Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Oral Microbio > Caries Diagnosis and Management > Flashcards

Caries Diagnosis and Management Flashcards

1
Q

T/F - Caries is a dichotomous disease (yes/no)

A

False - it is a continuum from incipient to advanced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the most common method for caries diagnosis?

A

Explorer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are you looking for when using an explorer to search for caries?

A

Feel for soft areas in enamel by breaking the surface with a probe
Can be done with poor light, on a wet, uncleaned tooth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is a negative possibility when using an explorer to search for caries?

A

Use of sharp explorers can produce irreversible traumatic defects in demineralized areas in occlusal fissures
This could prevent repair of the lesion by remineralization and contribute to lesion progression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the optimal conditions to look for caries?

A 
Clean tooth
Dry tooth
Good light
Sharp probe with a light touch
Magnification
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are we looking for when using a probe to search for caries?

A

Frank cavitation
Decalcificaiton (white spot)
Opalescence (deep caries)
Discontinuities in the surface

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

T/F - Black or brown staining is a reliable indicator of caries

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How can bitewing radiographs be used to look for caries?

A

They can supplement visual tactile exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Caries rates have declined over the last several years, what types of caries specifically?

A

Smooth surface caries - shift in prominence to fissure caries (which is more difficult to diagnose)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why is the measurement of progression of caries necessary?

A

Cavitation is easily recognized, but incipient or early caries is much more difficult
Caries may be slowly progressing and may be arrested

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the spectrum on how early lesions should be managed?

A

Highly aggressive –> Seal deep fissures and seal chalky or soft enamel –> Highly conservative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Highly aggressive management

A

“Exploratoy” excavation and enameloplasty

Seal/restore

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Highly conservative management

A

Seal incipient decay and intact fissures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Reliability

A

Relates to the reproducibility of measurements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Validity

A

The degree to which a measurement expresses the true value

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Sensitivity

A

How likely we are to say disease is present when it is truly there
Perfect sensitivity = no false negatives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Specificity

A

How likely we are to say disease is absent when it’s not there
Perfect specificity = no false positives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the treatment implications of low sensitivity?

A

Low sensitivity can lead to under treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the treatment implications of low specificity?

A

Low specificity can lead to over treatment

20
Q

T/F - the accuracy of probing and visual inspection of caries is similar

A

True

21
Q

What is the diagnostic accuracy of probing and visual inspection of caries?

A

Sensitivity low (very difficult)
Specificity high (seldom have false positives)
Reliability is less than excellent
Radiographs are helpful

22
Q

What is the preferred suggested method to detect fissure caries?

A

Visual inspection augmented with appropriate radiographs

23
Q

What types of lesions are the easiest to see via radiographs? Which are the most difficult?

A 
Easiest = cavitated lesions
Hardest = enamel lesions
24
Q

Are small lesions likely to be cavitated?

A

No - we may want to consider trying to reverse them by conservative methods

25
Q

What happens to lesions under sealants?

A

Studies show a decrease in viable microorganisms under intact sealants and caries progression is negligible
The effect results in blocking nutrients from reaching bacteria within the teeth

26
Q

What happens if hidden caries are “sealed in”?

A

They can’t do anything

27
Q

Exploratory operative intervention and restoration

A

Undertaken to avoid the risk of “hidden” caries

Could lead to substantial overtreatment

28
Q

If the probe does not stick, what can we determine?

A

No caries

29
Q

What happens if you apply too much pressure while using a probe to detect caries?

A

Probe can stick and cause cavitation

30
Q

Caries detection dye

A

Non-specific protein dyes that stain organic matrix of less mineralized dentin
Can give us false positives at the DEJ and circumpulpal regions

31
Q

KaVo DIAGNOdent laser

A

655 nm laser - penetrates 2-3 mm
Detects fluorescence form demineralized enamel
Readings are related to degree and intensity of demineralization (not depth of the lesion)
Low specificity (false positives)
High sensitivity (few false negatives)

32
Q

What can the DIAGNOdent laser respond to (and can potentially give false positives)

A 
Decalcified enamel (caries)
Hypocalcified enamel
High natural fluorescence of the tooth
Plaque and organic plug
Composite and stained margins
Calculus
Prophy paste (particularly green)
Food (particularly greens)
33
Q

How would you scan the fissure using the DIAGNOdent?

A

Rotate the tip around to “read” the fissure walls

34
Q

INSPEKTOR PRO Caries detection system

A

Research instrument
Monitors caries progression
Expensive
Time-consuming

35
Q

Midwest Caries ID Detection Handpiece

A

Has green and red LED lights with a receiving fiber

When green light is deflected by demineralized enamel, red light and audible signal is activated

36
Q

QLF Utility

A

Tracks lesions over time to locate active caries and remineralization
Expensive and time consuming research tool
High sensitivity
Low specificity

37
Q

CarieScan PRO

A

Less mineralized tissue contains more fluid and has greater electrical conductivity
Sensitivity is high

38
Q

Transillumination technology

A

Visible light illumination and computer imaging

Research suggests it’s more sensitive that radiography

39
Q

DEXIS CariVu

A

Utilizes near infra-red light

Images are captured to DEXIS system

40
Q

The Canary System

A

Laser system that measures:
-luminescence
-heat
Creates a “Canary Number” to reflect stat of mineralization and crystalization
Detects up to 5mm from the surface and as small as 50 um
Good for proximal caries

41
Q

How important is early detection of fissure caries?

A

If we detect it early, we can seal it

Late detection is balanced y effective therapy

42
Q

What are some microbiologic tests for risk assessment?

A

Saliva-check mutans
CariScren susceptibility test
CRT (caries risk test)

43
Q

Saliva-check mutans Test strip

A

Immunochromatography test that contains monoclonial antibodies that detect strep mutans
Evidence: Strep Mutans tests have not been shown to be good risk predictors on an individual basis

44
Q

CRT (Caries Risk Test)

A

CRT bacteria: cultivated for S mutans and lactobacilli can get results in 2 days
CRT buffer: dipstick test for salivary buffering capacity can get results in 5 minutes
Evidence is limited

45
Q

CariScreen Caries Susceptibility Test

A

1-minute chair-side bacterial test that measures ATP bioluminescence
Claims to detect levels of acid-producing bacteria residing in an individual’s plaque and assess patient’s caries risk
Evidence is very limited
Sensitivity is low
Specificity appears good

Oral Microbio (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions