6

Question 1

5 ways to classify caries

Answer 1

by extent

by cavitation

by activity

by site

by location

Question 2

2 classifications of caries by extent

Answer 2

D1

D3

Question 3

D1 caries classification

Answer 3

enamel only, not breached the ADJ
(cavitated or non-cavitated)

all visibly detectable lesions

Question 4

D3 caries classification

Answer 4

lesions extending into dentine
cavitated
shadowing
- school dental visits focus on these

Question 5

treatment if cavitated caries

Answer 5

restoration

cavity can’t reheal itself

Question 6

not-cavitated caries treatment

Answer 6

should be able to remineralise damage

Question 7

how to detect a cavity?

Answer 7

use a ball ended probe or perio probe along the surface
- probe will drop in

nerve probe with a sharp probe as even a micro-cavity can be made worse

Question 8

how to treat a small cavity

Answer 8

fissure seal over the top or thin layer of composite

Question 9

appearance of active caries

Answer 9

soft, light brown lesion

demineralising

Question 10

appearance of non-active caries

Answer 10

dark brown, leather like

Question 11

4 site classifications of caries

Answer 11

smooth surface
- most worrying as should be able to clean well

occlusal

• most common, especially in young
• harder to clean pits properly

approximal
- on surface approaching

root surface
- recession and exposed dentine can get caries easier than enamel

Question 12

when can remineralisation occur?

Answer 12

once the patient is able to cleanse tooth surface

Question 13

2 classifications of caries by location

Answer 13

primary
- de novo/new

secondary
- adjacent to a restoration

Question 14

2 types of caries scoring systems

Answer 14

DMFS - surfaces, each considered separately

DMFT - teeth, worst surface dictates tooth code

Question 15

accuracy

Answer 15

measures what is claimed
- how good an operator is at measuring decay

split into sensitivity and specificity

Question 16

precision

Answer 16

consistency of measurement

- measuring at the same level all the time

Question 17

accuracy sensitivity

Answer 17

% of disease found correctly

e.g. only detect 1 out of 2 decayed teeth = 50%

Question 18

accuracy specificity

Answer 18

% of healthy teeth found correctly

e.g. how many times correct if 30 healthy and 2 caries
risk of incorrectly detecting decay

want a high specificity score

Question 19

4 basic requirements for clinical examination

Answer 19

• good light
• dry the tooth
• take your time systematically
• don’t use a sharp probe

Question 20

4 ways accuracy can be improved

Answer 20

• ICCMS
• radiographs
• magnification
• FOTI

Question 21

ICCMS

Answer 21

international caries care and management system

• Carefully drying for 30 seconds
• And looking at each surface carefully

caused

• increase in sensitivity
• decrease in specificity (bad as more false positive for decay)

Question 22

advantage and disadvantages of taking radiographs for caries diagnosis

Answer 22

Advantage
- Permanent record at certain time

Disadvantages

• Ionising radiation
• Not good for all surfaces – approximal areas good, occlusal harder

Panoramic OPT – not ideal
Bitewing good take on both sides – see enamel, dentine and approximal clearly
Periapical – good

Question 23

what does caries look like on radiographs?

Answer 23

Lesions come as darker shadows as less mineral so more X-rays get through

secondary caries can be seen as shadows around radiopaque material

Question 24

advantages and disadvantages of magnification for caries diagnosis

Answer 24

Advantages

• Easy
• Relatively cheap

Disadvantages

• Time to adjust to them
• Field of view and depth of view gets smaller

Question 25

FOTI

Answer 25

Fibre Optic TransIllumination

thin beam of light

Question 26

advantages and disadvantages of FOTI for caries diagnosis

Answer 26

highly accurate
good for clinical trials

very expensive
very technique sensitive (not used in practices typically)