses, ulceration, gingival health
-hard tissues
-teeth present, dental age, occlusion, loose, missing or extra teeth, trauma, dental abnormalities, caries activity

Question 17

how is caries detected?

Answer 17

visual exam
radiographs
sensibility testing - nerve
vitality testing - blood supply

Question 18

how to do a caries clinical exam?

Answer 18

visual

• dry teeth, good light, sharp eyes
• ortho separators
• caries detector dyes
• lasers

Question 19

how does FOTI work?

Answer 19

light doesnt travel through caries only healthy tooth

Question 20

what are orthodontic separators used for?

Answer 20

to see interproximally

Question 21

what should you consider when evaluating the dentition?

Answer 21

tooth restorable
parent/px compliance
stage dental development
space management
anticipated difficulties
overal prognosis

Question 22

why is stabilisation used?

Answer 22

prevent pain
preventive therapy
arrest restorable lesions
acclimatisation
decrease bacterial load in mouth
improve OH by making areas easier to clean

Question 23

what co-operation issues can children have?

Answer 23

emotional maturity, fears, previous bad experience, behavioural problems, ability

Question 24

why should you consider stage of development when treating?

Answer 24

primary teeth may be close to exfoliation
extractions could be part of ortho plan
space maintenance

Question 25

why is caries pattern important?

Answer 25

indicated level of caries activity

Question 26

what is caries prognosis dependant on?

Answer 26

preventive issues and motivation

Question 27

why consider space maintanence?

Answer 27

``` effect of premature loss of primary teeth depends on -tooth size/jaw relation -muscle behaviour -age at loss -tooth loss of 1st perm molars crowding ```

Question 28

give examples of space maintainers

Answer 28

band and loop | distal shoe

Question 29

what are the results of early primary extractions?

Answer 29

crowding, tendency for space loss | greater space loss earlier removed

Question 30

how to balance/compensate extractions in primary teeth

Answer 30

balance primary canines to prevent centre line shift | balance of 1st molars if arch crowded

Question 31

what are the consequences of loosing upper FPM's?

Answer 31

loss before complete eruption of 7 = rotation | & mesial movement 7 and distal drift of 5

Question 32

what are the consequences of loosing lower FPM's?

Answer 32

loss after optimum age = tilting 7's | loss before optimum age = 5 drifts distally and rotates

Question 33

what does relief of symptoms depend on?

Answer 33

nature of the pain status of pulp stage of dental development level of px compliance

Question 34

pain history questions for a child

Answer 34

``` where is the pain what does the tooth feel like how long has the tooth been painful does anything make the pain better or worse keet px awake? spontaneous or precipitated eg eating relieved with analgesics/antibiotics ```

Question 35

when should you prescribe antibiotics?

Answer 35

systemic illness pyrexia facial swelling

Question 36

what are the emergency tx options?

Answer 36

``` caries excavation and sedative dressing pulp therapy drainage of pus extraction -LA +/- IHS -GA ```

Question 37

what age is IV sedation considered for?

Answer 37

12 and over

Question 38

how can you ensure pain free LA?

Answer 38

topical warm LA cartridge lower 6s (>6yrs) use IDB intra-papillary infiltration avoids palatal injection

Question 39

how does a rubber dam increase safety?

Answer 39

prevents: damage to soft tissues risk of inhalation cross-infection

Question 40

how does a dam benefit operator and px

Answer 40

``` isolation and moisture control retraction of gingivae and cheeks effective inhalation sedation px confidence operator confidence ```

Question 41

sequence of restoration

Answer 41

``` fissure sealants preventive restorations simple fillings eg. shallow cervical cavities fillings requiring LA but not into pulp -upper arch first pulpotomies/pulpectomies extractions ```

Question 42

what are the methods of caries removal?

Answer 42

``` hand excavation rotary instruments chemo-mechanical removal air abrasion lasers ```

Question 43

what are the anatomical features of primary crowns?

Answer 43

``` shorter narrower occlusal tables thin enamel and dentine broad contact areas enamel rods in gingival 1/3 extended occlusally marked cervical constrictions whiter ```

Question 44

where is the clinical significance of primary crown anatomical features

Answer 44

limited room for cavity prep clinical caries only detected if large- bitewings needed enamel at floor of box not undermined retention of ss crown

Question 45

what are the anatomical features of primary pulp and why is it significant?

Answer 45

large- limited room for caivty prep | pulp horns close to surface - pulp exposure easy

Question 46

what are the anatomical features of primary roots and why are they significant?

Answer 46

narrow mesio-distally, long, slender, flared | pulpectomy more difficult