Lecture 8 Flashcards
(150 cards)
1
Q
What is necessary to detect dental caries?
A
Both a careful clinical examination and interpretation are necessary.
2
Q
Why are dental images important for caries detection?
A
A dental examination for caries cannot be considered complete without dental images.
Dental images enable dental professionals to identify carious lesions not visible clinically and allow evaluation of the extent and severity of carious lesions.
3
Q
What is dental caries?
A
Dental caries, or tooth decay, is the localized destruction of teeth by microorganisms.
4
Q
What happens to the tooth structure due to dental caries?
A
Normal mineralized tooth structure (enamel, dentin, cementum) is altered and destroyed.
5
Q
Where does the term “caries” originate, and what does it mean?
A
The term “caries” comes from the Latin word cariosus, meaning “rottenness,” which refers to the “rotting of the teeth.”
6
Q
What are the components of an intraoral examination?
A
- Visual: Look for discoloration.
- Dental instrumentation: Use restorative explorers.
- Transillumination:
• Especially useful in the anterior region.
• Involves a transilluminator device or using a mirror to reflect light.
7
Q
How are carious lesions identified on a dental image?
A
Decreased density allows greater penetration of x-rays in the carious area, making the lesion appear radiolucent (dark or black) on the image.
8
Q
What is required for a dental image to be diagnostic for caries?
A
Images must be of diagnostic quality, and a bite-wing image used to detect dental caries must exhibit open contacts.
9
Q
What is interproximal caries?
A
Interproximal caries are caries found between two teeth.
10
Q
What defines advanced interproximal caries?
A
Advanced interproximal caries extend to or through the dentinoenamel junction (DEJ) and into the dentin but do not extend more than half the distance toward the pulp.
11
Q
What defines severe interproximal caries?
A
Severe interproximal caries extend through enamel, through dentin, and more than half the distance toward the pulp.
12
Q
What are occlusal caries, and why are they difficult to detect?
A
Occlusal caries are located on the chewing surfaces of teeth. They are difficult to see on dental images due to the superimposition of dense buccal and lingual enamel cusps. They are typically not visible on a dental image until they reach the dentinoenamel junction (DEJ).
13
Q
What are incipient occlusal caries, and how are they detected?
A
Incipient occlusal caries cannot be seen on a dental image. They must be detected clinically using an explorer.
14
Q
What are moderate occlusal caries, and how do they appear?
A
Moderate occlusal caries extend into dentin and appear as a very thin radiolucent line. This radiolucency is located under the enamel of the occlusal surface. On a dental image, little or no change is noted in enamel.
15
Q
What defines severe occlusal caries?
A
Severe occlusal caries extend into dentin and appear as a large radiolucency on a dental image.
16
Q
Why are buccal and lingual caries difficult to detect?
A
The superimposition of normal tooth structure densities makes buccal and lingual caries hard to detect on dental images. These caries are best detected clinically.
17
Q
What do root surface caries involve?
A
Root surface caries involve only the roots of teeth.
18
Q
Which parts of the tooth are affected by root caries?
A
The cementum and dentin located just below the cervical region of the tooth are affected.
19
Q
What precedes the caries process in root caries?
A
Bone loss and corresponding gingival recession precede the caries process and result in exposed root surfaces.
20
Q
Where do secondary or recurrent caries occur?
A
Recurrent caries occur adjacent to a pre-existing restoration.
21
Q
Why do recurrent caries occur in the region of a restoration?
A
Recurrent caries occur due to inadequate cavity preparation, defective margins, or incomplete removal of caries before placement of the restoration material.
22
Q
How do recurrent caries appear on a dental image?
A
Recurrent caries appear as a radiolucent area just beneath a restoration.
23
Q
What does the term ‘rampant’ mean?
A
The term ‘rampant’ means ‘growing or spreading unchecked.’
24
Q
What is rampant caries?
A
Rampant caries is advanced and severe caries that affect numerous teeth.
25
Who is typically affected by rampant caries?
Rampant caries is typically seen in children with poor dietary habits or in adults with decreased salivary flow.
26
What conditions resemble caries?
Conditions that resemble caries include: Cervical Burnout, Restorative Materials, Attrition, Abrasion, Abfraction, Pathology.
27
What is cervical burnout?
Cervical burnout is a radiolucent artifact seen on dental images that may be confused with caries.
28
Why does cervical burnout occur?
Cervical burnout occurs due to:
• Root concavities found in the area (e.g., maxillary root anatomy).
• Transition from enamel to the absence of enamel.
• Contrast between enamel and alveolar bone.
29
What is a fracture?
A fracture is the breaking of a part.
30
Which structures can exhibit fractures?
The maxilla, mandible, and teeth may all exhibit fractures.
31
When is dental imaging indicated for fractures?
Dental imaging is indicated whenever a fracture is evident or suspected.
32
What are examples of fractures?
Examples include:
• Jaw fracture.
• Crown fracture (crown fx).
• Root fracture (root fx).
33
What may trauma result in?
Trauma may result in the displacement of teeth.
34
What is luxation?
Luxation is the abnormal displacement of teeth.
35
How is luxation categorized?
Luxation is categorized as either intrusion or extrusion.
36
What is intrusion?
Intrusion refers to the abnormal displacement of a tooth into bone.
37
What is extrusion?
Extrusion refers to the abnormal displacement of a tooth out of bone.
38
What is dental avulsion?
Dental avulsion is the complete displacement of a tooth from the alveolar bone.
39
How is an avulsed tooth identified on a dental image?
An avulsed tooth is not seen on a dental image; instead, a periapical image reveals a tooth socket without a tooth.
40
What are the two types of resorption?
The two types are physiologic and pathologic resorption.
41
What is physiologic resorption?
Physiologic resorption is a process seen with the normal shedding of primary teeth.
42
How does physiologic resorption occur?
The roots of a primary tooth are resorbed as the permanent successor moves in an occlusal direction, and the primary tooth is shed when root resorption is complete.
43
What is pathologic resorption?
Pathologic resorption is a regressive alteration of tooth structure observed when a tooth is subjected to abnormal stimuli.
44
How can pathologic resorption be described?
Pathologic resorption can be described as external or internal, depending on the location of the resorption process.
45
What are the two types of resorption?
The two types of resorption are physiologic and pathologic.
46
What is physiologic resorption?
Physiologic resorption is a process seen with the normal shedding of primary teeth.
47
How does physiologic resorption occur?
The roots of a primary tooth are resorbed as the permanent successor moves in an occlusal direction. The primary tooth is shed when root resorption is complete.
48
What is pathologic resorption?
Pathologic resorption is a regressive alteration of tooth structure observed when a tooth is subjected to abnormal stimuli.
49
How is pathologic resorption classified?
Pathologic resorption can be classified as external or internal, depending on the location of the resorption process.
50
What is external resorption?
External resorption is the destruction of root structure along the periphery of the root surface.
51
Which region is most often affected by external resorption?
The apical region is most often involved in external resorption.
52
What is internal resorption?
Internal resorption is the destruction of dentin around the pulp cavity within the crown or root of a tooth.
53
What factors can stimulate the internal resorption process?
Factors such as trauma, pulp capping, and pulp polyps are believed to stimulate internal resorption. These factors serve as irritants and cause chronic inflammation of the pulp, which destroys the surrounding dentin.
54
What are the clinical findings of internal resorption?
Internal resorption is generally asymptomatic. The incisors are most often affected.
55
What are the treatment options for internal resorption?
Treatment is variable:
• Endodontic therapy may be used if the resorptive process has not physically weakened the tooth.
• Extraction is recommended if the tooth is weakened by the resorptive process or if a root perforation exists.
56
What are the types of pulpal lesions?
The types of pulpal lesions are:
• Pulpal Sclerosis
• Pulp Canal Obliteration
• Pulp Stones
57
What is pulpal sclerosis?
Pulpal sclerosis is a diffuse calcification of the pulp chamber and pulp canals.
58
What is the cause of pulpal sclerosis?
The cause of pulpal sclerosis is unknown, but it is associated with aging.
59
How does pulpal sclerosis appear on a dental image?
On a dental image, a pulp cavity of decreased size with very thin pulp canals is seen.
60
What are the clinical findings of pulpal sclerosis?
Pulpal sclerosis has no clinical features and is considered an incidental finding. It has little clinical significance unless endodontic therapy is indicated.
61
What is pulp canal obliteration?
Pulp canal obliteration is the calcification or deposition of hard tissue within the pulp cavity.
62
What causes pulp canal obliteration?
Causes include:
• Attrition
• Abrasion
• Caries
• Dental restorations
• Trauma
• Abnormal mechanical forces that stimulate the production of secondary dentin.
63
How does pulp canal obliteration appear on a dental image?
On a dental image, a tooth with pulp canal obliteration has no visible pulp chamber and/or pulp canals.
64
What is the clinical relevance of pulp canal obliteration?
A tooth with pulp canal obliteration is nonvital and may appear discolored clinically.
65
What is the cause of pulp stones?
The cause of pulp stones is unknown.
66
How do pulp stones appear on a dental image?
On a dental image, pulp stones appear as round, ovoid, or cylindrical radiopacities. Some pulp stones may conform to the shape of the pulp chamber or canal. They can vary in size and number.
67
What are the types of periapical lesions?
The types of periapical lesions are:
• Periapical granuloma
• Periapical cyst
• Periapical abscess
• Hypercementosis
68
What often causes a periapical radiolucent lesion?
A periapical radiolucent lesion often results from pulpal death and necrosis.
69
What is the most frequent cause of pulpal death and necrosis?
The most frequent cause of pulpal death and necrosis is dental caries.
70
What is another potential cause of pulpal death and necrosis?
Trauma may also cause pulpal death and necrosis.
71
What happens with pulpal necrosis?
With pulpal necrosis, an inflammatory process extends from the pulp chamber and canals to the periapical region of the affected tooth.
72
What types of lesions can result from pulpal necrosis?
Lesions may include:
• Periapical granuloma
• Periapical cyst
• Periapical abscess
73
What does PARL stand for?
PARL stands for Periapical Radiolucency.
74
What is hypercementosis?
Hypercementosis is the excessive deposition of cementum.
75
How does hypercementosis appear on a dental image?
Hypercementosis appears as a radiopaque band along all or part of a root surface.
76
What are examples of special needs in dental imaging?
Examples of special needs include:
• Hypersensitive gag reflex
• Physical or developmental disabilities
• Pediatric patients
• Endodontic patients
• Edentulous patients
77
What is gagging?
Gagging, also called retching, refers to the strong, involuntary effort to vomit.
78
What is the gag reflex?
The gag reflex, also called the pharyngeal reflex, is gagging elicited by stimulation of sensitive tissues, such as the soft palate and the posterior third of the tongue.
79
What is the purpose of the gag reflex?
The gag reflex is a protective mechanism of the body that serves to clear the airway of obstruction.
80
What two reactions occur before the gag reflex is initiated?
1. Cessation of respiration.
2. Contraction of the muscles in the throat and abdomen.
81
What are the types of stimuli for the gag reflex?
• Psychogenic stimuli: Stimuli originating in the mind.
• Tactile stimuli: Stimuli originating from touch.
82
How can the gag reflex be suppressed during dental procedures?
To suppress the gag reflex, the dental radiographer must eliminate or lessen the precipitating factors.
83
How does operator attitude affect the gag reflex?
Lack of confidence in the operator can cause psychogenic stimuli and elicit the gag reflex.
84
What preparations can help manage the gag reflex?
Limiting the time that a receptor remains in the mouth can help manage the gag reflex.
85
What exposure sequencing is recommended to manage the gag reflex?
It is recommended to start with more anterior regions during exposure sequencing.
86
What role does receptor placement and technique play in managing the gag reflex?
Proper receptor placement and technique are critical in minimizing the gag reflex.
87
How can operator attitude affect gag reflex management?
A lack of confidence in the operator can cause psychogenic stimuli, which elicit the gag reflex.
88
What preparations can help manage the gag reflex?
Limiting the amount of time that a receptor remains in the mouth helps manage the gag reflex.
89
What exposure sequencing is recommended for gag reflex management?
Starting with more anterior regions is recommended.
90
Why is receptor placement and technique important for gag reflex management?
Proper receptor placement and technique minimize the chances of triggering the gag reflex.
91
What should you avoid suggesting to patients?
Never suggest gagging first.
92
Why is it important to reassure patients?
Reassurance helps reduce anxiety, which can lower the likelihood of a gag reflex.
93
Why is knowledge of anatomy and physiology important for managing the gag reflex?
Understanding tongue muscle contraction and recognizing when a patient may need rest are essential for effective management.
94
What techniques can be used to manage the gag reflex?
Techniques include:
• Deep breathing.
• Distraction.
• Using table salt.
• Applying topical anesthetics (ensuring the patient isn’t allergic).
• Rubbing a finger along the tissue to desensitize it.
95
What is an anecdotal solution for gag reflex management?
Have the patient press their chin on the facial surface with their thumb during exposure.
96
Why is it important to understand the patient’s limits?
Understanding the patient’s limits ensures comfort and prevents triggering the gag reflex.
97
How is a disability defined?
A disability is defined as a “physical or mental impairment that substantially limits one or more of an individual’s major life activities.”
98
How should dental radiographers treat patients with disabilities?
Treat them with dignity and respect, recognizing that the disability is simply a characteristic.
99
What challenges might patients with disabilities face?
They may have problems with vision, hearing, or mobility.
100
What role can caregivers play in assisting patients with disabilities?
Caregivers can assist with communication or help meet the patient’s physical needs.
101
What should radiographers do to accommodate patients with disabilities?
Radiographers should know and make necessary modifications to procedures for such patients.
102
What should you avoid doing with a patient who has vision impairment?
Avoid gesturing to another person in the presence of a person who is blind.
103
How should you communicate with a patient who has hearing impairment?
Ask the patient how they prefer to communicate.
• Use a caregiver as an interpreter if needed.
• Use gestures, sign language, assistive technology, or written instructions.
104
What should the dental radiographer do for patients with motility impairments?
The dental radiographer may perform imaging procedures with the patient seated in the wheelchair.
105
How can caregivers assist with motility impairments?
Caregivers can assist the patient in transferring to the chair.
106
How can the radiographer facilitate the transfer process?
The radiographer can help set the chair to aid in the transfer.
107
What should be considered during imaging for patients with motility impairments?
The patient’s interests and liability should be considered.
108
What should be done if a patient cannot use their upper limbs and a beam alignment device is unavailable?
The dental radiographer may ask the caregiver to assist with holding the receptor.
109
What precautions must a caregiver take during x-ray exposure?
• Wear a lead apron with a thyroid collar.
• Wear a lead glove (if available).
110
What instructions should the caregiver receive?
The caregiver must be given specific instructions on how to hold the receptor for the patient.
111
What must the dental radiographer avoid during x-ray exposure?
The dental radiographer must never hold a receptor for a patient during an x-ray exposure.
112
What is a developmental disability?
A developmental disability is “a substantial impairment of mental or physical functioning that occurs before the age of 22 and is of indefinite duration.”
113
What are some examples of developmental disabilities?
Examples include autism, cerebral palsy, epilepsy, neuropathies, and mental retardation.
114
What is the responsibility of the dental radiographer for patients with developmental disabilities?
The dental radiographer must make every effort to meet the individual needs of these patients.
115
What challenges might patients with developmental disabilities face?
They may have problems with coordination or comprehension of instructions.
116
How should the radiographer communicate with a patient who has comprehension difficulties?
• Use clear, simple sentences.
• Allow extra time for communication.
• Avoid finishing the patient’s sentences.
117
How should you treat a patient with a disability?
Treat the patient as you would like to be treated.
118
Why is it important to use 'people first' language?
Using 'people first' language empowers rather than marginalizes a person with a disability.
## Footnote
Say 'a person who is blind' instead of 'blind person.' Say 'a person who uses a wheelchair' instead of 'wheelchair-bound.'
119
Should you assist a person with a disability without asking?
No, always ask before assisting. A person with a disability will indicate whether help is needed and specify how assistance should be provided.
120
How should you interact with a person with a disability?
Talk directly to the person, not to their caregiver.
## Footnote
Ask the patient, 'Can you transfer out of the wheelchair?' rather than addressing the caregiver.
121
What should you do to protect the patient and yourself?
Be cautious when handling sharp instruments.
122
Why is it important to determine a patient’s tolerance?
Determining a patient’s tolerance ensures that procedures are completed comfortably and safely.
123
How can time management help in patient care?
Efficient time management minimizes discomfort and ensures smoother procedures.
124
When should you consider assistance from a caregiver?
If the patient requires additional support during the procedure.
125
What is a pediatric patient?
A pediatric patient is a child patient.
126
What aspects should be considered when working with pediatric patients?
Consider:
• Tooth eruption sequences.
• Prescribing dental images.
• Recommended techniques.
• Types of examinations.
• Digital sensor issues.
• Patient and equipment preparations.
• Patient management.
127
When do primary teeth typically erupt?
The 20 primary teeth usually erupt by the age of 3 years.
128
What is mixed dentition?
Mixed dentition is the combination of primary and permanent teeth, which occurs between the ages of 6 and 12 years.
129
How many permanent teeth do most adolescents have by age 13?
By age 13, most adolescents have 28 permanent teeth.
130
When do third molars usually erupt?
Third molars usually erupt by age 21.
131
What intra-oral techniques are commonly used in children?
Bite-wing, occlusal, and the bisecting technique may be preferred over the paralleling technique.
132
What size intraoral receptor is used for maxillary pediatric occlusal projections?
Size 2 intraoral receptors are used.
133
What is the recommended number of projections for primary dentition (ages 3–6 years)?
• 1 occlusal projection for maxillary and mandibular each (using size 2 receptors).
• 2 bite-wing projections (using size 0 receptors).
• Periapical molar projections are not needed.
134
What is the recommended number of projections for mixed dentition (ages 6–12 years)?
• 1 periapical projection for maxillary incisor, maxillary canine, mandibular anterior, and mandibular canine (using size 1 or 2 receptors).
• 2 bite-wing projections (using size 2 receptors).
• 2 periapical projections for maxillary molar and mandibular molar (using size 2 receptors).
135
What are the components of a four-image series?
• 1 anterior occlusal/maxillary.
• 1 anterior occlusal/mandibular.
• 2 posterior bite-wings (right and left).
136
What are the components of an eight-image series?
• 1 anterior periapical/maxillary.
• 1 anterior periapical/mandibular.
• 2 posterior periapicals for maxillary and mandibular (right and left).
• 2 posterior bite-wings (right and left).
137
What are the components of a twelve-image series?
• 1 incisor periapical for maxillary and mandibular.
• 2 canine periapicals for maxillary and mandibular (right and left).
• 2 posterior periapicals for maxillary and mandibular (right and left).
• 2 posterior bite-wings (right and left).
138
What are the components of a sixteen-image series?
• 1 incisor periapical for maxillary and mandibular.
• 2 canine periapicals for maxillary and mandibular (right and left).
• 2 premolar periapicals for maxillary and mandibular (right and left).
• 2 molar periapicals for maxillary and mandibular (right and left).
• 2 posterior bite-wings (right and left).
139
Why might a patient not tolerate the use of a wired digital sensor?
The size and thickness of a digital sensor can make intraoral placement difficult in young children.
140
What issue might children have with the wires of a digital sensor?
Children may chew on the wires, making their use problematic.
141
Which type of sensors is preferred for pediatric dentistry?
Wireless sensors or PSP (Photostimulable Phosphor) sensors are preferred over wired sensors in pediatric dentistry.
142
How should the explanation of the procedure be communicated to a child?
The procedure should be explained in terms that are easily understood by the child.
## Footnote
For example, the tubehead can be referred to as a “camera,” the lead apron as a “coat,” and the image as a “picture.”
143
Why is a lead apron important for children during x-ray exposure?
The growing tissues of a child are particularly vulnerable to the effects of ionizing radiation. A lead apron and thyroid collar must be placed on the child to protect them before exposure.
144
What should be considered regarding exposure factors for pediatric patients?
Exposure factors like milliamperage, kilovoltage, and time must be reduced due to the smaller size of pediatric patients. A shorter exposure time reduces the chance of blurred images if the child moves. All exposure factors should be set according to the manufacturer’s recommendations.
145
What size receptor is recommended for pediatric imaging?
Size 0 receptors are recommended for pediatric patients with primary dentition because of their small mouth size.
## Footnote
For children with a transitional dentition, size 1 or size 2 receptors are recommended. Size 2 receptors are recommended for maxillary and mandibular occlusal exposures in children.
146
How should a dental radiographer’s confidence affect the child’s behavior?
Most children react favorably to a confident and capable operator. The radiographer must be patient and avoid rushing the imaging procedures.
147
What is the “show and tell” technique in dental radiography for children?
The “show and tell” technique involves showing the child the equipment and materials that will be used and describing what will happen during the procedure. This approach helps prepare the child for imaging procedures.
148
How can a radiographer reassure a pediatric patient during imaging?
The radiographer can provide positive feedback to reassure the patient.
149
What should be done if a child cannot stabilize the receptor during imaging?
The radiographer can ask the parent or an accompanying adult to assist. The adult should wear a lead apron with a thyroid collar and hold the receptor or the child during the x-ray exposure.
150
When should a dental imaging examination for a child be postponed?
Imaging should be postponed unless it is an emergency. It is better to delay the procedure until the second or third visit rather than instill a fear of the dental office in the child.
