1. Cariology Flashcards
Caries classified by… (5)
- location
- activity
- development stage
- mode of appearance
- location and size
Caries classification by location? (3)
- Fissures, groove, pits
- Free enamel surfaces: Proximal, buccal, lingual
- Root
Caries classification by activity? (3)
- Active
- arrested
- Rampant/ Early childhood caries.
Caries classification by development stage? (5)
- White spot
- Dentin affected, no cavity
- Cavity
- Pulp exposure
- Crown destruction
Caries classification by mode of appearance? (3)
- Primary
- Recurrent, secondary
- Residual
Caries classification by location and size? (2)
- Blacks classification (dissused)
- Hume and mount
Hume and mounts classification: location (3)
1: pits, fissures, grooves and all surface defects (except in the proximal areas)
• 2:Proximal
caries below
contact area in
all teeth
• 3:Caries in the
gingival 1/3 or in
the exposed root
when recession
Hume and mounts classification: stages (5)
- Stage 0: White spot. Can be remineralized.
- Stage 1: Minimal cavitation, dentine is affected, it cannot be remineralized.
• Stage 2: Moderate loss. Remaining tooth can
support a restoration.
• Stage 3: Large caries, weakened cusp or incisal
angle. (Restoration must protect the remain tooth
structure)
• Stage 4: Very extensive caries, close to the pulp,
affecting most of the tooth (more than one cusp,
incisal edge, root caries affecting two or more
adjacent walls)
Treatments for hume and mounts stages (3)
o Stage 0: (white spot) remineralization techniques.
o Stage 1: Minimally invasive restorative treatment.
o Stage 2, 3, and 4 more complex restorative
treatment
How to write hume and mounts classifications?
1st number: location
2nd number: stage
ex. lesion 3/0
What is ICDAS?
Evaluation and detection of dental caries. Used for early detection or assess caries severity
What was ICDAS designed for? (2)
- to inform decisions about appropriate diagnosis, prognosis and clinical management
- individual and public
health levels
What is ICDAS 0?
- Sound tooth surface
- not demineralized
What is ICDAS 1?
- First visual change in enamel (dry)
- 1/2 out enamel
What is ICDAS 2?
- Distinct visual change in enamel (wet)
- 1/2 inner enamel and 1/3 outer dentin
What is ICDAS 3?
- localized enamel breakdown due to carries with no visible dentin (small cavitation)
- 1/3 mid dentin
What is ICDAS 4?
- Underlying dark shadow from dentin (with or without enamel breakdown)
- 1/3 mid dentin
What is ICDAS 5?
- distinct cavity with visible dentin
- 1/3 inner dentin
What is ICDAS 6?
- extensive distinct cavity with visible dentin
- 1/3 inner dentin
How do you write an ICDAS code?
first digit = restoration/sealant code
second digit = caries code?
What is assessed on CAMBRA?
disease indicators / risk factors: o Caries activity. o History of caries (number of restorations present). o Eating habits/disorders. o Medication/Medical conditions o Salivary flow. o Oral hygiene habits.
Reccomendations for CAMBRA high risk patients?
mouthwashes, gels, gum and
sprays. They must wait for the definitive and aesthetic
dental work until the risk level has decreased.
Reccomendations for CAMBRA low risk patients?
preventive care at home to keep it
at low risk, permanent treatment can be done if
needed.
Diagnostic methods for caries? (7)
- Visual and tactile diagnosis
- Xray
- Transillumination
- quantitative light-induced flourescence
- laser flourescence
- ultrasonic techniques
- electrical measurement
What is the sound enamel refractive index?
RI = 1.62
Whats the reflective index of water accumulation in demineralized enamel?
1.33
Whats the reflective index of demineralized enamel after water dried?
RI=1.0. opaque lesion = caries
Sensitivity & specificity of visual inspection?
Low sensitivity (lots of undiagnosed) high specificity *= no over treatment and less number of false +
Sensitivity & specificity of Xrays?
- high number of false positives
- false negatives in snall caries
Problems with occlusal caries and xrays? (2)
- thick layer of enamel covering the dentin of
the buccal and lingual cusps , which , in an X-ray masks
any incipient occlusal demineralization inside the
occlusal fissures, decreasing sensitivity. - enamel - dentin junction is difficult to
appreciate at the occlusal level when we take a
bitewing xray, leading to false (+).
