Dental Caries Case Studies PDF

Dental Caries Case Studies Dr Neel Sethi Dr Annika Hindocha  GDC Learning Outcomes C1.2 Describe and identify the clinical presentations of oral and dental diseases relevant to the role of a dental therapist and explain the principles underpinning their diagnosis, prevention and treatment....

Dental Caries Case Studies Dr Neel Sethi Dr Annika Hindocha  GDC Learning Outcomes C1.2 Describe and identify the clinical presentations of oral and dental diseases relevant to the role of a dental therapist and explain the principles underpinning their diagnosis, prevention and treatment. C1.24 Explain the principles of preventative care and apply as part of a comprehensive personalised treatment plan. C1.25 Underpin all patient care with a preventative approach, that takes account of patient compliance and self-care, to contribute to the patients’ long-term oral and general health. C1.27 Explain how diet and nutritional status can influence oral and general health and how to provide appropriate advise and support. C1.30 Describe the aetiology and pathogenesis of diseases of the oral and maxillofacial complex I2.1 Explain the responsibilities and limitations of delegating to other members of the dental team Intended learning outcomes By the end of this session you will be able to.. Apply theoretical knowledge of dental caries to real world scenarios Describe a systematic technique to evaluating dental caries risk Explain how clinical and historical findings impact the decision to undertake operative or preventative dentistry CASE BASED DISCUSSIONS  Task Split into 4 groups. You will have 30 minutes to discuss as a group the questions relevant to each case Nominate 1 person from each group as the spokesperson to present your groups case  Case 1 Background Patient Name – Patient X Age – 26 years old C/O – Does not like the appearance of her front teeth. Clinical photograph of patients UR1 (11), UR2 (12), UR3 (13) Case 1 Medical History; Social History; Occupation – Professional Medical conditions – Sjogren’s syndrome, Rheumatoid arthritis swimmer Non smoker Medication – Ibuprofen PRN Doesn’t drink alcohol NKDA Relevance of this information?  Case 1 Dental History; Diet; Irregular dental attender. Patient Patient reports ‘sweet tooth’ reports last dental visit was over 5 years ago Current Oral hygiene regime; Previous orthodontic treatment as a child Brushes once daily with a mtb. Uses charcoal toothpaste. Rinses with water after brushing. Relevance of this information? Brushes once daily with a manual brush. Uses charcoal toothpaste. Rinses with water after brushing. Radiographs  Questions 1. What are the risk factors for dental caries and tooth surface loss associated with this patient? 2. Can you identify the carious lesions present and provide an ICDAS grade for them? 3. What is the relevance of this patients medical history? 4. What caries risk level would you give the patient and why? 5. Based on the information provided can you make a provisional treatment plan for this patient? 6. If you had to refer this case on, which dental professionals are able to manage this case/parts of this case?  Case 2 Background Patient Name – Patient Y Age – 17 years old C/O – Patient wants braces as unhappy with overlapping of teeth Photograph taken from – BSP ‘Good Practitioners Guide’ Case 2 Medical History; Social History; Occupation – Apprentice pastry Medical conditions – T1DM chef Medication – Insulin Non smoker NKDA Doesn’t drink alcohol Relevance of this information?  Case 2 Dental History; Diet; Regular dental attender every 6/12 Not having regular meals, tends to snack throughout day Patient anxious about having dental treatment Current Oral hygiene regime; Brushes twice daily with an ETB and aloe vera toothpaste. Not interdentally cleaning. Rinses with water after brushing. Relevance of this information? Brushes once daily with a manual brush. Uses charcoal toothpaste. Rinses with water after brushing. Radiographs  Questions 1. What are the risk factors for dental caries and gingivitis associated with this patient? 2. Can you identify if there are any carious lesions present? 3. What is the relevance of this patients medical history? 4. What caries risk level would you give the patient and why? 5. Based on the information provided can you make a provisional treatment plan for this patient? 6. What would your recall be for this patient using NICE guidance? 7. Would you refer this patient for an orthodontic consultation?  Case 3 Background Patient Name – Patient C Age – 12 years old C/O – Mum attends with her daughter who is getting teased at school for her crooked teeth Pari et al. (2014) Case 3 Medical History; Social History; Occupation – High Schooler Medical conditions –Asthma Medication – Beclomethasone and Salbutamol NKDA Relevance of this information?  Case 3 Dental History; Diet; Irregular dental attender. Last dental High sugar intake both frequency and visit was over 3 years ago amount Patient is dentally anxious Current Oral hygiene regime; Brushes a few times a week as doesn’t like teeth. Uses children’s toothpaste as prefers the taste Relevance of this information?  Questions 1. What are the risk factors for dental caries and tooth surface loss associated with this patient? 2. Can you identify the carious lesions present and provide an ICDAS grade for them? 3. What is the relevance of this patients medical history? 4. What caries risk level would you give the patient and why? 5. Based on the information provided can you make a provisional treatment plan for this patient? 6. If you had to refer this case on, which dental professionals are able to manage this case/parts of this case?  Case 4 Background Patient Name – Patient D Age – 55 years old C/O – Having pain from teeth with hot and cold temperatures and when eats sweet things Pari et al.2014 Case 4 Medical History; Social History; Occupation – Carer Medical conditions Hypertension Medication – Amlodipine Amoxicillin Relevance of this information?  Case 4 Dental History; Diet; Most relies on snacks through the day. Picky eater. Fizzy drinks as doesn’t like Hasn’t been for a few years due to water Covid Current Oral hygiene regime; Brushes once a day with an Manual Toothbrush in the morning. Sometimes forgets at the weekend Relevance of this information? Radiographs Chen et al. (2022)  Questions 1. What are the risk factors for dental caries and tooth surface loss associated with this patient? 2. Can you identify the carious lesions present and provide an ICDAS grade for them? 3. What is the relevance of this patients medical history? 4. What caries risk level would you give the patient and why? 5. Based on the information provided can you make a provisional treatment plan for this patient? 6. If you had to refer this case on, which dental professionals are able to manage this case/parts of this case?  Bibliography AEGIS Communications, B.H.E.S. (2005) Cervical caries - treatment options based upon etiology of the lesion: Inside dentistry, Cervical Caries - Treatment Options Based Upon Etiology of the Lesion | October 2005 | Inside Dentistry. Available at: https://www.aegisdentalnetwork.com/id/2005/10/clinical- treatment-options-cervical-caries-treatment-options-based-upon-etiology-of-the-lesion (Accessed: 06 January 2024). Chen, X. et al. (2022) ‘Detection of proximal caries lesions on bitewing radiographs using Deep Learning Method’, Caries Research, 56(5–6), pp. 455–463. doi:10.1159/000527418. Pari, A. et al. (2014) ‘Gingival diseases in childhood – a review’, JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH [Preprint]. doi:10.7860/jcdr/2014/9004.4957. BSP: The Good Practitioner’s Guide to Periodontology