Caries Diagnosis and detection:

Question 1

what does is required to carry out an Intra-oral exam?

Answer 1

Requires good lighting
Dry clean tooth
Loupes if preferred
Never probe a suspected lesion
Wedges/ separators for proximal surface

Question 2

Diagnostic tests need to be

Answer 2

valid & reliable / don’t forget soft tissue assessment don’t just zone in on teeth!

Question 3

After verbal history ………..

The more diagnostic aids…………………

Answer 3

…………..is taken a physical examination follows

……………. applied the more lesions will be identified

Question 4

Carious lesions can be diagnosed at any level of carious process
Caries can be detected in 3 ways

Answer 4

– visual / radiographic / transillumination

Question 5

Classify caries according to activity

Concept of activity is very important as

Answer 5

it directly affects the management of a lesion as active lesions require active management

Question 6

Active caries lesion-

Arrested or inactive lesion-

Answer 6

progressive/orange/brown/soft

formed earlier and then stopped / dark brown/ black/ hard/ leathery

Question 7

Transillumination

Answer 7

Assists diagnosis of approximal caries
The technique consists of shining light through contact points
Carious lesion has low index of light transmission and appears as dark shadow
Anterior- light reflected through teeth using dental mirror
Posterior- stronger light needed i.e fibreoptic (FOTI)

Question 8

Radiography

Permanent dentition

Answer 8

Can clinically detect more enamel lesion than radiographically
Radiographs are important in disgnosis of proximal carious lesion

Question 9

Radiography

In primary dentition

Answer 9

bitewings are better than clinical exam, because contact are broad because contct are broad and difficult to assess

Question 10

Clincian must link visual clinical appearance of a lesion with underlying histological damage to enable them to

Answer 10

diagnoise problems and decide how to manage lesion/disease process and develop and individual care plan

Question 11

ICDAS-

Answer 11

International caries detection and assesment system allows the clinician to clinically exam the tooth surface and appreciate the underlying damage that has been caused

Question 12

ICDAS
0
1
2
3
4
5

Answer 12

0- sound tooth tissue- noevidenc of careis after airdryign for 5 secs
1- first visual changes in enamel: opacity discoloration (white/brown) is vsable at the entrace to the pit or fissure after prolonged air drying
2- distinct visual change in enamel visible when wet, lesion must be visible when dry
3- localised enamel breakdown (without clinical visulal signs of dentinal involvement) seen when wet and prolinged drying
4- underlying dark sahdow from dentine
5-distinct cavity with visible dentine
6 extensive (more than half the surface) distinct cavity with visible dentine