Management of Early Caries Flashcards
(43 cards)
what should you consider when you detect caries?
- the diagnosis
- the impact its having
- the risk factors
- how to manage it
define caries
dynamic disease which takes place within the biofilm covering the teeth
- fuelled by sugar
- results in demineralisation of the tooth
- tissue gets destroyed from the acids produced by bacterial fermentation
what impacts does caries have on children?
- eating
- sleeping
- tooth brushing
- school - taking time off due to pain or concentration issues
- work attendance for parents
- damages underlying permanent teeth
- trauma from hospital and GA
- may have to consider orthodontics due to gaps and tooth movements
how should teeth be examined?
- under good light with a dental mirror
- a 3in1 air to dry the surfaces
why is restoring a tooth not always the best?
- it lessens the lifespan of the tooth
- requires LA
what are the 2 inhaled anaesthetic agents used on pads and what negative impacts do they have?
- sevofluorane
- 100x global warming potential to CO2 - nitrous oxide
- 300x GWP to CO2
what 3 things should you consider with the environment?
- the persistence of the material in the environment
- waste and by products
- energy consumption
what’s the most common reason for hospital admission in children? how much does it cost on average per child?
tooth decay
£1,300
what major aspect of dentistry needed to be changed during COVID and why?
using NAGP
- non aerosol generated procedures
- to reduce the spread of viral transmission
which preventative techniques became used more during covid?
- silver diamine fluoride
- Hall Crowns technique
describe the 6 scoring stages for determining the lesion management.
Score 0:
- sound tooth surface
- no evidence of caries, after 5 second air dry
Score 1:
- air dry and see change in enamel
Score 2:
- see change in enamel when wet and dry
Score 3:
- localised enamel breakdown (pitting) when its wet and under drying
Score 4:
- dark shadow from dentine
Score 5:
- cavity with visible dentine
Score 6:
- extensive distance cavity with visible dentine
for the low risk, mod risk and high risk children, how often should you take bitewings?
low risk with prim and mixed dentition
- 12-18 months
low risk with perm dentition
- 2 years
moderate risk
- every 12 months until no new or active lesions
high risk
- every 6 months until no new or active lesions
does caries progress faster in primary or permanent dentition? and why?
primary
- thinner enamel, less mineralised, less resistant to acid attacks
what is elective tooth separation?
when you place bands to separate the teeth for 5 days
- teeth will move slightly apart
- can confirm interdentally if there is caries
give 5 other diagnostic tools that are used apart from clinical assessment.
- fibre-optic transillumination - shining light through tooth, can see any shadowing or changes
- electrical methods - carious enamel has less resistance to electric
- laser fluorescence - bacterial byproducts by fluorescence red
- prone to false positives
- non-invasive
- quantitive laser fluorescence - measures fluorescence under specific wavelengths
- caries activity tests - measures levels of s.mutans
what may active caries look and feel like compared to arrested caries/
soft/sticky
lighter in colour
arrested - scratchy surface, dark in colour
7 Risk Factors for Patients
- Diet
- OH - brushing
- Behaviour
- Family
- Medical
- Socio-Economic
- Environmental
what is bottle caries?
prolonged use of bottles with sugary fluids or from prolonged breastfeeding
how can a patients behaviour be related with caries?
- poor brushing habits
= increase plaque accumulation
= high caries risk - frequent carbs and sugar
- non-fluoridated toothpaste
how can the biological status of the child lead to caries?
- xerostomia
- impairs natural defence against caries
- teeth less time remineralising, neutralising acids and washing away bacteria
- more streptococcus mutant and lactobacilli = caries
how can the environment affect a child?
- lack of fluoridated water
- poor parent attitudes
- school environments can promote
how does the child get affected socio-economically?
- limited access to dentists = untreated caries
- income and travel
- dietary chouces
how can the child be affected by caries if they have medical issues?
some medications can contribute to xerostomia
what are the tooth/clinical risk factors?
- the type of surface - interproximal and fissures
- enamel quality - hypo mineralised?
- morophology - grooves, pits
- caries in adjacent teeth
- presence of plaque
- existing restoration with poor margins
- orthodontic appliances
