Diagnosis and management of early caries Flashcards
(31 cards)
Describe dental caries
It is a preventable disease that can be stopped and reversed in early stages
How can dental caries affect someone qualify of life
Can affect: Eating Sleeping School attendance Loss of work
How many extractions did the NHS carry out in 2016
42,911
List some caries risk factors
- Diet
- Fluoride exposure
- Oral hygiene
- Saliva
- Habits
- Family caries
- Health
- dental attendance
How do we assess caries risk clinically
LOOK AT:
- Tooth surface
- Enamel quality
- Morphology
- Caries in adjacent teeth
- Presence of dental plaque
How do we clinically assess a tooth for caries
- Dry the tooth and look using reflected light
- Careful probing to feel surface texture with a blunt probe
- Transillumination
- Separation of teeth
State the different stages of a carious lesion
- Sound
- Dry Opacity- white, brown
- Wet opacity- white, brown
- Surface integrity loss
- Underlying grey shadows
- Distinct cavity
- Extensive cavity
Describe how an active lesion would present clinically
- White/yellow surface
- Enamel is opaque
- Rough to periodontal probe
- Covered in plaque
Describe how an inactive lesion would present clinically
- White brown black surface
- Enamel is shiny
- Smooth to periodontal probe
- No plaque
After assessing clinically what is the nest step to forming a diagnosis
Radiographs
Which score do we use to assess caries on teeth
ICDAS scores
How is the ICDAS score used
Scale of 0-6
Talk through what each score of the ICDAS scale relates to
0- sound
- first visual change in enamel
- Distinct visual change in enamel
- Localised enamel breakdown
- Underlying dentine shadow
- Distinct cavity with visible dentine
- Extensive cavity with visible dentine
How else can we diagnose caries other than clinically and radiographically
- Laser fluorescence
- Electrical impedance
- Caries activity tests
- Caries detection dyes
Name the difference categories we place management of caries in
- Preventative care
2. Operative care
What is the management technique dependent on
How far the caries has progressed
In terms of diet what things are we looking at
- Number of eating/ drinking occasions in 24 hours
- Frequency and amount of Risk foods
- Bedtime eating
- Dairy exposures each day
- Acid drinks
- Water
- If they snack and what on
- Fruit and veg intake
When talking to patients about diet advice what can we talk about?
- Explain how decay occurs
- Explain risks with sugary drinks
- Explain frequency of eating carbohydrates
- Advise use of diary foods for protection
- Avoid eating at bedtime especially after brushing teeth
What specific diet advice can we give all patients
- Avoid sipping drinks other than water
- Give your teeth a rest between meals (2 hours)
- Eat foods with protective factors
- Sugar free gum after meals
Why is fluoride good at preventing dental caries spread
- Slows down demineralisation
- Enhances remineralisation
- Interferes with bacterial metabolism
- Is incorporated in developing enamel
What advise do we give parents of children up to 3 years regarding fluoride tooth paste
Toothpaste with 1000ppm F-
Smear of toothpaste
Avoid swallowing toothpaste
Parents brush
What advise do we give parents of children 3-6 years regarding fluoride tooth paste
Toothpaste with 1350-1500ppm F-
Pea size toothpaste
Avoid swallowing toothpaste
Parents help with brushing
Other than fluoride toothpaste how else can we give fluoride to children
- Fluoride prophylaxis paste
- Fluoride varnish
- Fluoride mouthwash
- Silver diamine fluoride
- Fluoride containing sealants
How can we show parents and patients where the plaque is in the mouth
By using disclosing solution or tablets
