CDT 2

Question 1

the carious lesion is a manifestation of?

Answer 1

the carious process, which occurs in the biofilm

Question 2

what is lesion detection

Answer 2

determines whether disease is present or not

Question 3

what is lesion assessment

Answer 3

characterize/monitor lesion once it has been detected

Question 4

2 methods of caries detection?

Answer 4

• visual detection

- radiographical detection

Question 5

gold standard of caries detection in:

• lab on extracted teeth?
• in the mouth?

Answer 5

1. histology, micro-radiographic techniques

2. bitewing radiograph, visual assessment, lesion biopsy

Question 6

clinical examination for caries detection: what are the 3 tools required?

Answer 6

• mirror
• 3 in 1 syringe
• ball ended probe

Question 7

why must teeth be dry for caries exam?

Answer 7

water has different refractive properties

caries scatter light more than enamel and dentine

Question 8

visual detection of caries: describe
backer dirks 1966?
ekstrand 1998?

Answer 8

backer dirks 1966: minute black line at base of fissure, white zone along margins of fissure, look for smallest break in continuity of enamel. large cavity >3mm

ekstrand 1998: codes 0 to 4
0 - no change after drying
1 - opacity visible after drying
2- opacity visible without drying
3 - localized enamel breakdown in opaque/discolored enamel, discoloration from underlying dentine
4- cavity in enamel exposing underlying dentine

Question 9

poking for caries: why is it not advisable to use sharp probes for enamel caries?

Answer 9

lead to tissues damage, may accelerate caries

Question 10

other methods of caries detection?

Answer 10

• temporary elective tooth separation: interproximal caries only
• FOTI: fibre-optic transillumination: interproximal caries
• diagnodent: detects amount of fluorescence related to caries
• QLF: quantitative light fluorescence: fluorescence in relation to mineral content of enamel
• ICDAS

Question 11

ICDAS criteria: describe the different codes

Answer 11

code 0 - sound tooth surface
code 1 - first visual change in enamel
code 2 - distinct visual change
code 3 - localized enamel breakdown
code 4 - dentine shadow
code 5 - distinct cavity 
code 6 - extensive cavity

Question 12

caries activity: how to access
area/location?
appearance and texture?
translucency/opacity?
color?

Answer 12

• plaque stagnation area: look for white spot under plaque
• location: relative to gingiva, more than 1mm - less active. lesion more active if in plaque stagnation area
• appearance and texture: shiny or dull
  the more dull, the more active
  rough/smooth: rougher, more active
• translucency/opacity: the more opaque, the more active
• color: white spots more active than brown spots

Question 13

describe how an active lesion with a ICDAS code of 1/2/3 would look like

Answer 13

• white/yellow
• opaque
• dull, loss of lustre
• rough
• in a plaque stagnation area; pits and fissures