Management of Carious Lesions
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Questions and Answers

What is the primary role of prevention in caries management?

  • To maintain good hygiene practices
  • To provide nutrition to tooth enamel
  • To restore lost tooth structure
  • To hinder the development of carious lesions (correct)

Which score on the ICDAS indicates a first visual change in enamel?

  • Score 2
  • Score 3
  • Score 1 (correct)
  • Score 4

What should be assessed to manage caries effectively?

  • The aesthetic preference of the patient
  • The patient's diet alone
  • Only the patient's age
  • The extent of caries and tooth wear (correct)

Which of the following is NOT a direct management option for dental caries?

<p>Root canal treatment (C)</p> Signup and view all the answers

How does plaque bacteria contribute to caries formation?

<p>By metabolizing fermentable carbohydrates (A)</p> Signup and view all the answers

What is the most extensive stage of caries according to ICDAS?

<p>Score 6 (B)</p> Signup and view all the answers

What action is primarily taken when there is extensive loss of tooth tissue?

<p>Utilize indirect management options (D)</p> Signup and view all the answers

Which aspect should be recorded as part of a comprehensive patient history?

<p>Relevant oral health and lifestyle factors (B)</p> Signup and view all the answers

What is a primary characteristic of an indirect restorative approach like inlays or onlays?

<p>An impression of the tooth is taken and sent to a dental lab. (D)</p> Signup and view all the answers

What is the primary reason for preparing a tooth for a crown?

<p>To provide strength to a weakened tooth structure. (C)</p> Signup and view all the answers

Which of the following statements correctly describes a step in creating an inlay or onlay?

<p>The tooth must be reshaped to create space for the restoration. (A)</p> Signup and view all the answers

Why might a direct restoration pose issues compared to an indirect restoration?

<p>Direct restorations may not fit as accurately as lab-created options. (A)</p> Signup and view all the answers

What is the procedure followed if a dentist decides a crown is necessary?

<p>The dentist reshapes the tooth to prepare for the fitting of the crown. (D)</p> Signup and view all the answers

What additional restorative option is typically used when a large amount of tooth tissue is lost?

<p>Crowns can be used to cover lost tooth tissue. (A)</p> Signup and view all the answers

In the context of dental restorative options, which of the following is NOT typically completed by a hygienist or therapist?

<p>Creating an inlay or onlay. (D)</p> Signup and view all the answers

What is the first stage in treating any patient with a carious lesion?

<p>Diet advice (D)</p> Signup and view all the answers

Which of the following best describes arrested caries?

<p>Non-progressive lesion in enamel (B)</p> Signup and view all the answers

Which stage of caries involves penetration into the middle third of dentine?

<p>Caries into outer third of dentine (B)</p> Signup and view all the answers

Which technique is emphasized in minimally invasive dentistry?

<p>Long lasting materials (C)</p> Signup and view all the answers

What should be emphasized alongside any operative treatment in caries management?

<p>Preventative advice (C)</p> Signup and view all the answers

What is a key component of the Delivering Better Oral Health toolkit?

<p>Oral hygiene education (B)</p> Signup and view all the answers

What is a potential management strategy for severe caries into the pulp?

<p>Crown restoration (C)</p> Signup and view all the answers

Which of the following options represents an advanced stage of carious lesions in dental management?

<p>Caries into inner third of dentine (B)</p> Signup and view all the answers

Which intervention would primarily aim to prevent the initiation of caries?

<p>Regular fluoride varnish application (A)</p> Signup and view all the answers

In the context of dental caries, what does 'fissure sealant' refer to?

<p>A material used to prevent caries in pits and fissures (D)</p> Signup and view all the answers

What is the recommended restorative material for outer to middle 1/3 dentine caries?

<p>Amalgam and composite (B)</p> Signup and view all the answers

Which treatment is primarily used when dealing with inner 1/3 dentine caries that may invade the pulp?

<p>Stepwise excavation (D)</p> Signup and view all the answers

What is a characteristic of amalgam restorations?

<p>Will be phased out due to mercury concerns (D)</p> Signup and view all the answers

What should be done after removing superficial necrotic caries in stepwise excavation?

<p>Place calcium hydroxide base and provisional restoration (C)</p> Signup and view all the answers

What is the purpose of using preventative resin restorations (PRR)?

<p>To seal and prevent caries progression (C)</p> Signup and view all the answers

What is a significant challenge in managing root caries?

<p>Difficulty ensuring moisture control (B)</p> Signup and view all the answers

What is meant by 'pulp capping' in caries treatment?

<p>Restoration placed over exposed pulp to promote healing (A)</p> Signup and view all the answers

What approach does the Atraumatic Restorative Technique (ART) use?

<p>Chemically adhesive high viscosity glass ionomer cement (B)</p> Signup and view all the answers

What factor does the Cochrane review suggest regarding composite restorations?

<p>They have a slightly higher failure rate due to secondary caries (D)</p> Signup and view all the answers

Which strategy is recommended for managing outer to middle 1/3 dentine caries?

<p>Removal of caries followed by restorative treatment (A)</p> Signup and view all the answers

What is the primary course of action for arrested caries?

<p>Regular monitoring without active treatment (C)</p> Signup and view all the answers

Which of the following statements is true regarding enamel caries with white spots?

<p>They are reversible and can be managed with preventive strategies. (A)</p> Signup and view all the answers

What is the recommended approach to treat enamel caries?

<p>Avoid drilling and apply preventive measures (B)</p> Signup and view all the answers

What is the purpose of fissure sealants in treating carious enamel?

<p>To seal the enamel and deprive bacteria of nutrients (D)</p> Signup and view all the answers

Which of the following methods is NOT considered an active prevention strategy for enamel caries?

<p>Routine tooth extraction (D)</p> Signup and view all the answers

What should be regularly reviewed to ensure the effectiveness of fissure sealants?

<p>The condition of the sealant to prevent decay (D)</p> Signup and view all the answers

What is the key preventive strategy to support enamel health aside from dietary advice?

<p>Using high fluoride toothpaste or mouthrinse (B)</p> Signup and view all the answers

Why should drilling be avoided in treating certain types of caries?

<p>It can lead to a restorative spiral and further deterioration. (A)</p> Signup and view all the answers

What factor does NOT contribute to the potential reactivation of arrested caries?

<p>Regular dental check-ups (D)</p> Signup and view all the answers

What is the ultimate goal when managing cases of enamel caries?

<p>To arrest the caries and restore enamel health (B)</p> Signup and view all the answers

Flashcards

Caries Management

The process of controlling and treating dental cavities, taking into account the extent of damage and the patient's needs. It includes direct methods like fillings and indirect options like crowns when extensive tooth loss occurs.

Direct Caries Management

A direct approach to treating caries involving restoring the damaged tooth structure, usually with fillings or other similar materials.

Indirect Caries Management

A less direct approach to caries management used when extensive tooth damage has occurred, typically involving prosthetic devices like crowns or bridges to rebuild the lost structure.

Prevention in Caries Management

The process of preventing the development of caries in the first place, through measures like oral hygiene practices, diet modifications, and fluoride applications.

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ICDAS

A visual scoring system used to assess the severity of dental caries, ranging from initial enamel changes (Score 1) to extensive dentin involvement (Score 6).

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Extent of Caries

The amount of tooth structure that has been affected by caries. This determines the appropriate management approach, ranging from simple fillings for minimal damage to more complex solutions for extensive loss.

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Plaque Bacteria

The bacteria present in plaque that contribute to the development of dental caries by breaking down sugars and producing acids that attack tooth enamel.

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Fermentable Carbohydrates

Substances like sugars and starches that are broken down by bacteria in plaque, contributing to the formation of acids that lead to tooth decay.

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Tooth Surface

The outer layer of tooth structure, primarily composed of enamel, which is the hardest substance in the human body.

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Arrested Caries

A stage of tooth decay where the process has stopped and no active treatment is needed unless for aesthetic reasons.

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Enamel Caries (White Spots)

Early stage of tooth decay where the enamel is affected, but still reversible.

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Fissure Sealant

A technique used to stop enamel caries progression by sealing the fissures with a protective layer.

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Restorative Spiral

The strategy of avoiding dental drilling unless absolutely necessary, favoring preventive measures.

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Prevention Strategies

Practices aimed at preventing the development of tooth decay, like proper oral hygiene and diet.

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Review of Arrested Caries

The process of checking the state of arrested caries to ensure they haven't reactivated.

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Dentin Caries

An irreversible stage of tooth decay affecting the dentin.

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Active Prevention Strategies

The practice of actively increasing fluoride exposure to strengthen enamel and prevent further decay.

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Fluoride Varnish

A type of fluoride treatment for teeth that provides a high concentration of fluoride.

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Tooth Mousse

A fluoride-rich gel that strengthens enamel.

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Early Enamel Caries

The earliest stage of enamel breakdown, visible as a white spot on the tooth.

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Caries into outer 1/3 of dentine

A type of enamel caries where the decay has progressed into the outer layer of dentine.

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Caries into middle 1/3 of dentine

Caries that has progressed to the middle layer of the dentine, indicating a more advanced stage of decay.

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Caries into inner 1/3 of dentine

A stage of caries where the decay extends to the inner layer of the dentine, requiring more significant intervention.

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Caries into pulp

A type of caries where the decay reaches the tooth's pulp, causing pain and requiring prompt treatment.

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Caries with limited tooth tissue remaining

Caries that is characterized by significant loss of tooth structure, often requiring more advanced restorative procedures.

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Minimally Invasive Dentistry

A philosophy in dentistry that emphasizes preserving tooth structure and avoiding unnecessary interventions.

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The Restorative Spiral

An approach to dental caries management that involves a series of steps, from prevention to restoration.

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Prevention

The initial step in treating any carious lesion, emphasizing preventative measures.

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What's an inlay or onlay?

When a filling cannot be placed directly, a lab takes a mold of the affected tooth. They create a custom-made inlay or onlay, which is then cemented in place by the dentist.

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How do inlays and onlays work?

Inlays and onlays are custom-made fillings crafted in a lab. They are then cemented into the tooth by the dentist, much like a traditional filling.

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Why do some teeth need crowns?

When a tooth has lost a lot of its structure due to decay, a crown might be needed. It's a cap that covers the entire tooth, protecting it and restoring its strength.

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How is a tooth prepared for a crown?

A dentist prepares the tooth for a crown by shaping it to fit the crown perfectly. This creates space for the crown to fit securely over the tooth.

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How does a crown protect a weak tooth?

A crown encases the tooth completely, providing strength and protecting it from further damage. It's placed over the entire tooth, acting like a strong shield.

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When are crowns most commonly used?

Crowns are often used when teeth have been significantly weakened by decay, trauma, or other factors. They provide a strong and durable solution for restoring a damaged tooth.

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How does crown treatment differ for children?

Not all treatments are suitable for children. A dentist will determine the best course of action based on a child's individual needs and development.

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Outer 1/3 Dentine Caries

Caries affecting only the outer 1/3 of dentine.

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Outer to Middle 1/3 Dentine Caries

This is the point where caries has spread to the middle 1/3 of dentine, making it irreversible and requiring restorative treatment.

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Inner 1/3 Dentine Caries

Caries affecting the inner 1/3 of dentine. This may involve pulpitis symptoms.

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Root Caries

Caries that occurs on the root surface, often due to gum recession.

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Stepwise Excavation

A minimally invasive approach to treating deep caries, involving removing the superficial layer of dentine, placing a calcium hydroxide base, and then re-entering months later to remove remaining caries and place a permanent restoration.

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Atraumatic Restorative Technique (ART)

A more modern approach to dealing with deep caries, focusing on removing the superficial layer and sealing the remaining tooth with a glass ionomer cement to prevent further bacterial activity. This method eliminates the need for re-entry.

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Pulp Capping

A treatment for exposed pulp where a restoration is placed over the pulp to promote healing before placing a final restoration.

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Root Canal Treatment

A treatment where instruments are used to remove the pulp, disinfect the chambers and canals, and then fill them. The tooth is then restored with a permanent restoration.

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Caries with Limited Tooth Tissue

A situation where caries is so extensive that there is not enough tooth structure remaining above the gum line, requiring extraction.

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Restorative Treatment

The treatment involves the removal of the damaged tooth structure and its replacement with restorative material.

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Study Notes

Management of Carious Lesions

  • Carious lesions are cavities in teeth caused by bacteria.
  • Initial management focuses on prevention.
  • Prevention involves diet advice (reducing sugar), oral hygiene advice (effective cleaning), and increasing fluoride exposure.
  • Prevention is essential for all stages of caries management.
  • Minimally invasive dentistry is prioritised, aiming for least tooth structure removal and long-lasting materials.
  • The restorative spiral is an approach to managing different stages of caries. (Images show examples)
  • Management approaches vary depending on the extent of caries (e.g., arrested caries, enamel caries, dentine caries, root caries).
  • Caries extent is categorised using ICDAS scores (Images show examples).
  • The progression of caries from enamel to dentine is described. (Images show examples and the different depths of caries)
  • Outer dentine caries usually requires intervention and restorative materials.
  • Middle dentine caries also requires intervention but more focused preventative measures like fluoride exposure are still needed.
  • Inner dentine caries may need extensive treatment, including pulp capping, or root canal treatment.
  • Root caries often requires prevention and is managed differently from other areas.
  • Newer techniques, like preformed crowns (PMCs) and the "Hall Technique" are used for pediatric patients to reduce space loss.
  • Minimally invasive techniques, like stepwise excavation, are increasingly used.
  • Additional restorative options, like inlays, onlays, and crowns, can be applied by clinicians or technicians, depending on the extent of caries and the needs of the patient.
  • Specific considerations for pediatric patients due to different tooth sizes and quicker caries progression include prevention, fluoride management, and the use of fissure sealants.
  • There are different degrees of intervention needed for carious lesions in paediatric patients, particularly when space retention is desirable.
  • Conventional techniques are useful when the caries is not extensive and pulpal involvement is unlikely.
  • Newer techniques are better for cases with more extensive caries.
  • Hygienist involvement is relevant for patient education and risk discussion related to the different restorative options.

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Description

This quiz on Management of Carious Lesions focuses on the prevention and management of dental cavities caused by bacteria. It covers dietary advice, oral hygiene practices, minimally invasive dentistry techniques, and the restorative spiral approach for managing various stages of caries. Additionally, it touches on the categorization of caries severity using ICDAS scores.

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