Paediatrics > Caries > Flashcards

Caries Flashcards

(48 cards)

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1
Q

Define caries

A
  • Reversible in it’s earliest stages

- Disease of the dental hard tissues caused by the action of micro-organisms on fermentable carbohydrates

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2
Q

Most common hospital admission reason in children between 5-9

A

Caries

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3
Q

How many caries present

A
  • Decalcification (WSL or BSL)
  • Pit and fissure caries
  • Smooth surface caries (buccal/lingual cervical areas)
  • Occult (hidden so only on rx)
  • Recurrent/Secondary
  • Arrested
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4
Q

Define SECC

A
  • Any sign of smooth surface caries in children below 3
  • If between 3-5, 1 or more smooth surface lesions (either cavitated, missing or filled)
  • Dmfs is greater than or equal to age plus 1
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5
Q

Most likely teeth to get caries

A
  • Mandibular molars
  • Maxillary molars
  • Maxillary anteriors
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6
Q

Where is caries rare and why

A

Mandibular anteriors

  • Buccal and lingual surfaces
  • Protective action of saliva buffer and tongue
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7
Q

In which primary teeth are you more likely to get occlusal caries

A

-E’s>D’s

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8
Q

When would you get inter proximal caries

A

-Not until contacts develop

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9
Q

In which primary teeth are you most likely to get caries (in order of likelihood)

A

-36/46 > 16/26

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10
Q

Which pits and grooves are you most likely to get caries in mixed dentition

A
  • Palatal of Upper 6s
  • Palatal of Upper laterals
  • Buccal of Lower 6s
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11
Q

What factors specific to children are involved in caries management

A
  • Parental involvement
  • Patient development
  • Dealing with 2 dentitions
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12
Q

3 main indicators of a child being at increased risk of developing caries within the next X years

A
  • 3 years
  • Previous carious experience (any dmfs)
  • Healthcare workers opinion
  • Resident in area of deprivation (postcode)
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13
Q

Who can give a healthcare worker opinion

A
  • Health visitor, public health nurse or dental health support worker
  • Identified the need for additional preventative care
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14
Q

Other factors that may influence patient risk assessment

A
  • Sibling history with caries
  • Oral hygiene
  • Diet
  • Access to fluoride
  • Medical history
  • Clinical findings
  • Habits
  • Social History
  • Saliva
  • Level of mutans
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15
Q

Name things that would indicate a high risk individual

A

-Look at slides

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16
Q

Name things that would indicate a low risk individual

A

-Look at slides

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17
Q

What would caries risk assessment inform

A
  • Treatment plan (provision of preventative techniques)
  • Frequency of rx
  • Frequency of recall
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18
Q

name ways in which you can detect caries

A

Clinical Examination

  • clean dry tooth
  • mag
  • light
  • ortho separators
  • sharp eyes
  • FOTI (fibre optic transillumination)

Rx

Sensibility testing

Vitality testing

Laser/electric caries detectors

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19
Q

How do you determine vitality of primary molars

A
  • Using history, clinical assessment and vertical bitewings

- vitality unreliable

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20
Q

should you do a rx on initial examination of a child and what rx
how often if so

Study These Flashcards
A
  • bitewings should be taken at initial examination for all high risk children
  • 6 monthly rx should be taken until no new or active lesions are apparent and the individual has entered another risk category
21
Q

when should you note record and review a lesion on rx

Study These Flashcards
A
  • if small lesion is less than half way through proximal enamel is detected
  • preventitve tx should be instigated
22
Q

what features on rx examination indicate cavitation

Study These Flashcards
A
  • if lesion extending into dentine

- may require intervention

23
Q

if a low risk child, when should you bitewing

Study These Flashcards
A
  • Child with no or little caries activity does not require bitewings at every recall
  • If low caries risk then rx at 12-18 months in primary dentition and 2 years In permanent dentition
24
Q

When should you investigate unerpted teeth

Study These Flashcards
A
  • If failure of eruption beyond the normal age

- then rx

25
At what age should you palpate canines
- In late mixed dentition | - If pt is 11+ and canines cannot be palpated then rx is required
26
Name some alternatives to taking rx when detecting caries
- Orthodontic separators - Elective tooth separation - Direct assessment of approximate surfaces - Silicone impression material can be used to confirm cavitation - Transullimination - Electrical caries monitor
27
How can electric be used to detect caries
- Electrical caries monitor measures bulk resistance - Loss of mineral leads to increased porosity of tooth structure - Porosities filled with fluids - Decreased electrical resistance
28
What is diagnodent
- Laser fluorescence - Wavelength of 655nm - Clean healthy tooth structure exhibits no or little fluorescence - Altered tooth substances and bacteria fluoresce when exposed to a certain wavelength of light - Carious tooth structure will exhibit fluorescence proportionate to the degree of caries, resulting in elevated scale readings
29
What must you consider when thinking about xla or restoration
- Natural tooth structure remaining (restorability of tooth) - Signs symptoms - Caries risk - Med history - Pt and parent compliance - Stage of dental development - Space management
30
List ICDQS codes and criteria
0- sound tooth structure. no evidence of caries after prolonged drying 1- white opacity not visible until prolonged drying 2- white opacity visible when wet 3- localised enamel breakdown 4- underlying dark shadow from dentine 5- distinct cavity with visible dentine 6- extensive (more than half the surface) with visible dentine
31
Benefits of restorative therapy
- Stopping progression of caries - Restoring integrity of tooth structure - Prevent spread of infection - Prevent shifting of teeth
32
Risk of restorative therapy
- Lessens the longevity of teeth by making them more susceptible to fracture - Recurrent lesions - Restoration failure - Pulpal exposure iatrogeni - iatrogenic damage to adjacent teeth
33
RMGIC or GIC
- RMGIC more successful than GIC - Small to moderate sized class II - RMGIC can be considered for Class I and II restoration of primary molars in a high risk population because of fluoride release - Conditioning the dentine also improves success rate - Cavosurface bevelling leads to high marginal failure in RMGIC and is therefore not recommended
34
Advantages of RMGIC
- Biocompatible - Adhesive (chemical bonding) - Coefficient of thermal expansion similar to tooth strcture - Reasonable wear resistance - Release of fluoride - Sets by command light cure - LEss sensitive to moisture than resin - Tooth coloured - Better aesthetics than GIC
35
Disadvantages of RMGIC
Care needs to be taken to mix material to correct consistency Components have sensitising potential- avoid contact of skin and mucosa with uncured material Inferior cohesive strength, wear resistance and aesthetics compared to composite resin
36
Most common reason for restoration failure esp composites
-Recurrent caries
37
Stabilisation of paeds patient
- Preventitive therapy - Prevent pain and further infection - Arrest/stabilise restorable lesions - Acclimatization - Remove unrestorable teeth
38
How may stage of dental development affect tx
- PRimary teeth - Assess time for exfoliation - Space maintenance
39
Ortho implications when restoring teeth
- Increasing crowding increases tendency for space loss - Earlier the tooth is xla the greater the amount of space loss - If centre line shift, balance the cs
40
4 options in management of caries of anterior primary teeth
1) Prevention 2) Interproximal disking 3) Strip crowns 4) XLA
41
Aim and indications for topical fluoride
-To prevent new, arrest active and reverse earlier - Early cervical decalcification, pre-cooperative child - Evidence of changed eating/bottle habits
42
What is a toxic dose of fluoride
5mg/kg
43
Indications for interproximal stripping (disking)
- Exfoliation time close - Precooperative - Extensive superficial/minimal inter proximal
44
+ and - of inter proximal stripping
+ -Simple, quick, open contacts, renders self cleansing - - PULP - food impaction - space loss - poor aesthetics
45
How do you inter proximally disc
- Soft flex paper discs - Tapered stone or diamonds in slow speed - Tapered crown- narrow incisally - Round off proximal surfaces - Polish and fluoride varnish
46
Technique for strip crown
- LA and rubber dam - Tapered prep - Labial groove - 2mm incisor reduction - Cellulose acetate crown form and composite
47
When else can strip crowns be used
- Enamel hypoplasia | - Dental anomalies (AI/DI)
48
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