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Hard Tissue Charting

Hard Tissue Charting. Dental Hygiene Theory Instructor: Nickee dela Cruz R.R.D.H. Hard Tissue Charting. Is completed & documented at the ASSESSMENT appointment Is updated at each maintenance appointment Should follow a routine so that nothing is missed (sequencing)

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Hard Tissue Charting

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  1. Hard Tissue Charting Dental Hygiene Theory Instructor: Nickee dela Cruz R.R.D.H.

  2. Hard Tissue Charting • Is completed & documented at the ASSESSMENT appointment • Is updated at each maintenance appointment • Should follow a routine so that nothing is missed (sequencing) • Do not use erasers or white out, if you make a mistake stroke 1 line through it & date & initial the change

  3. Charting • Conditions which exist or are present in the oral cavity are recorded in BLUE • Carious lesions, teeth requiring treatment (extractions & other pathologic conditions, such as abcesses) are recorded in RED • SUSPECTEDcarious lesions are charted in GREEN, but if they are diagnosed by the DDS as being decay, they are changed to RED

  4. Normal, Atypical, & Abnormal Findings to Observe during Hard Tissue Exams

  5. The dental hygienist should be able to … • Recognize signs of development anomalies & acquired tooth damage & bring them to the DDS’s attention • Be able to properly document in the odontogram (hard tissue) in the client’s chart

  6. Anomalies of the Teeth • Hyperdontia – or supernumary teeth, extra teeth such as mesiodens which will occur between the maxillary anterior teeth • Hypodontia– absence of 1 or 2 teeth or anodontia, congenitally missing teeth most common are 3rd molars than maxillary lateral incisors, than mandibular premolars

  7. Mesiodens

  8. Mesiodens (arrow). A, Radiographic appearance. B, Clinical appearance

  9. Hypodontia

  10.  Microdontia (arrow)

  11. Supernumary Teeth

  12. Anomalies of the Dental Tissue • Macrodontia – larger than normal teeth, they tend to be wider, longer, & higher than normal teeth, may affect several or all teeth in the dentition

  13. Anomalies of the Dental Tissue • Gemination – a tooth tries to split or twin

  14. Gemination

  15. Gemination (arrow)

  16. Anomalies of the Dental Tissue • Dens in dente – a tooth within a tooth usually the lingual of maxillary incisors

  17. Dens in dente

  18. Anomalies of the Dental Tissue • Dilacerations – severe distortion or crown or root by trauma during formation

  19. Dilaceration

  20. Definition of DYSPLASIA • medically abnormal development or growth of a part of the body, for example, an organ, bone, or cell, including the total absence of such a part

  21. Intrinsic StainingStain or discoloration within the tooth Enamel dysplasia HYPOPLASIA – (rough, pitted enamel surface, ameloblasts disrupted during the matrix formation of the tooth) • Interruption of the enamel developmental process results in irregular enamel formation or lack of enamel formation. Restorative treatment may be required because of susceptibility to decay and to improve appearance.

  22. Enamel Hypoplasia

  23. Enamel hypoplasia

  24. Syphilitic enamel hypoplasia. • A, Hutchinson's incisors. • B, Mulberry molars.

  25. Enamel Dysplasia HYPOCALCIFICATION – defect in enamel during mineralization, spotted surface is generally smooth, may be from trauma, nutritional deficiencies, excess fluoride intake

  26. Enamel Hypocalcification

  27. Enamel Dysplasia AMELOGENESIS IMPERFECTA – hereditary condition where dentin & pulp develop normally but enamel is easily chipped or worn away • A spectrum of hereditary defects in the function of ameloblasts and the mineralization of enamel matrix that results in teeth with multiple generalized abnormalities affecting the enamel layer only. • teeth vary in color from white opaque to yellow to brown    • all teeth are affected, smaller and pitted

  28. Amelogenesis Imperfecta

  29. Enamel Dysplasia Dentinogenesis Imperfecta • The bluish color and translucent features of this dentition are very suggestive of dentinogenesis imperfecta. • Unlike amelogenesis imperfecta, the enamel in dentinogenesis imperfecta is normal; it is the underlying dentin that is structurally deficient.

  30. Dentinogenesis Imperfecta

  31. Dentinogenesis Imperfecta

  32. Here is another example of the clinical features of dentinogenesis imperfecta.

  33. Dentin Dysplasia (Rootless Tooth) • A hereditary defect in dentin formation in which the coronal dentin and tooth color is normal; the root dentin is abnormal with a gnarled pattern and associated shortened and tapered roots

  34. Taurodontism • A malformed multirooted tooth characterized by an altered crown-to-root ratio, the crown being of normal length, the roots being abnormally short, and the pulp chamber being abnormally large. • Observed on radiographs – shows enlarged pulp chamber resulting in thinner dentin

  35. Taurodontism

  36. Talon Cusp • Lingual of maxillary & mandibular anterior teeth

  37. Acquired Anomalies • Attrition – wear from tooth on tooth Attrition of the mandibular anterior teeth

  38. Abrasion • Mechanical tooth wear caused by a foreign substance

  39. Erosion • Loss to tooth surface due to a chemical agent • Erosion from sucking on lemons (arrow) NEXT SLIDE

  40. Tooth Fracture • Small to large chips or breaks in the enamel

  41. Surfaces of the Teeth

  42. Quadrants Primary vs. Permanent

  43. Charting Symbols for Oxford Dental Hygiene Clinic Chapter 13 pg 247

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