Podcast
Questions and Answers
What concept is emphasized as the first step in managing any carious lesion?
What concept is emphasized as the first step in managing any carious lesion?
Which of the following is NOT considered a minimally invasive dentistry technique?
Which of the following is NOT considered a minimally invasive dentistry technique?
What is the primary goal of minimally invasive dentistry?
What is the primary goal of minimally invasive dentistry?
In the context of the "Restorative Spiral" diagram, what is a possible follow-up procedure after a restoration?
In the context of the "Restorative Spiral" diagram, what is a possible follow-up procedure after a restoration?
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Which of the following is NOT mentioned as an essential aspect of preventative advice for managing dental caries?
Which of the following is NOT mentioned as an essential aspect of preventative advice for managing dental caries?
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What does the term "arrested caries" refer to in the context of the text?
What does the term "arrested caries" refer to in the context of the text?
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Based on the provided text, what is a possible next step if a patient has "Caries with limited tooth tissue remaining"?
Based on the provided text, what is a possible next step if a patient has "Caries with limited tooth tissue remaining"?
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What is indicated as the primary motivation behind the "Restorative Spiral" concept?
What is indicated as the primary motivation behind the "Restorative Spiral" concept?
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What type of restorative option is used when extensive tooth tissue is lost due to caries?
What type of restorative option is used when extensive tooth tissue is lost due to caries?
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In the context of restorative options, what is the primary purpose of preparing a tooth for a crown?
In the context of restorative options, what is the primary purpose of preparing a tooth for a crown?
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What occurs after the dentist takes an impression of a tooth for an inlay or onlay?
What occurs after the dentist takes an impression of a tooth for an inlay or onlay?
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Which of the following is NOT a benefit of using an indirect restoration?
Which of the following is NOT a benefit of using an indirect restoration?
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What is the main advantage of using a crown over an inlay or onlay?
What is the main advantage of using a crown over an inlay or onlay?
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What is the difference between an inlay and an onlay restoration?
What is the difference between an inlay and an onlay restoration?
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What is the primary reason for taking an impression of a tooth before placing an inlay or onlay?
What is the primary reason for taking an impression of a tooth before placing an inlay or onlay?
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Which of these is NOT a valid reason for a dentist to recommend a crown over an inlay or onlay?
Which of these is NOT a valid reason for a dentist to recommend a crown over an inlay or onlay?
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What is the primary role of a dental therapist in caries management?
What is the primary role of a dental therapist in caries management?
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What is indicated by an ICDAS score of 3?
What is indicated by an ICDAS score of 3?
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Which of the following represents a direct management option for dental caries?
Which of the following represents a direct management option for dental caries?
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Which factor is essential in the management of carious lesions?
Which factor is essential in the management of carious lesions?
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Which of the following options reflects indirect management of extensive tooth tissue loss?
Which of the following options reflects indirect management of extensive tooth tissue loss?
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What is the primary approach to managing arrested caries?
What is the primary approach to managing arrested caries?
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Why should drilling be avoided in cases of enamel caries?
Why should drilling be avoided in cases of enamel caries?
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What is one of the active prevention strategies to manage enamel caries?
What is one of the active prevention strategies to manage enamel caries?
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What role do fissure sealants play in managing enamel caries?
What role do fissure sealants play in managing enamel caries?
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What is essential for preventing the progression of sealed enamel caries?
What is essential for preventing the progression of sealed enamel caries?
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What is a significant reason why caries progresses rapidly in deciduous dentition?
What is a significant reason why caries progresses rapidly in deciduous dentition?
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What is a key aspect of managing caries in paediatric patients?
What is a key aspect of managing caries in paediatric patients?
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What is the primary role of fissure sealants in paediatric caries management?
What is the primary role of fissure sealants in paediatric caries management?
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Which of the following describes a challenge when using conventional restorative techniques in paediatric patients?
Which of the following describes a challenge when using conventional restorative techniques in paediatric patients?
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What is a limitation of using Glass Ionomer Cement (GIC) in caries management?
What is a limitation of using Glass Ionomer Cement (GIC) in caries management?
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What is the recommended treatment for outer 1/3 of dentine caries?
What is the recommended treatment for outer 1/3 of dentine caries?
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Which restorative material is typically phased out due to environmental concerns?
Which restorative material is typically phased out due to environmental concerns?
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What is the main objective of active prevention strategies for outer to middle 1/3 dentine caries?
What is the main objective of active prevention strategies for outer to middle 1/3 dentine caries?
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What is a potential consequence of untreated inner 1/3 dentine caries?
What is a potential consequence of untreated inner 1/3 dentine caries?
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In cases requiring stepwise excavation, what is the initial step?
In cases requiring stepwise excavation, what is the initial step?
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Which of the following treatments may be required for teeth where caries has invaded the pulp?
Which of the following treatments may be required for teeth where caries has invaded the pulp?
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Which restoration type is considered more modern compared to stepwise excavation?
Which restoration type is considered more modern compared to stepwise excavation?
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What does ART primarily aim to do?
What does ART primarily aim to do?
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What is a key consideration for using amalgam restorations in pregnant women?
What is a key consideration for using amalgam restorations in pregnant women?
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Which treatment option may be needed if pulp exposure occurs during caries management?
Which treatment option may be needed if pulp exposure occurs during caries management?
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What is used to manage root caries when moisture control cannot be achieved?
What is used to manage root caries when moisture control cannot be achieved?
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What is the advantage of using glass ionomer cement in caries management?
What is the advantage of using glass ionomer cement in caries management?
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When may tooth extraction be the only option during caries treatment?
When may tooth extraction be the only option during caries treatment?
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Flashcards
Dental Caries Management
Dental Caries Management
Approaches to treat and prevent dental caries effectively.
Direct Management Options
Direct Management Options
Immediate treatments such as fillings or restorations for carious lesions.
Indirect Management Options
Indirect Management Options
Strategies used when there is extensive loss of tooth tissue, like crowns.
ICDAS Scoring
ICDAS Scoring
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Role of Prevention
Role of Prevention
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Paediatric Caries
Paediatric Caries
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Fissure Sealants
Fissure Sealants
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Conventional Management Techniques
Conventional Management Techniques
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Fluoride Adjustment
Fluoride Adjustment
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Regular Review of Sealants
Regular Review of Sealants
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Extent of caries
Extent of caries
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Enamel caries
Enamel caries
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Early enamel breakdown
Early enamel breakdown
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Caries into dentine
Caries into dentine
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Preventative advice
Preventative advice
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Minimally Invasive Dentistry
Minimally Invasive Dentistry
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Fluoride exposure
Fluoride exposure
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The Restorative Spiral
The Restorative Spiral
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Outer 1/3 Dentine Caries
Outer 1/3 Dentine Caries
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Restorative Treatment for Caries
Restorative Treatment for Caries
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Preventative Resin Restoration (PRR)
Preventative Resin Restoration (PRR)
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Active Prevention Strategies
Active Prevention Strategies
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Temporary Restorations
Temporary Restorations
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Amalgam Restorations
Amalgam Restorations
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Composite Restorations
Composite Restorations
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Root Caries Management
Root Caries Management
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Stepwise Excavation
Stepwise Excavation
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Atraumatic Restorative Technique (ART)
Atraumatic Restorative Technique (ART)
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Arrested Caries
Arrested Caries
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Pulp Capping Treatment
Pulp Capping Treatment
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Restorative Spiral
Restorative Spiral
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Root Canal Treatment
Root Canal Treatment
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Extraction Necessity
Extraction Necessity
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Dentine Caries Progression
Dentine Caries Progression
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Fluoride Varnish Use
Fluoride Varnish Use
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Direct restorative approaches
Direct restorative approaches
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Indirect restorative approaches
Indirect restorative approaches
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Inlay
Inlay
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Onlay
Onlay
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Crown
Crown
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Tooth preparation for crowns
Tooth preparation for crowns
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Loss of tooth tissue
Loss of tooth tissue
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Role of dental technician
Role of dental technician
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Study Notes
Management of Carious Lesions
- Carious lesions are managed using a preventative approach as the first step
- This includes dietary advice to reduce sugar intake, oral hygiene advice on effective cleaning, and increasing fluoride exposure.
- These steps are consistent throughout the management progression.
Pre-reading
- The aetiology and sequelae of dental caries were covered in a lecture.
- The histopathology of enamel and dentine caries was covered in a lecture.
GDC Learning Outcomes
- Describe oral diseases and their relevance to prevention, diagnosis, and treatment.
- Assess and manage caries, occlusion, and tooth wear; and, where appropriate, restore the dentition using minimal intervention maintaining function and aesthetics.
- Explain the role of a dental therapist in teeth restoration.
- Recognise the importance of and record a comprehensive and contemporaneous patient history.
Intended Learning Outcomes
- List direct management options for various presentations of dental caries.
- List indirect management options for cases with extensive tooth tissue loss.
- Describe the role of prevention in caries management.
- Describe the differences between the use of each management option.
Caries Recap
- Caries development involves susceptible tooth surfaces, plaque bacteria, and fermentable carbohydrates.
- These factors interact over time to cause caries.
ICDAS Recap
- ICDAS scores are used to assess the severity of caries.
- Different scores, from 1 to 6, depict varying stages of visual change in enamel and the progression to dentine decay.
How do we approach caries management?
- This is a question used to prompt discussion on the approaches used to manage various degrees or severity of caries.
Extent of caries
- Caries extent is categorised into reversible and irreversible stages, along with initial, moderate, and extensive categorisation.
- Different stages of caries involve enamel and dentine.
- ICDAS scores from 0–6 are used to further define caries extent.
Extent of Caries - Visual
- Caries progression from sound tooth tissue to initial, moderate, and extensive lesions is visually depicted.
- Images illustrate different stages of progressive enamel and dentin damage.
- The image references the ICDAS scoring system to match each stage.
Extent of Caries – Increasing Severity
- This section illustrates caries progression from arrested caries to pulp involvement.
- Stages show caries into varying portions of dentin, including middle and inner thirds, culminating in caries into the pulp.
- Caries can also be arrested to prevent further progression.
Philosophies in the management of dental caries
- This section is designed for discussion among learners on the theories or philosophies involved in managing dental caries.
The first stage of treating any patient with any carious lesion
- Prevention is paramount in the primary treatment of carious lesions.
- This section highlights the need for dietary advice, oral hygiene advice, and increasing fluoride exposure.
Minimally Invasive Dentistry
- Minimal intervention is preferred.
- Employ techniques that minimise tooth structure removal.
- Use long-lasting materials for restorations.
The Restorative Spiral
- The restorative spiral diagram depicts various stages of tooth repair.
- The images include visual examples showcasing tooth decay in various levels of severity.
How would each of these presentations be managed?
- This is a question for reflection and discussion on the different ways to approach tooth decay.
Arrested Caries
- Arrested caries is inactive and typically doesn't require active treatment unless aesthetics are a concern.
- Prevention and review are key to monitoring potential re-activation.
Enamel Caries (white spots)
- Enamel caries (white spots) are reversible and require prevention strategies, including oral hygiene improvement, better diet, and increasing fluoride.
Enamel Caries - Fissure Sealant
- Fissure sealants are a simple preventive measure.
- Used to seal off the tooth's grooves, thus preventing bacteria from entering and causing damage.
- Requires regular review to ensure the sealant is working effectively.
Now into dentine...
- This is a transition point in the discussion to the more invasive aspects of caries management as they advance to involvement of dentine.
Extent of caries in dentine
- Different stages of dentine involvement are categorised.
- These include outer third, outer to middle third, inner third, and root caries, each requiring different management strategies.
Enamel Caries/Outer 1/3 Dentine Caries
- Caries progression to the outer third of dentine is irreversible.
- A preventative resin restoration is necessary.
- Prevention remains a crucial aspect of treatment.
Dentine Caries - Outer to Middle 1/3
- Restorative treatment is commonly undertaken in this stage to address dentine decay.
- Prevention and active strategies for fluoride exposure remain essential to reduce further deterioration.
Dentine Caries - Outer to Middle 1/3 (restorative treatments)
- Specific restorative treatments, such as temporary restorations, and various types of permanent restorations, are used in dentine caries management.
- Ionomer cements, amalgam, and composite are common restorative materials.
- Certain restorative materials should not be used with pregnant or breastfeeding patients.
Dentine Caries - Outer to Middle 1/3 (composite and amalgam)
- Composition and amalgam restorations are the common methods of restoring outer-to-middle dentin cavities.
- Amalgam use is declining due to environmental concerns.
Dentine Caries - Outer to Middle 1/3 (Radiographic Visualization)
- Radiographic images are used as visual aids to outline the progression and severity of dentine decay.
Dentine Caries - Outer to Middle 1/3 (Treatment Visualization)
- Images showing the various stages of treatment progression within deeper caries are used to further explain the management techniques.
Root Caries
- Root caries management differs from coronal caries management.
- Prevention remains crucial. Restoration with composite or glass ionomer cement is often used, ideally under a rubber dam.
Dentine Caries - Inner 1/3
- Deep dentin caries are typically irreversible.
- Pulp treatment, such as direct or indirect pulp caps, may be necessary.
- Root canal treatment or extractions might be required for extensive cases affecting the pulp.
- Therapists should use caution in cases potentially outside their scope to avoid unnecessary intervention or risk of potentially damaging treatments.
Stepwise Excavation and the Atraumatic Restorative Technique (ART)
- ART is a minimally invasive approach for deep caries.
- Stepwise removal of affected dentin, using calcium hydroxide base, and provisional restorations are elements of the process.
- The technique involves re-entry following the formation of tertiary dentin for permanent restorations later.
Stepwise Excavation and the Atraumatic Restorative Technique (ART) (additional details)
- ART involves the removal of necrotic caries and the placement of a suitable restorative material.
- This method aims to minimise the removal of healthy tooth structures.
- A specific type of glass ionomer cement is used for the restoration to seal and stop bacteria supply.
Dentine Caries - Inner 1/3 (Pulp exposure)
- Pulp may become exposed during treatment, even with ART.
- Pulp capping materials, such as calcium hydroxide or biodentine, may help preserve the pulp.
- This approach aims to avoid root canal treatment.
Dentine Caries - Inner 1/3 (advanced caries)
- If the caries extends into the pulp, the damage is considered irreversible.
- Treatment options are limited to root canal therapy or tooth extraction.
- Root canal treatment removes the pulp, and a filling is placed.
- The coronal portion of the tooth is then restored to complete the treatment process.
Caries with limited tooth tissue remaining
- Extraction may be the only option for severe, extensive caries involving significant tooth tissue loss.
- This might necessitate discussion with the dentist on tooth replacement options.
What additional restorative treatments are there?
- Additional restorative treatments include procedures like inlays, onlays, and crowns.
- These treatments are beyond the scope of dental hygienists or therapists.
Additional restorative options
- Restorative treatments for caries can be direct or indirect.
- Direct restorations are completed by the clinician.
- Indirect restorations use materials crafted by technicians and cemented by the clinician.
- Inlays, onlays, and crowns are examples of indirect restorations.
Additional restorative options – inlay or onlay
- Inlays and onlays are indirect restorative treatments for caries.
- The process involves removing decayed parts, taking impressions, creating restorations in a dental lab, then cementing them into place.
- This approach avoids some of the challenges of direct restorations.
Additional restorative options – Crowns
- Crowns are used to restore severely damaged teeth, encasing the remaining tooth structure to strengthen it.
- Prepared grooves allow space for the crown to fit over the tooth.
- This method strengthens the tooth against further damage.
How does this vary for paediatric patients?
- Childrens' teeth are smaller and thin-enameled, leading to faster caries progression.
- Prevention and fluoride doses adapted to the patient.
- Paediatric patients also require involvement of their parents in the treatment process.
Paediatric Caries Management
- Prevention is crucial for children.
- Adjustments in fluoride doses might be needed for children compared to adults.
- The involvement of parents in the treatment process is necessary.
Fissure Sealants
- Fissure sealants protect early cavities, especially on primary and permanent molar teeth.
- Regular reviews are required to ensure the sealants are effective.
Conventional Management Techniques
- For less extensive caries, conventional restorative methods can be used.
- Moisture control complications could arise when utilizing composite material restorations.
Newer Techniques
- Stainless steel crowns and specifically tailored techniques, such as the Hall Technique, are new approaches to preserving teeth.
- These methods aid in reserving space for future orthodontic treatments.
PMCs
- Preformed metal crowns (PMCs) are easier to apply than other techniques.
- No tooth grinding or drilling is required.
- PMCs are often preferred in children's dental care.
Newer Techniques (retained teeth)
- PMCs retain teeth and reduce the risk of space loss and orthodontic complications in children.
Why is this relevant to me as a hygienist?
- Patients will often ask hygienists about restorative procedures.
- Understanding restorative techniques allows hygienists and clinicians to adequately address patient concerns about procedures.
- Collaboration with dentists is essential.
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Description
This quiz focuses on the management of carious lesions, emphasizing a preventative approach. Key elements include dietary advice, effective oral hygiene, and fluoride exposure. It also covers the role of dental professionals in diagnosing and treating oral diseases.