Cariology 3 w/ Hodgson

Question 1

Dental caries

Answer 1

progressive loss by bacteria produced acid of apatite composed of dentin and enamel or of cementum and dentin-it is the disease

Question 2

Acid from what causes caries

Answer 2

ONLY from bacteria

Question 3

Dental cavity

Answer 3

break in enamel or dentin of tooth caused by caries

Question 4

Caries reversible?

Answer 4

most not, will need operation

Question 5

Caries infectious?

Answer 5

yeah

Question 6

How many types of bacteria in biofilm in mouth

Answer 6

600-800

Question 7

modifiers of caries

Answer 7

saliva and flouride

Question 8

Why is diagnosis important

Answer 8

forms basis of treatment decisions, enables professional to inform patient, advises health service planners on population level

Question 9

Diagnosis general definition

Answer 9

determination of the nature of a (one single) case of disease

Question 10

clinical diagnosis defined

Answer 10

diagnosis based on signs, symptoms, and lab findings during life- cavities are a sign of the disease dental caries

Question 11

who has caries

Answer 11

nearly everyone, cavities are less ubiquitous

Question 12

Diagnostic Problems…

Chart

Answer 12

Disease + and Test + = true +
Disease + and Test - = false -

Disease - and test + = false +
Disease - Test - = true -

Question 13

Continuum of caries

Answer 13

Mineral loss over time, some do not lose enough tooth structure to develop a cavity

Question 14

Sensitivity vs specificity

Answer 14

Sensitivity is the True ++ and specificity is true negative –

Question 15

Explain the trend of caries

Answer 15

Depends on when you have girlfriends and how much booze you consume

Question 16

universal definition of when a tooth needs to be restored

Answer 16

there is not one

Question 17

True + plus false - =

Answer 17

1

Question 18

Sensitivity (and % of dental tests)

Answer 18

How often do we get a true positive=90%

Question 19

Specificity (and % of dental tests)

Answer 19

How often do we get a True Negative= 85%

Question 20

When disease prevalence drops, what happens to accuracy?

Answer 20

It drops significantly

Question 21

How should we diagnose caries? (what to tell the patient/classification)

Answer 21

Do not tell patients they have no caries

Question 22

number of surfaces/sites that can develop a cavity

Answer 22

4

pits/fissures, proximal, smooth/cervical, root

Question 23

Caries extent types

Answer 23

4
Sound surface
Initial
Moderate
Advanced

Question 24

Caries that involves DEJ

Answer 24

Advanced

Question 25

Caries Activity

Answer 25

Inactive Active Undetermined-cannot tell Not recorded

Question 26

of items recorded on a lesion

Answer 26

12

Question 27

Dry tooth increases

Answer 27

sensativity

Question 28

highest specificity test

Answer 28

visually

Question 29

opaque white spots

Answer 29

carious lesion

Question 30

good lighting increases

Answer 30

visual sensitivity

Question 31

Tactile detection

Answer 31

resistance to catch of explorer, palpate for roughness

Question 32

Disadvantages of tactile detection (3)

Answer 32

catch on healthy tooth Too much force causing microfractures May seed bacteria from one area to another

Question 33

location of interproximal cavity

Answer 33

lesions develop under the interproximal contacts

Question 34

Orthodontic separators allow for

Answer 34

better inter proximal vision

Question 35

Radiographic sensitivity and specificity vs tactile and visual

Answer 35

lower, only shows deminerlization

Question 36

Disadvantages of Radiographs (3)

Answer 36

radiation does not show activity extent of demineralization more extensive than shown on radiograph

Question 37

How to determine activity of caries

Answer 37

serial radiographs needed

Question 38

digital enhancement of radiographs (vs film)

Answer 38

not as good as film unless enhanced, does have lower levels of radiation

Question 39

Subtraction radiography

Answer 39

two radiographs taken at two different times placed over one another, image is subtracted from the other, gives great contrast

Question 40

Fiber Optic transillumination sensativity

Answer 40

very low

Question 41

Digitally enhance fiber optic transillumination sensitivity and specificity

Answer 41

very high

Question 42

DIAGNOdent (laser light flourescense) sens and spec

Answer 42

not better than visual

Question 43

Qualitative light flourescence

Answer 43

very expensive, commercially available; mineral loss quantifiable

Question 44

Electrical conductance

Answer 44

time consuming, fluids more conductive, enamel low in fluids and electrolytes, caries increases conductivity

Question 45

Electrical impedance

Answer 45

opposite of conductance, resistance to flow of electrical current, carious tissue has lower impedance (conduct electricity better)

Question 46

Ultrasound

Answer 46

works, not available, would eliminate radiaiton

Question 47

evidence of caries arrestment is which level

Answer 47

Inactive

Question 48

evidence of continued deminerlization is which level of caries

Answer 48

active

Question 49

unable to provide evidence of arrestment or advancement is which level of caries

Answer 49

Undetermined

Question 50

a full cavitation through enamel and the dentin is clinically exposed

Answer 50

Advanced caries lesion

Question 51

deep deminerlization with possible surface microcavtations/shallow cavitation/dentin shadowing through enamel (50-88% of lesions likely to have histological dentin penetratioin)

Answer 51

moderate caries lesion

Question 52

no clinically detectable lesion is which caries level

Answer 52

sound surface

Question 53

earliest detectable lesion- usually remineralizable (0-50% may have histologic evidence of dentin penetration)

Answer 53

Initial caries lesion

Question 54

initial caries lesion still considered cavitated?

Answer 54

No