Test 2 Flashcards

(60 cards)

1
Q

What is the single greatest contributor to behavior change? 2nd greatest?

A

Patient’s own self-change efforts. The relationship between parent and care provider.

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2
Q

What is health promotion?

A

Any process enabling individuals or communities to increase control over the determinants of their health. Multiple determinants of health.

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3
Q

What are the social determinants of health?

A

Knowledge, health belifs and attitudes. Patterns of behavior and psychosocial factors.

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4
Q

Salutogenic Model

A

Focus on health and well being, not the disease. In oral health, it focuses on factors associated with children and caregivers who ave avoided oral disease rather than on the more more common pathogenic approach, which describes factors associated with dental caries. “This is what you can do/are doing that’s right. Rather than, this is what you are doing that’s wrong.

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5
Q

Locus of Control

A

A belief about outcomes of our actions being contingent on what we do (internal LOC) or events outside our personal control (external LOC). Where we put the blame. Most are in between the two extremes. Inner LOC patients are much better.

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6
Q

What is the central concept of MI?

A

Identify, examine and resolve ambivalence about changing behavior.

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7
Q

What is ambivalence?

A

Feeling two ways (love-hate) about behavior change.

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8
Q

What are the 3 essential elements of MI?

A

Specific form of conversation about change.
Collaborative, person-centered, honors autonomy.
Evocative, brings forth the person’s own motivation and commitment.

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9
Q

What are the 4 fundamental processes of MI?

A

Engaging: the relational foundation.
Focusing: Strategic centering.
Evoking: recognizing, eliciting, responding to change.
Planning: bridge to change.

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10
Q

What is OARS?

A

Core communication strategies.

Open-ended questions.
Affirmations
Reflection (most common response)
Summaries

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11
Q

If importance is low, how do you talk to the parent?

A

Do not give advice. Ask the person about their values, goals. Ask what they want their life to be like.

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12
Q

If confidence is low, how do you talk to the parent?

A

Provide info, advice. Ask about what will help to change. Ask about past success, challenges/strategies used. Ask about strengths, abilities.

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13
Q

What’s the most effective way to control caries in pit and fissure?

A

Restorations. Fluoride is less effective.

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14
Q

What’s the most effective way to control caries on smooth surface?

A

Fluoride, oral hygiene and dietary modification.

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15
Q

What’s the earliest clinical sign of dental caries?

A

White spot.

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16
Q

What are the 4 classical zones of a white spot lesion?

A
  1. Surface Zone: High concentration of mineral.
  2. Body of lesion. Principal area of demineralization.
  3. Dark zone:
  4. Translucent Zone: Furthest away.
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17
Q

What constitutes as ECC?

A

A child less than 6 years or 71 months with 1 or more decayed, missing (from caries) or filled tooth surface in any primary tooth.

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18
Q

What constitutes as severe ECC?

A

Child less than 3 with any sign of smooth surface caries.

Or chlide 3-5 yr with 1 or more cavitated, missing, or filled smooth surfaces in MX anterior teeth or DMFS score, greater than 4 at age 3, 5 at age 4 and 6 at age 5.

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19
Q

Why are primary teeth at greater risk for caries?

A

Thinner enamel and dentin. Larger pulp, closer to surface, reached more rapidly. Flat broad contacts that are harder to clean.

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20
Q

Summary of Hopewood House

A

Children lived there and had limited oral hygiene and dental care, but had a lacto-vegetarian diet without refined foods. Extremely low caries prevalence.

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21
Q

Summary of Vipeholm Study

A

Swedish government used long term controlled conditions and extreme carbohydrate consumption to induce caries. Increased caries in consumption between meals and highest caries in retentive or sticky candies. But also found that it varies. Some people just don’t get caries.

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22
Q

How much juice intake does the AAP recommend per day?

A

4-6 oz.

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23
Q

What is in the preop evaluation for exodontia?

A

Med and dental history. Physical exam. Imaging. Diagnosis.

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24
Q

What are some med history contraindications?

A

Systemic disorders (blood, heart, leukemia, bisphosphate therapy, etc)

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25
What are some med history considerations?
Systemic disorders (premature birth, genetic disorders and syndromes, pulmonary problems such as asthma and cystic fibrosis, growth and development, obesity, endocrinology disorders, etc), local factors (radiation, cancer, teeth and tumor association, abscess, infection, chemo, etc)
26
Where is the Cow Horn is contraindicated?
MN Molars.
27
What forceps do you use for MN molars?
151 (S-K)
28
Why would you maybe need to section primary MN 2nd molars.
The diverging mesial and distal roots on the primary 2nd molars. Prevents damage to developing tooth bud.
29
What forceps do you use on anterior teeth?
1, 150 (S-K) or 151 (S-K)
30
What type of forces do you use on anterior teeth?
Rotational force on conical roots.
31
What is the purpose of apical pressure?
Expansion of the tooth socket, moves center of rotation apically.
32
What is the purpose of buccal pressure?
Expansion of buccal plate.
33
What is the purpose of lingual pressure?
Expansion of linguo-crestal bone.
34
What is the purpose of rotational forces?
Internal expansion of socket.
35
What are the purposes of tractional forces?
Gentle and limited to the final portion of the extraction process.
36
1st step in extraction procedure?
Loosening of the ST attachment. Reassurance of profound anesthesia. Push tissue away to allow forceps to be positioned as apically as possible.
37
2nd step in extraction procedure?
Luxation of tooth with dental elevator. Expansion of alveolar bone and tearing of PDL.
38
Step 3 in extraction procedure?
Firm adaption of forceps to tooth. Beaks should grasp underneath loosened soft tissue. Luxation of tooth with combination of all motions.
39
Step 5 in extraction procedure?
Removal of tooth with forceps. Compression of socket.
40
What is the primary tooth treatment for reversible pulpitis?
Indirect pulp treatment: Deep caries with no pulp exposure. Objective is to completely seal the involved dentin from the oral environment and stimulate dentin healing and repair. Calcium hydroxide, zinc oxide and eugenol, glass ionomer cement then tooth restored with material that seals the tooth from microleakage. A direct pulp cap is not recommended for carious pulp exposure in primary tooth.
41
When do you use a pulpotomy and what is it's objective?
Reversible pulpitis. A deep carious lesion adjacent to the pulp, a carious pulp exposure in a tooth with a normal pulp or reversible pulpitis, large traumatic pulp exposure. Objective is to amputate coronal pulp tissue and reat remaining radicular pulp surface with a medicament to preserve health. Fill coronal pulp chamber with a suitable base, then restoration that seals from microleakage.
42
When do you perform a pulpectomy and what are it's objectives?
Irreversible pulpitis or necrotic pulp. Pulp tissue is infected or necrotic due to caries or trauma. Indications include: Irreversible pulpitis or necrotic pulp, tooth planned for pulpotomy in which radicular pulp exhibits clinical sings of pulp necrosis such as excessive hemorrhage. Objectives: Maintain tooth and resolution of the infectious process radiographically in 6 months. Root canals are debrided, enlarged, disinfected and filled with a resorbable material such as zinc oxide/eugenol.
43
When would you extract a tooth?
Irreversible pulpitis or necrotic pulp. Tooth is non restorable due to insufficient tooth structure for restoration. Tooth is within 1 year of exfoliation or shows root resorption.
44
What is a sedative restoration and when do you do it?
On reversible pulpitis on young permanent teeth. You place a protective base on the pulpal surface of cavity preparation, covers the dental tubules, acts as a protective barrier between restorative material or cement tooth's pulp.
45
When do you use indirect pulp treatment on a young permanent tooth?
Reversible pulpitis, deep caries with no pulp exposure. You want to completely seal dentin from the oral environment and stimulate dentin healing and repair. Calcium hydroxide, zinc oxide and eugenol, glass ionomer, then restored with material that seals from microleakage.
46
When do you do a direct pulp cap?
NOT ON PRIMARY TEETH. Only on young permanent teeth. Small, mechanical pulp exposure during cavity preparation, small carious exposure or following traumatic injury. Maintain tooth's vitality with pulp healing and reparative dentin formation resulting. After hemorrhage control completed, cap the exposed pulp. Put material in direct contact with the exposed pulp tissue, then restoration that seals tooth from microleakage.
47
When are partial pulpotomy carious exposures indicated? Objective?
Young permanent tooth for small carious exposure in which pulp bleeding is controlled in 1-2 minutes. Inflamed pulp tissue beneath carious exposure is removed to depth of 1-3 mm or, in some cases, deeper to reach healthy pulp tissue. Control bleeding, cover.
48
How do you do a partial pulpotomy for traumatic exposures?
Inflamed pulp tissue beneath exposure is removed to depth of 1-3 mm to reach the deeper, healthy tissue. Bleeding is controlled using bactericidal irrigants. covered. Vital, traumatically exposed, young permanent teeth. Especially with incompletely formed apex. Bleeding must be controlled. Must amputate to healthy pulp. Maintain vital pulp. NO symptoms, no radiographic signs of resorption or pulp calcification or periapical radiolucency. Immature root shows continued normal root development.
49
How do you treat a non-reversible/nonvital pulp of permanent tooth?
PULPECTOMY. Rootcanal.
50
Infraction
Incomplete fracture (crack) of the enamel with no loss of tooth structure. Craze lines and normal radiographic appearance. For treatment, you want to maintain structural integrity and pulp vitality. Complications are unusual.
51
Uncomplicated Crown Fracture
An enamel fracture or enamel-dentin fracture that doesn't involve the pulp. Diagnosis: Clinical and/or x ray findings reveal the loss of tooth structure confined to enamel or both enamel and dentin. Treatment: Maintain vitality and restore to normal esthetics and function. Prognosis: dependent on concominant injury to PDL and secondarily to extent of dentin exposed. Improved prognosis with timely care.
52
Complicated Crown Fracture
An enamel/dentin fracture with pulp exposure. Diagnosis through clinical and x ray findings reveal a loss of tooth structure with pulp exposure. Treatment: Maintain pulp vitality and restore normal esthetics and function. Primary teeth: Decision is based on life expectancy of traumatized tooth and vitality. Pulpotomy/ectomy or extraction. Permanent: Direct pulp cap, pulpotomy (partial or full) and pulpectomy. Prognosis is dependant on pdl, age of exposure, dtent of dentin and root develoupment.
53
Crown-Root Fracture
An enamel, dentin and cementum fracture with or without pulp exposure. Diagnosis: Mobile coronal fragment attached to gingiva with or without pulp exposure. Radiolucent oblique line on xray, usually vertical. Primary: Remove tooth and apical shit, unless you will result in damage to succedaneous tooth. Permanent: Stabalize coronal fragment. Remove cronoal fragment and restore. Prepare for subgingival restoratuon by fingivectomy, osteotomy or extruson. Pulp treatement. Most permanent can be restored with complex treaatment.
54
Root fracture
Dentin and cementum fracture involving pulp. Primay: extract coronoal fragment. Permanent; Reposition and stabliilze cornoal fragment. Pulp necroses. Should preserve in cervical third. Yong teeth, immature roots, high pulp senstivity and disolatoin within 1 mm are good at healing.
55
Concussion
Injury to tooth-supporting structures without abnormal loosening or displacement of the tooth. PDL absorbs injury and is inflamed. Tender. No radiographic abnormalities. You want to help it heal and maintain vitality. Unless infection, do nothing. Minimal risk for necrosis. Perm teeth may undergo.
56
Subluxation
Injury to tooth with loosening. Mobile tooth without displacement. Can have sulcular bleeding. No radiographic abnormalities. Watch primary teeth for pathology. Permanent teeth: stabilize, releive occlusion, flexible stint. Favorable prognosis. Primary teeth will return to normal within 2 weeks, but often discolors. Need to follow permanent teeth closely for pulpal necrosis.
57
Lateral Luxation
Displacement of tooth in a direction otther than axially. PDL is torn and contusion or fracture of spporting bone occurs. Tooth displaced laterally. Normally palatal or lingual (crown). Not moble. X ray shows increased PDL space. Primary: Allow passive repositioning if no occlusion. Gently reposition if minor interference. Extract if severe. Permanent: Reposition and stablility with splint and monitor vitality. Primary teeth have risk of pulp necrosis if repositioned. Permanent teeth: necrossis and canal obliteration are common.
58
Intrusion
Apical displacement of bone into alveolar bone. Driven into socket. Compressing PDL. Crushing fracture. Tooth is shortened or missing. Apex is usually labial in primary teeth and driven into alveolar process in permenant. Not moble or tender. PDL noot continuous on radiograph. Primary: Allow re eruption with successor then take out. Permanent: passive reposition. Or with traction. Or surgically. If immature: spontaneous. If mature: reposition and treat with endo within 3 weeks. Primary teeth, most will re-erupt within 2-6 month. Ankylosis can occur. Permanent teeth: Mature with closed apex: high risk for bad stuff. root resorption. Immature: allow to reposition. low risk for complication.s Adjacent intrudet teeth is bad.
59
Extrusion:
Displacement axially, PDL normally torn. Elongated and mobile. Increased PDL apically. Primary: Allow to reposition spontaneously. Severe,, near exfoliation, fully formed, then extract. Permanent: reposition as soon as possible, then stabilize in anatomically correct osition. Splint. Not that good of a prognosis.
60
Avulsion
Complete displacement. Tooth is gone. Reimplant immediately, less than 5 min. Do not wait. drying of cells is bad. Use milk or packed ice if can't reimplant. Water damages. Primary teeth, don't replant. Don't want to damage developing tooth. Permantnt: Reimplant and stabilize. Tetanus and abx. Prognosis is dependent upon formation of tooth development and extra orald dry time. You want an immature tooth. No chance for PDL if its been out for more than 60 min. ankylosis is a risk.