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MDENT110 > Prevention and management of caries > Flashcards

Prevention and management of caries Flashcards

(55 cards)

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1
Q

How much toothpaste do you use for a child under 3 years old?

A

Smear

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2
Q

How much toothpaste do you use for a child 3 years old and over?

A

Pea size

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3
Q

What is caries driven by?

A

Biofilm on surface of teeth

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4
Q

What are the 4 zones of enamel caries?

A

Surface zone, body of lesion, dark zone and translucent zone

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5
Q

What sort of disease is caries?

A

Socioeconomic

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6
Q

What are the impacts of caries for children?

A

Pain, time off school, difficulty brushing teeth, difficulty eating, loss of sleep, interference with social activities

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7
Q

what percentage of UK children have dental sepsis?

A

5%

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8
Q

Why do we need to diagnose accurately?

A

To make correct restorative decisions and initiate prevention

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9
Q

How can you detect and diagnose caries?

A 
Visual examination
Radiographs
FOTI
TTS
Laser fluorescence 
Magnification
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10
Q

Under what conditions would you look at enamel and dentine caries?

A

Enamel - dry

dentine - wet

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11
Q

Why do we no longer use probing as the main method of detection of caries?

A

Probing can break surface of tooth and lead to more bacteria entering - plaque trap
The probe transfers cariogenic bacteria between different teeth
probing does not mean a better or more accurate diagnosis

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12
Q

What does ICDAS code 0, code 1, code 2, code 3, code 4, code 5 and code 6 mean?

A

Code 0 - sound tooth, no evidence of caries after surface drying
Code 1 - first visual change in enamel, white/brown discoloration at entrance to pits/fissures, after drying
Code 2 - distinct enamel change when wet, must also be seen when dry
Code 3 - localised enamel breakdown without dentine involvement, seen when wet and after prolonged drying
Code 4 - underlying dark shadow from dentine
Code 5 - distinct cavity with visible dentine less than half the surface
Code 6 - more than half the surface showing cavity with visible dentine

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13
Q

What is included in the risk assessment of caries?

A 
Previous disease
Diet
Social
Use of fluoride / plaque control
Medical history
Saliva
Bacteria
Hunch
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14
Q

What 4 things do you need to think about when diagnosing caries?

A

Detection
Risk
Activity
Management

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15
Q

How would you brush an erupting tooth?

A

Sideways brush strokes

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16
Q

What is the hall technique?

A

A non-invasive treatment for decayed baby back teeth. Decay is sealed under preformed crowns, avoiding injections and drilling.

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17
Q

What is the critical pH?

A

5.5

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18
Q

What does active and arrested caries tend to look like on the teeth?

A

Active - white spot usually

Arrested - brown spot usually

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19
Q

What are the 4 factors of caries?

A

time, tooth surface, microflora, substrate

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20
Q

What type of lesion is not visible on a bitewing radiograph?

A

Enamel lesions

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21
Q

Which tooth surface is difficult to spot a white spot lesion on?

A

Approximal surface

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22
Q

What is best used to detect approximal caries?

A

bitewing radiograph

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23
Q

What are the advantages of using transmitted light to detect caries?

Study These Flashcards
A

Better in patients with posterior crowding as BW will produce overlapping and for pregnant women to avoid unnecessary radiation

24
Q

How does tooth separation help to detect caries?

Study These Flashcards
A

Place separators/matrix bands between contact points - after 2 days feel gently with probe to detect cavity. Elastomer impression material can be used between teeth to record cavity if present

25
How may laser fluorescence methods be inaccurate to detect caries?
Readings can be confused by staining and calculus so should be used in conjuction with conventional methods
26
How does laser detect caries?
Emits light 655nm laser light penetrates tooth light is measured and intensity is an indication of size and depth of lesion better for occlusal caries
27
What factors indicate high risk of caries?
Medical history - disability, sjorgrens dental history - past caries/restorations oral hygiene - low frequency of tooth cleaning etc diet - high sugar saliva - stimulated and un-stimulated saliva flow is low social and demographic factors - poverty, education, religion, unemployed
28
How does a white spot lesion occur?
Enamel exposed to acids from microbial biofilm, mineral is removed from surface. inter-crystalline spaces enlarge and become more porous clinically has white spot appearance
29
What is the response to caries in dentine?
Odontoblasts form tertiary dentine at pulp/dentine border - tubular sclerosis
30
Which comes first infected or affected dentine?
Infected
31
What are dead tracts?
empty dentinal tubules filled with air due to degeneration of OB processes (caries etc)
32
What are transverse clefts?
Penetration of bacteria in the dentinal tubules which traverse at right angles to the tubules along the incremental lines of growth
33
What is the defense to dentine caries?
Tubular sclerosis tertiary dentine formation reduction in permeability of the dentine removal of bacterial mass and sealing it - allow patient to clean/OH/fluoride can arrest lesions and encourage reparative dentine
34
What are the 3 types of caries management?
Non invasive/preventive, minimally invasive, restorative
35
Describe preventive caries management
``` 3 diet diary - assess extrinsic and intrinsic acids effective tooth brushing salivary flow assessment fluoride exposures - optimal levels fluorides in gels, varnish, mouthwash, toothpaste etc DBOH ```
36
Why should we restore teeth?
``` Aids plaque control prevent sensitive teeth pulp is endangered failed alternative preventative measures function has been impaired loss of contact point and subsequent tooth movement aesthetic reasons ```
37
When should surgical intervention for caries only be carried out?
Once cavitation has occurred
38
What are the factors associated with compliance?
``` Disease Patient Operator Treatment support system facilities ```
39
What are the 3 operator variables that exist for compliance factors?
* Explanations * Attitude towards the treatment * Quality of the therapeutic relationship
40
Why is communication important? (6 points)
* Patient trust * Patient involvement in decision making * Patient motivation/co-operation * Management of patient expectations * Patient satisfaction * Prevents medico-legal issues/complaint
41
What are the general barriers to communication?
* Social status: class, age, gender, socio-economic group * Cultural/ethnic * Environment
42
What are the patient barriers to communication?
* Pain * Anxiety * Embarrassment * Cognitive level * Jargon
43
What are the dentist barriers to communication?
* Lack of interpersonal skills/training * Lack of sensitivity/empathy * Lack of active listening * Time pressures
44
What are the three models of health care relationship?
* Active/passive * Guidance/co-operation * Consensus/Action
45
What are the 3 types of motivated patient groups?
* Already motivated; guidance and reinforcement * Latent motivation; only need a “trigger” * Lacking motivation; difficult
46
What are the 4 pre-requisites for change?
* A problem exists which affects the patient personally * There will be an unwanted outcome – loss of teeth * There is a practical solution – adequate plaque control * The problem is serious enough to justify inconvenience/time/effort
47
What are the strategies for changing motivation? (5 points)
* Education and communication * Participation * Facilitation and support * Negotiation * Coercion/Threat
48
How would you approach OHI? (3 points)
* Explain problem, using appropriate resources. (radiographs, mirror, models, charting/indices) * Disclose * Plaque score
49
What does effective communication improve? (7 points)
The quality and amount of information obtained from the patient increased accuracy and efficiency of diagnosis The likelihood of patient adherence to recommendations and treatment Health outcomes for patients Patient’s anxiety levels Satisfaction for both patient and dentist Levels of patient complaints and litigation Patient referrals
50
What are the goals of communication in dentistry? (4 points)
``` To increase; Accuracy Efficiency Supportiveness To enhance patient and dentist’s satisfaction To improve health outcomes To promote collaboration and partnership ```
51
What type of approach is the Calgary-Cambridge framework? - Silverman J, Kurtz S & Draper J. (2005). Skills for communicating with patients (2nd Ed.).
Patient-centred
52
What is a patient centred approach?
Dentist tries to enter the patient’s world to see the [illness/symptoms/condition] through the patient’s eyes
53
What are the 5 stages of a consultation?
``` Initiating the session Gathering information Physical examination Explanation and planning Closing the session ```
54
What are the 7 steps in initiating the session?
Establishing initial rapport 1. Greet patient and obtain name 2. Introduce yourself and clarify role 3. Demonstrates respect and interest Identifying reasons for appointment 4. Identifies the patient’s problem/issue with appropriate opening question e.g. why are you here today? 5. Listens attentively to opening statement without interrupting or directing conversation 6. Confirms list and screens for further problems 7. Negotiates agenda taking patient’s needs into account
55
What is attentive listening?
the process by which an individual listens to and, at the same time, attempts to interpret and summarise what the speaker is saying Wait time Facilitative response ‘Occasional smile, nod, praise, eye-contact ‘uh-huh’, ‘go on’, ‘I see’ Non-verbal skills Picking up patient’s verbal and non-verbal cues

MDENT110 (26 decks)

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