Dentistry for Doctors

Question 1

What are the 2 most prevelant diseases in the world?

Answer 1

• Dental Caries

- Periodontal disease

Question 2

What percentage of scottish adults are edentulous? (Have no teeth)

Answer 2

9% (2014)

- 44% (1972)

Question 3

What percentage of annual health care budget goes to dentistry?

Answer 3

~ 5%

Question 4

What is the most common reason for a child to have a general anaesthetic in the UK?

Answer 4

Dental extractions

Question 5

What is the consequence of dental abscesss?

Answer 5

Infection (can be chronic) - drains out through gum usually

Question 6

How common are oral and oropharyngeal cancers?

Answer 6

6th most common malignancy and incidence in young is rising (HPV?)

Question 7

How many patients with dental issues are seen a year by GPs?

Answer 7

30 - 48 (usually seeking a course of antibiotics)

Question 8

When should an ulcer be considered malignant until proven otherwise?

Answer 8

If present after 3 weeks

Question 9

What are different examples of cancers of the mouth?

Answer 9

• Squamous cell carcinomas

- Leukoplakias

Question 10

What do pre-malignant leukoplakias look like?

Answer 10

• White

- Or red velvety patch

Question 11

Why do oral mucosal lesions often look white?

Answer 11

Unshed dead keratin - abosrbs light

Question 12

What may TMJ (temporo-mandibular joint) disfunction syndrome present with?

Answer 12

• Trismus and pain
• Possibly clicking
  Refer to dental hospital

Question 13

What are the 2 main components of teeth?

Answer 13

• Enamel (hard but brittle)

- Dentine (soft but flexible)

Question 14

What lies in the middle of a tooth?

Answer 14

The dental pulp (leaves dentine on outside and shrinks in (contains nerve, blood vessels and connective tissue)

Question 15

How many of each tooth in each quadrant (primary/baby) teeth?

Answer 15

5

• 2 incisors
• 1 canine
• 2 molars

Question 16

How many of each tooth in each quadrant in an adult?

Answer 16

8

• 2 incisors
• 1 canine
• 2 premolars
• 3 molars (wisdom tooth)

Question 17

When does eruption of adult teeth begin?

Answer 17

6 years

Question 18

When do babies start to get teeth?

Answer 18

• 6 months first tooth

- All baby teeth at 30 months

Question 19

When are all baby teeth shed?

Answer 19

12

Question 20

What percentage of people do not develop wisdom teeth?

Answer 20

25%

Question 21

What is plaque?

Answer 21

A micro biofilm (huge variety of species)

Question 22

Name some uncommon infections of the mouth that do not affect children or elderly?

Answer 22

• Pericoronitis
• Acute necrotizing Ulcerative Gingivitis (trench mouth)
• Acute Alveolar Osteitis (dry socket)

Question 23

Describe the perfect storm which leads to dental caries and periodontal disease?

Answer 23

Perfect storm between a dysfunctional soma (high sugar, poor oral ygiene), and a dysfunctional psyche (poor motivation) leading to a disrupted homeostasis in the microbiome, changing it from benign / protective to actively pathogenic

Question 24

WHere are the 2 places where the vast majority of cavities occur?

Answer 24

• Near base of the fissure

- Below contact point

Question 25

What bacteria may dissolve enamel, cause cavities and feed off sugar?

Answer 25

- Strep Mutans - Lactobacilli Drive out competitor micro-organsims

Question 26

What is periodontal disease?

Answer 26

- Loss of hoeostasis in biofilm - Plaque which is left undisturbed under gingival margin causes localised inflammation causes gingivy to swell bone resorbs to increase blood flow, bone shrinks and takes epithelial attachment with it causes pocket in tooth with many bacteria - only starts to hurt at end stages

Question 27

How large can a pocket be in periodontal disease?

Answer 27

6 - 7 mm

Question 28

How can periodontal disease cause disease elsewhere in the body?

Answer 28

- Periodontal tissues are very vascular and blood vessels within the inflamed tissue are very leaky allowing periodontal bacteria (bacteraemia) and inflammatory mediators to spill over into the bloodstream

Question 29

What diseases are thought to possibly have a link to periodontal disease?

Answer 29

- Cardiovascular disease - Diabetes - Pulmonary disease - Kidney disease - Adverse pregnancy outcomes (pre-eclampsia)

Question 30

What are the different types of dentists?

Answer 30

- Primary care dentist, therapist and hygienist - Restorative and implant dentist - Endodontist - Paediatric dentist - Prosthodontist - Periodontist (gums) - Oral surgeon (within jaw) - Orthodontist - Oral and maxillo facial surgeon (head and neck cancer mostly) - Special care dentist (medical compromise) - Oral medicine specialist (lumps and mumps) - Specialist in Dental Public Health

Question 31

What is the acid etch technique?

Answer 31

Dry surface then etch it with 33% phosphoric acid will demineralise and pause possibly 20-30 microns into the tooth surface this is then dried off and a thin monomoplastic is flowed in which is them polimerised wih light and a filling material which is the same plastic but filled with various tiny glass beads which are the shades/colours required

Question 32

What structure causes the colour on someone's teeth?

Answer 32

The colour of the dentine (not enamel)