What is the difference between reversible & irreversible pulpitis and how can you test for each?
REVERSIBLE PULPITIS
- inflammation and discomfort go away when you remove the aetiology/source of problem
- characterised by short sharp pain/sensitivity on application of cold stimulus which lingers for a few seconds
- does not hurt spontaneously
IRREVERSIBLE PULPITIS
- pulpal inflammation does not go away even after removal of cause, inflammation causes pulp tissue to die.
- characterised by pain on thermal stimulus, lingering pain for longer than 30s after stimulus removed
- spontaneous pain
- keeps patient awake
TESTS = sensibility testing (ethyl chloride, hot GP points), electro stimulation pulp tests
Patient has sensibility to heat & cold, lasts for a few seconds.. what is the diagnosis?
- reversible pulpitis
Patient has pain on pressure, what is the diagnosis?
Symptomatic apical periodontitis/acute apical abscess if pus present
Explain gaseous porosity:
Voids occurring in the material when PMMA is cured fast; monomer boils & this usually happens in thicker acrylic sections
Give 2 reasons why you cannot leave acrylic dentures in dry environment for too long?
- acrylic becomes brittle if overdried
- warping can occur (therefor wont fit patient correctly)
Discuss 2 thermal properties of acrylic dentures and why they are important:
- Low thermal conductivity = denture base not able to transmit heat well to palate, patient will be less sensitive to hot foods/drinks and may get scalded
- High softening temperature = allows the denture to maintain its shape/tolerate hot foods or drinks, patient should not clean dentures in boiling water
What radiograph can be taken in a highly uncooperative child for examination of carious teeth 16, 36 & 46?
OPT with deciduous dentition setting
If teeth 16, 36 and 46 need to be extracted from a childs mouth what should you do with tooth 26?
compensating extraction
What 2 thinks should you look out for on a radiograph when looking to extract a childs 6s?
- development of bifurcation of 7
- premolars and 8s present
What are 2 advantages of extracting 6s from a child (assume at the correct time)?
- carious free dentition
- 7s will experience mesial drift to close space left by 6
What are 2 disadvantages of extracting 6s from a child (assume at the correct time)?
- risks associated with GA
- negative experience of extraction can affect child at future dental appointments
If you were to do an extraction on a 3 year old child, what must occur?
- GA or inhalation sedation
- ascertain who has parental responsibility
- gain consent (explain procedure, risks, alternate treatment options)
- write referral letter for GA
A patient needs an extraction of a mandibular premolar (in an otherwise healthy dentition), what 4 common peri-operative complications can occur?
- haemorrhage
- soft tissue damage
- damage to nerve
- tooth/root fracture
A patient needs an extraction of a mandibular premolar (in an otherwise healthy dentition), what 2 types of LA needed for this extraction?
- inferior alveolar nerve (IDB)
- lingual nerve (infiltration or lingual block)
How would you test if anaesthesia has been achieved after giving a patient LA for extraction of lower premolar?
- probe around tooth and check for any presentation of pain
- ask if patients lip/chin feels numb
What are the 3 different types of neuro-sensory complications that can occur after LA administration?
- Paraesthesia (tingling)
- Hypoaesthesia (no sensation)
- Anaesthesia ( lack of sensation)
Child patient attends your clinic with trauma. Give signs that trauma was non-accidental:
- injuries to both sides of body
- delayed presentation of injury
- mismatched story/story does not match injury
- child behaviour around parent
What are 2 effects of trauma on primary teeth?
- delayed exfoliation
- discolouration
What are 4 side effects of trauma to primary teeth on permanent tooth?
- delayed eruption
- enamel defect
- abnormal anatomy formation
- arrested tooth formation
A child presents to your practise with a digit sucking habit, give 4 ways to manage this?
- bad tasting nail varnish
- URA with a crib/rake
- place elastomers on fingers
- identify any triggers
Give 4 occlusal presentations of a digit sucking habit:
- proclined upper incisors
- posterior cross bite
- anterior open bite
- retroclined lower incisors
What happens to posterior dentition during thumb sucking? what is the result?
- thumb placed where tongue should be
- cheek muscles gradually push upper teeth palatally leading to narrow upper arch
- when teeth meet together posterior crossbite is observed
What is the definition of SIMD (Scottish Index Multiple Deprivation)?
Are based index which ranks data zone in Scotland in order of deprivation based on a range of domains including:
- housing
- income
- geographical access to public services
- health services
- crime
- education
- employment
Give 4 modifiable aetiologies of head and neck cancer:
- tobacco use
- alcohol use
- HPV
- sun exposure
- poor diet
