Caries Tutorials

Question 1

What are the depth classifications of caries?

Answer 1

E1 - outer half of enamel
E2 - inner half of enamel
D1 - outer 1/3 of enamel
D2 - mid 1/3 of enamel
D3 - inner 1/3 of enamel

D2+D3 are always cavitated

Question 2

What do diagnostically acceptable radiographs have (A)?

Answer 2

minimal errors in either patient prep, exposure, positioning, image processing, image reconstruction and of sufficient image quality to answer the clinical question

Question 3

What do diagnostically unacceptable radiographs have (N)?

Answer 3

errors in either patient prep, exposure, positioning, image processing, image reconstruction which render the image diagnostically unacceptable

Question 4

What are indications of high caries risk?

Answer 4

Oral Health Factors:
Previous caries experience
Visible signs of decay
Poor oral hygiene
Dry mouth
Plaque retentive factors

Dietary Factors:
Frequent consumption of sugary foods and drinks
Excessive consumption of acidic drinks

Systemic Factors:
Medications that cause dry mouth
Medical conditions
Radiation therapy to the head and neck

Socioeconomic Factors:
Low socioeconomic status
Geographic location

Question 5

How can you assess the need for operative intervention of interproximal caries?

Answer 5

probe
seperators + impressions
FOTI
radiographs

Question 6

What are things that must be noted in a radiographic report?

Answer 6

• Type of radiograph
• Quality grading
• Teeth present
• Caries (location, extent, tooth)
• Restoration (material, location, tooth)
• Apical pathology (location, margins - diffuse/defined, corticated)
• RCT (taper, quality, condensation)
• Bone levels (1-3mm from ACJ is normal)
• Others (calculus, extruded sealer, etc)

Question 7

What does more than 2/3 marginal ridge breakdown mean?

Answer 7

pulpal ingress

Question 8

What do you have to tell parents for consent?

Answer 8

the worst case scenerio and the most common risks

Question 9

What should a referral letter for GA state and include?

Answer 9

• patient name
• address
• contact numbers
• MH
• GP details
• parental responsibility
• justification for GA with radiographs (if not avaliable have to explain why)
• proposed treatment plan
• previous treatment details

Question 10

Why are GA treatment plans more radical than other modalities?

Answer 10

they have to last 5 years otherwise should not be done (ie. extractions, fillings on permanent teeth)

Question 11

Why should 2nd primary molars be left even if they are compromised?

Answer 11

avoid mesial drift of FPM causing crowding later on

Question 12

Why are crowns indicated for pulpotomies?

Answer 12

teeth with pulp removed have brittle dry dentine which will fail if under conventional restoration

Question 13

What type of management is the hall technique and what type is a conventional crown?

Answer 13

hall - biological caries management
crown - operative treatment