Caries Diagnosis and Management Flashcards
Define “caries”
Dental caries is an infectious microbiologic disease of the teeth that results in localized dissolution of the calcified tissues
Define dental plaque
a gelatinous mass of bacteria adhering to the tooth surface
___ is involved in caries initiation, while ____ are able to withstand acidic environment and lead to progression of caries
STREPTOCOCCUS MUTANS is involved in caries initiation, while LACTOBACILLI are able to withstand acidic environment and lead to progression of caries
Tightly packed enamel rods are made up of ____
hydroxyapatite
Each enamel rod originates at ___ an terminates at the ____
Each enamel rod originates at DEJ an terminates at the EXTERNAL SURFACE
What is Straie of Retzius?
The core of enamel rods. It is higher in organic content
What allows for the dissolution of underlying dentin even before actual cavitation of enamel occurs?
Porosity of enamel rods, which allow for the movement of small molecules and ions
What area of the tooth is least resistant to caries ttack?
DEJ - which is why lateral spreading of caries occurs once bacteria have invaded enamel
Why is dentin more prone to acid attack?
because it contains higher organic content than enamel (ie. less mineral)
Dentinal tubules provide a direct pathway for the ingress of ___ and the egress of ___
Dentinal tubules provide a direct pathway for the ingress of ACIDS and the egress of MINERALS
The time for progression from incipient caries to clinical caries (cavitation) on smooth surfaces is estimated to be:
18 months, plus or minus 6 months
caries are classified into 4 categories:
- incipient
- moderate
- advanced
- extensive
The class of caries which is the first evidence of carious activity within enamel is called
incipient carious lesions
T/F: incipient caries have not reached the DEJ
true
In which class of caries is remineralization possible?
incipient
How do incipient caries appear clinically?
- opaque white when dried, disappears when wet
- may only appear as a faint radiolucency on radiograph
When the carious lesion has advanced into dentin and remineralization is no longer possible, this is known as
moderate caries
At which point is remineralization no longer possible and tooth must be restored?
Once caries have reached the DEJ
What are advanced caries?
When the lesion is advancing towards the pulp.
Treatment is required (prep and resto)
May require a root canal or extraction
Define extensive caries
- acute or rampant caries, infectious disease process causing rapid damage to teeth.
- numerous soft, light coloured lesions in the mouth
How to treat extensive caries?
Root canal if restorable, exo if not
Clinical characteristics of normal enamel when hydrated, dessicated, surface texture, and surface hardness
Hydrated: translucent
Dessicated: translucent
Surface texture: smooth
Surface hardness: hard
Clinical characteristics of hypocalcified enamel when hydrated, dessicated, surface texture, and surface hardness
Hydrated: opaque
Dessicated: opaque
Surface texture: smooth
Surface hardness: hard
Clinical characteristics of incipient caries when hydrated, dessicated, surface texture, and surface hardness
Hydrated: translucent
Dessicated: opaque
Surface texture: smooth (could be roughened too)
Surface hardness: softened
Clinical characteristics of active caries when hydrated, dessicated, surface texture, and surface hardness
Hydrated: opaque
Dessicated: opaque
Surface texture: cavitated
Surface hardness: very soft
Clinical characteristics of arrested caries when hydrated, dessicated, surface texture, and surface hardness
Hydrated: opaque, dark
Dessicated: opaque, dark
Surface texture: roughened
Surface hardness: hard
Where does recurrent decay typically occur?
at the cavosurface junction
What types of caries involve the cementum and are commonly associated with periodontal disease?
root caries
Color of arrested decay
brown or black. Shiny
Define Cervical Burnout
Diffuse radiolucency with ill defined borders of proximal surfaces between CEJ and alveolar crest
When a uniformly dark shade meets a uniformly light shade, what occurs?
Mach Band effect is observed in which the dark shade looks darker and the light shade looks lighter
dark shades in xrays are ___ and light shades are ___
dark - radiolucent
light - radiopaque
Best diagnostic tool for class II caries?
BW
As it moves towards the pulp, what shape does a class ii lesion follow radiographically?
2 cone tips (big small big small….or tip of dark cone on enamel to head of cone in dentin)
How are Class III lesions diagnosed?
primarily clinically, with radiographs as an adjunct
etiology of class IV lesions
usually trauma
Etiology of non carious class V lesions
Erosion - chemical dissolution due to acid exposure
Abrasion - physical dissolution due to frictional forces
Abfraction - loss of tooth structures due to flexural forces
Where are abrasion lesions typically observed?
They typically start around the CEJ where enamel is thin and progress to cementum.
V-shaped with apex pointing apically
What might you observe in gingival tissue due to abrasion lesions?
increased keratinization due to chronic trauma of tissues
In abfraction, what shape is the lesion due to tension and compression?
tension - V
compression - C
