WEEK 2

Question 1

Define caries

Answer 1

preventable, chronic, and biofilm mediated disease modulated by diet.

Question 2

What causes caries?

Answer 2

An imbalance of the oral flora due to the presence of fermentable dietary carbs on tooth surface overtime.

Question 3

What are the different types of caries?

Answer 3

primary, secondary, and residual

Question 4

what are primary caries?

Answer 4

initial or incipient caries occurs on a surface not previously affected

Question 5

what are secondary caries?

Answer 5

adjacent to existing restoration, crown, or sealent.

Question 6

what are residual caries?

Answer 6

Caries that remain in a completed tooth preparation, left accidentally or intentionally

Question 7

what are some caries risk factors?

Answer 7

Diet
Fluoride exposure
Saliva quality and quantity
Oral hygiene
Previous or active caries.

Question 8

What are the diagnostic tools and techniques used to detect caries?

Answer 8

Visual exam
Blunt probe
Wet and dry tooth
Radiographs
ICDAS

Question 9

What are the pros and cons about amalgam?

Answer 9

fit for large cavities with high chewing forces, not ideal for aesthetics

Question 10

what are the pros and cons about composite?

Answer 10

good for front and back teeth small to moderate fillings, less durable for high stress areas

Question 11

what are the pros and cons of glass ionomer content?

Answer 11

baby teeth, high risk, not ideal for high stress

Question 12

3 phases in treatment planning

Answer 12

1. acute/contol phase - adress pain
2. definitive phase
3. maintenance phase

Question 13

Acute/Control phase

Answer 13

• Pain control
• OHI
• Motivational interviewing for behavioural change
• Recommend remineralisation products (e.g., high-strength fluoride)
• diet analysis
• temporisation
• Interprofessional referrals

Question 14

Definitive phase

Answer 14

• OHI
• Motivational interviewing
• Definitive restorations (replace GIC restorations with permanent ones)

Question 15

Maintenance phase

Answer 15

• 6-12 month radiographs
• carries risk assessment
• OHI
• Diet analysis
• motivational interviewing
• 3-6 month review

Question 16

ICDAS CODES

Answer 16

ICDAS 0 - sound tooth surface
ICDAS 1 - white spot visible when dry
ICDAS 2 - visible when wet
ICDAS 3 - inital enamel breakdown
ICDAS 4 - shaddow from dentine
ICDAS 5 - cavity with visible dentine
ICDAS 6 - really big cavity

Question 17

ICDAS CODE RCOMENDATIONS

Answer 17

ICDAS 0 - optional sealant, DIAGNOdent may be helpful
ICDAS 1 - sealant optional DIAGNOdent may be helpful
ICDAS 2 - sealant optional, caries biopsy if DIAGNOdent is 20-30
ICDAS 3 - sealant or minimally invasive restoration if needed
ICDAS 4 - minimally invasive restoration
ICDAS 5 - minimally invasive restoration
ICDAS 6 - minimally invasive restoration

Question 18

What is DIAGNOdent?

Answer 18

A device for detecting caries using laser fluorescence.

Question 19

ICDAS RADIOGRAPHIC SCORING SYSTEM

Answer 19

RA 0 - no radiolucnecy
RA 1 - radiolucency in the outer half of enamel
RA 2 - radiolucency in the inner half of enamel
RA 3 - radiolucency in outer 1/3 of dentin
RA 4 - radiolucency in middle 1/3 of dentin
RA 5 - radiolucency in inner 1/3 dentine
RA 6 - radiolucency in pulp

Question 20

access form

Answer 20

• first step
• establish depth
• allows visualisation
• initial opening prepared
• allows access to carious tissue

Question 21

outline form

Answer 21

• second step
• preserve marginal ridge and cusp strength
• minimise tooth loss
• cavity margins created
• planned and estimated
• maintain marginal integrity

Question 22

retention form

Answer 22

• third step
• flat floor
• dove tail
• convergent walls
• rounded internal line angles
• avoids restoration displacement

Question 23

resistance form

Answer 23

• fourth step
• cusp reduction of requires
• resist functional forces
• Removes weakened tooth structure

Question 24

what is the concept of marginal integrity and what is its relationship to prepping teeth?

Answer 24

the tight, smooth well adapted seal between a restoration and the tooth.

Question 25

What is the importance of proper cavity preparation and finishing techniques?

Answer 25

refined margins and contours prevent leakage, minimize sensitivity, and enhance durability.

Question 26

What are some ways to improve amalgam retention?

Answer 26

remove unsupported enamel, slightly undercut, round angles, tooth preservation

Question 27

What are the stages of cavity design?

Answer 27

outline form, primary resistance, convenience form, removal of infected dentine, pulp protection, secondary resistance, finishing.

Question 28

What is primary resistance/retention form?

Answer 28

box shaped prep, flat floor, rounded internal angles, removal of weakened structures, material choice, cusp reduction

Question 29

What is a class I tooth prep?

Answer 29

- pits and fissures of posterior teeth - lingual surface of anterior teeth

Question 30

What is a class II tooth prep?

Answer 30

carries on proximal surfaces of posterior teeth (mesial or distal surface)

Question 31

What is a class III tooth prep?

Answer 31

carries on proximal surfaces of anterior teeth (mesial or distal surfaces) NOT INCISAL EDGE

Question 32

What is a class IV 4 tooth prep?

Answer 32

carries on proximal surfaces of anterior teeth (mesial or distal surfaces + INCISAL EDGE)

Question 33

What is a class V 5 tooth prep?

Answer 33

carries on gingival third/cervical third of any tooth

Question 34

What is a class 6 tooth prep?

Answer 34

- caries on incisal edge of anteriors or occlusal tips of posteriors

Question 35

What is the active ingredient in savacol or curasept?

Answer 35

chlorhexidene gluconate 0.2%

Question 36

What are the advantages of chlorhexidene gluconate?

Answer 36

long antibacterial, antiviral, and antifungal activity

Question 37

What are the disadvantages of chlorhexidene gluconate?

Answer 37

reversible brown staining, bitter taste, can irritate mucosa if used for too long.

Question 38

How long should chlorhexidene gluconate be used for?

Answer 38

no longer than two weeks

Question 39

How do you apply chlorhexidine gluconate?

Answer 39

rinse for 60 seconds with 10mL twice per day after brushing and flossing. Patients need to be advised not to rinse with water immediately after and not to brush for at least 30 mins after use.

Question 40

What does chlorhexidine gluconate bind with?

Answer 40

sodium lauryl sulphate (SLS) DO NOT USE chlorhexidine mouth rinse within 30 min of using SLS-containing toothpaste

Question 41

What is curasept?

Answer 41

a toothpaste with 0.5% chlorhexidene

Question 42

What are some long term indications associated with chlorahexidene?

Answer 42

disabilities, ortho, high risk caries patients, aggressive gingival inflammation, after perio therapy, patients receiving radiation in their head or neck

Question 43

What is the active ingredient in fluoride toothpastes? Which one is considered more effective?

Answer 43

either sodium fluoride (NaF) or sodium monofluorophosphate (MFP). NaF more effective

Question 44

What is the fluoride amount for children?

Answer 44

500ppm

Question 45

What amount of flouride is recommended for high risk caries patients aged 12+?

Answer 45

5000ppm

Question 46

What fluoride mouth rinse is recommended for daily use?

Answer 46

colgate neutrafluor 220ppm

Question 47

what fluoride mouth rinse is recommended for daily use of high risk patients over 6 years?

Answer 47

colgate neutrafluor 990ppm

Question 48

What professionally applied fluoride gel do we use for children 10 and under?

Answer 48

none to prevent ingestion

Question 49

Why do we use professionally applied fluoride? What is the preferred gel?

Answer 49

a booster to at home fluoride, high concentration. Neutral Fluoride gel.

Question 50

What are the acidulated phosphate fluoride (APF) precautions?

Answer 50

avoid with porcelain crowns or bridges because it can etch. Not ideal for infections. Has an unpleasant taste.

Question 51

What are the indications of fluoride varnish?

Answer 51

typically used for single teeth, but premier enamelpro varnish can be applied to the entire mouth of high risk patients under 10.

Question 52

What are common fluoride varnishes?

Answer 52

fluor protector, duraphat, premier enamelpro varnish.

Question 53

How do you apply fluoride varnish?

Answer 53

remove plaque, isolate teeth with cotton rolls, dry area, apply with microbrush.

Question 54

What are the patient instructions after applying a fluoride varnish?

Answer 54

teeth may be temporarily discoloured, avoid crunchy food for 4 hours, don't brush or floss til next morning.

Question 55

What is tooth mousse made out of?

Answer 55

sodium fluoride 990ppm and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP)

Question 56

What are the indications of using tooth mousse?

Answer 56

High caries risk patients, white spot lesions, desensitizing teeth, dry mouth, erosion, pregnancy morning sickness, orthodontics, post whitening.

Question 57

What are the contraindications for tooth mousse?

Answer 57

not suitable for children under 6 years, those with milk protein allergy, but still suitable for lactose intolerant patients.

Question 58

What are the mechanisms of tooth mousse?

Answer 58

provides fluoride, calcium, and phosphate ions to form acid resistant fluoroapatite

Question 59

What is an alternative to tooth mousse that can be used on children under 6?

Answer 59

unfluoridated tooth mousse.

Question 60

What are ways to improve salivary flow?

Answer 60

sugar free gum, biotene products which mimic the immune boosting properties of saliva.