Caries in the Permanent Dentition Flashcards Preview

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Flashcards in Caries in the Permanent Dentition Deck (13):

What has been the trend in dental caries in Australia since 1990?

Decline until 1996-1997 due to water fluoridation
After increase (theories include decreased use of fissure sealants, increased bottle water usage


What percentage of teenagers between 12-15 have decay in the permanent teeth?

In the top 10% in regards to most extensive history, 5-8 permanent teeth affected (ignore this line if too confusing)


What are some risk factors for permanent tooth caries?

-If from Indigenous population
-Household income < $40 000
-Parents not attended Uni
-<50% lifetime exposure to fluoride
-Brushing < 1/2 x day
-Living in regional or remote location
-Drinking 3 or more sugar sweetened beverages per day


What is the order of susceptibility of the permanent dention to caries (which teeth are most likely to get caries)

-First permanent molars
-Second molars
-Upper lateral incisors

*Most at risk sites are occlusal surface of the upper 6's and occlusal/buccal surfaces of lower 6's (think buccal developmental groove)

*Second most at risk sites:
-Occlusal of upper 7's
-Occlusal/buccal of lower 7's
-Occlusal of 5's
-Palatal of upper 6's


What should you do straight away as part of management if detect interproximal caries?

-Fissure seal rest of occlusal system
(Occlusal is usually at greater risk of decay than proximal; most of the time will develop first, thus if detect proximal then take a good look at occlusal and if no caries prevent)


What are some patterns of caries development?

-Often occur symmetrically
-Similar pattern in maxilla and mandible
-Occlusal more often than interproximal
-Distal caries on E's signficant risk indicator for caries on mesial of 6's-->NEVER leave distal caries on E's even if they are about to fall out, be more aggressive on treatment of E e.g. consider restoration even if only into enamel on the E.

*If find caries on 16, F/S 26, 36, 46 as well


If children have caries in their primary teeth, how does this affect their chance of getting caries in permanent teeth?

-3x more likely to get permanent tooth caries


What is occult caries and how do they develop?

-Caries that have no signs clinically (i.e. clinical examination shows sound crown but subsurface caries visible radiographically)

-Develop due to the presence of resorptive cells getting inside the tooth due to developmental defect and start resorptive process (more common)-->treat as normal caries
*Usually progresses much quicker once tooth erupted into mouth
*If actual caries reaches this area it will progress very very quickly

-Fluoride keeps crown sound while bacteria cause caries to progress subcoronally (rarer)


What information would you collect on a patient's history if they were previously low risk and you detect some plaque build up?

-Change in lifestyle
-Oral hygiene


What prevention options have you got available?

-Fluoride varnish, fluoride toothpaste
-Tooth mousse
-Mouth wash


What additional risk factors do adolescents have to oral hygiene?

-Less parental influence
-Increased independance (choice of food and drink), parents less reliable as source of info
-May participate in smoking, alcohol consumption, recreational drugs
-Parents wanting orthodontic therapy
-Change in lifestyle and attitudes (not prioritising oral health, busier)
-MHx and SHx in constant change


What are some tricks to get teenagers to disclose more information?

-Ask parents to wait out in waitng room with an excuse (e.g. needing to take more x-rays)
-Build rapport
-Avoid lecturing/going through parents-->teenager will jsut shut down


How should you manage caries in children?

-Gatehr info
-Behaviour modification
-Home/clinic preventative care
-Clinical management
-MOre frequent review

Summary: determine the cause, treat the cause, treat the caries, review