Case Based Seminar OP #2 Diagnosis of hard tissue

lesions; caries diagnosis; caries as an infectious disease; ICDAS evaluation

Questions

REST 528A Operative Dentistry

ICDAS scoring in clinical practice Clinical view- determination of pathology:

clinical exam + radiographs

ICDAS Classification Tooth #18?

ICDAS Classification Tooth #20

ICDAS Classification Tooth # 6? Tooth #7? Tooth #8?

Using an explorer, there is a slight cavitation on the occlusal surface

1. From the radiograph and clinical appearance, how large a carious lesion do you expect #31 to be (size of occlusal outline form and depth of the preparation?

2. What other clinical aids could you use in your assessment for caries?

Diagnosis for #31-O?

Clinical Dental Appearance Of “Meth Mouth”

Methamphetamine: oral effects

• Methamphetamine: potent central nervous system stimulant with high potential for addiction and abuse

• Forms - orally tablet form; intranasal; snorting of powder form; smoking crystalline form; injection

• Other names: ice, crystal, speed, glass, tweak, rock, yuba

• 10 million people have tried methamphetamine at least once

Clinical signs and symptoms of abuse and addition crystal meth

• Episodes of delusional psychosis and paranoia

• Extreme and sudden mood changes;

• Repetitive motor activity

• Stroke, weight loss

• DENTAL: tooth damage; periodontitis

• Addicted users report drug binges lasting up to 10 days without sleep and with minimal nutritional sustenance

How did the meth use contribute to the oral condition?

How long does it take to see the effects?

What are the affected surfaces?

What is the likelihood you will see a “meth mouth” patient?

Do you know…

• What is this patient’s caries risk?

• Recommendations for oral hygiene maintenance?

• How do you proceed with dental treatment?

• What level of dental treatment should you provide; is there concern about use of local anesthetics? Do you provide complicated treatment?

• Are there any other recommendations to the patient?

How will you treat this white spot lesion?

Slight cavitation