Caries Risk Assesment, Stage And Activity

Question 1

What are the 4D when it comes to caries?

Answer 1

1. Determine - caries risk
2. Detect - asses caries staging and activity
3. Decide - personalised care for patient and tooth level
4. Do - provide appropriate tooth preservation and tell patient prevention and control

Question 2

What are protective factors for caries?

Answer 2

1. Fluoride tooth paste
2. Regular dental care
3. Systemic fluoride - fluoridated water

Question 3

How much fluoride should be in toothpaste?

Answer 3

At least 1000ppm

Question 4

What are 3 categories of caries risk factors?

Answer 4

1. Social/ medical and behaviours risk factors
2. Clinical risk factors
3. Risk factors associated with age

Question 5

What are medical/ behavioural and social risk factors?

Answer 5

• High intake of sugars
• low motivation and engagement with treatment
• physical disability
• diabetes

Question 6

What are clinical risk factors for caries?

Answer 6

• Recent or active caries lesions
• poor oral hygiene with plaque accumulation
• low salivary flow rate

Question 7

What are caries risk factors associated with age?

Answer 7

Children:
- they need supervision so they don’t use too much toothpaste - this avoids fluorosis
- erupting molar can be hard to clean

Elderly:
- exposed root (dentine)
- reduced ability to perform oral hygiene steps

Question 8

What are the aims of caries assessment?

Answer 8

1. Try to identify potential carious lesions developing
2. Tracking progress of current lesions
3. Evaluating consequences of developing caries - this contributes to what treatment plan is made

Question 9

How is caries staging codes?

Answer 9

ICDAS - International Caries Detection and Assessing System
From 0-6

Question 10

What is a code 0 on the ICDAS?

Answer 10

Sound tooth no caries

Question 11

What is a code 1 on the ICDAS?

Answer 11

Visual change in the enamel and can be seen when the tooth is dry
Lesion is a brown or white discolouration or the colour change is only visible in the pits or fissures

Question 12

What is a code 2 on the ICDAS?

Answer 12

This is when a lesion is can be seen even when the tooth is wet
- Looks like a white spot
Or
- Looks like a brown discolouration not consistent with the colour of the pits and fissure (also wider)

Question 13

What is a code 3 on the ICDAS?

Answer 13

There is localised enamel breakdown, no dentine or underlying shadow visible
Tooth can be viewed wet and still see a white spot if brown lesion which is wider than natural pits/fissure

Question 14

What is a code 4 on the ICDAS?

Answer 14

There is an underlying shadow from dentine being exposed with or without localised enamel breakdown
- shadow looks blue/grey/ brown
- seen more easily when tooth is wet

Question 15

What is a code 5 on the ICDAS?

Answer 15

Large cavity with dentine visible
- exposes less than half the tooth
- opaque enamel (chalky white) where it’s been demineralisation around opening to dentine

Question 16

What is a code 6 on the ICDAS?

Answer 16

• Opaque or discoloured enamel exposing the dentine beneath involving more than half the tooth
  Loss of tooth structure and dentine is clearly visible

Question 17

What is caries?

Answer 17

The dynamic process of remineralisation and demineralisation that results in a loss of minerals this leads to cavitation