Caries Symposium 6 Flashcards
What is meant by D1 when classifying caries?
- All visible detectable lesions
- Enamel only
What is meant by D3 when classifying caries?
- Lesions extending into the dentine
What does D2 mean when describing caries classification?
- Clinically detectable ‘cavities’ limited to enamel
- PLUS clinically detectable enamel lesions with intact surfaces
How can caries be classes by cavitation?
- Cavitated
- Not-cavitated (should be able to remineralise)
A sharp instrument should not be used to probe a cavity as this may make the cavity worse. Instead what should be used?
- If want to se anything should use a ball ended probe or a perio probe and do not push into it
How can caries be classified by activity?
- Active (demineralising)
- Inactive (remineralising)
How can caries be classified by site?
- Smooth surface
- Occlusal (most common type especially in upper 6’s)
- Root surface (if get recession and dentine is exposed)
- Approximal
How can caries be classified by location?
- Primary (de novo - from the beginning)
- Secondary - adjacent to a previous restoration
What are the 5 ways caries can be classified?
- Extent
- Cavitation
- Activity
- Site
- Location
You can use ‘surfaces’ as a scoring system for caries diagnosis. What does this mean?
- Each surface is considered separately
You can use ‘tooth’ as a scoring system for caries diagnosis. What does this mean?
- The worst surface of the tooth dictates the tooth code
For caries diagnosis what does accuracy measure?
- Measures what is claimed
What is meant by ‘sensitivity’ in the accuracy of caries diagnosis?
- % of disease found correctly
- So if there’s 2 decayed teeth and you find only 1 of them then your sensitivity is 50%
What is meant by ‘specificity’ in the accuracy of caries diagnosis?
- % of healthy teeth found correctly
- If there are 30 healthy teeth and you find 28 then that’s 28/30 as a percentage, so 93%
What are the basic condidions needed for a good clinical exam? (4 points)
- Good light
- Dry the tooth
- Take your time (and do systematically)
- Don’t use a sharp probe
When doing a normal examination what is the sensitivity and specificity of identifying D1 caries class teeth?
- Sensitivity = 0.32
- Specificity = 0.97
When doing a normal examination what is the sensitivity and specificity of identifying D3 caries class teeth?
- Sensitivity = 0.34
- Specificity = 0.99
What can we use to improve the accuracy of correct caries diagnosis?
- ICCMS (International Caries Classification and Management System)
- Radiographs
- Magnification
- FOTI (fibre optic trans-illumination)
When doing an ICCMS examination what is the sensitivity and specificity of identifying D1 caries class teeth?
Sensitivity = 0.65
Specificity = 0.85
When doing an ICCMS examination what is the sensitivity and specificity of identifying D3 caries class teeth?
Sensitivity = 0.8
Specificity = 0.8
What are the advantages and disadvantages of using radiographs in caries diagnosis?
Advantages
- Permanent record
Disadvantages
- Ionising radiation
- Not very good for all surfaces
- Good for seeing approximal areas but not so good for occlusal surfaces and so occlusal caries identification
When doing a caries diagnosis examination using bitewing radiographs, what is the sensitivity and specificity of identifying approximal D1 caries class teeth?
Sensitivity = 0.31
Specificity = 0.87
When doing a caries diagnosis examination using bitewing radiographs, what is the sensitivity and specificity of identifying approximal D3 caries class teeth?
Sensitivity = 0.57
Specificity = 0.95
What are the advantages and disadvantages of using magnification in caries diagnosis?
Adavntages
- Easy
Disadvantages
- Takes a while to get used to
- Field of view gets much smaller
When doing a caries diagnosis examination using magnification, what is the sensitivity and specificity of identifying D1 caries class teeth?
Sensitivity = 0.42
Specificity = 0.94
When doing a caries diagnosis examination using magnification, what is the sensitivity and specificity of identifying D3 caries class teeth?
Sensitivity = 0.37
Specificity = 0.99
What are other techniques that can be used to diagnose caries? (3 points)
- Fibre-optic trans-illumination
- DIAGNOdent
- Electrical techniques
