Classification and Measurement of Caries Flashcards
Classifications for caries come from (2)
G.V. Black and outside of this for epidiemology that go beyond the affected tooth surface
Classification no longer used today
etiology-i.e. baby bottle decay since caries is a multifactorial disease
Affected tissues caries? (classification-there are 3)
Is it the….
Enamel? Dentin? Cementum?
Changes in classification of caries are a result of improved knowledge regarding what (3)
preventative management
adhesive and bioactive restorative materials
recognition of minimal intervention
Epidemiological assesments
prevalence and treatment need in population
clinical assement
decision making for treatments
D1
initial caries but NO detectable loss of substance (can be significant staining or rough spots)
D0
staining with sound surface
D2
Enamel caries- the floor or walls are not softened and dentin is NOT affected
D3
caries of dentin-SOFTENED floor or walls-Explorer point must enter the lesion with certainty
D4
Pulpal involvement-Pulp should NOT be probed
The method we use to measure caries
DMF (T)
DMF (T) Explained
Decayed permanent teeth
Missing permanent tooth due to decay
Filled permanent teeth due to decay or periodontal disease (F is only caries T includes perio?)
T-teeth
Index
a numerical scale with numerical scale with upper and lower limits, with scores on the scale corresponding to specific criteria (to a disease point/diagnosis)
Properties of index
Valid, Reliable, Acceptable, Sensitive, Quantifiable, Clarity, Simplicity, and Objective
DMF (S)
Sites and surfaces among adolescents
def index
**KNOW THIS
used for children only
def
decayed deciduous, extracted (indicated for extraction)
Used to ensure standard caries measurement
ICDAS-International Caries Detection and Assessment System
D1-D3 scale allows for
**KNOW THIS
ID lesion progression as well as initiation
Limitations to DMF or def scoring
no information on severity
Scoring issues (i.e. extraction counts as caries on all sides even if just one caries caused extraction)
Can survey and index info be used for treatment planning?
Why or why not?
NO-criteria may be different than clinical
Significant Caries index (SiC) intended use
intended for use alongside the mean of DMF to give a complete summary
ICDAS
The hopeful future classification system:
international- addresses gaps between American and European systems
Primary Prevention
at the patient level
Secondary Prevention?
Includes which levels of ICDAS?
addresses caries involvement that will not require restoration
ICDAS 1,2,3
Tertiary Prevention
Includes which levels of ICDAS?
requires surgical intervention/restoration
ICDAS 4,5,6
_______ is the basis for ICCMS
ICDAS
ICCMS (define)
Based on what?
international caries classification and management system which addresses all diagnostic, preventative, and restorative decisions to be made
is based on the ICDAS-clinical protocols for managing caries
Classification for caries by G.V. Black only included
tooth surfaces affected
Is the D0-d4 scale reliable?
Training and calibration of examiners ensures it is
How is the score of an index expressed?
as the mean
Uses for an index
planning a resource allocation, monitoring/planning/implementing health services, enable study uniformity, patient counseling
Is DMF(T) quickly “saturated”?
Yes, because each tooth is scored as a single point
A tooth has several restorations, according to DMF scoring the tooth should be counted as how many teeth?
Just 1 tooth
According to DMF scoring, teeth lost to what are counted?
Caries ONLY- DMFT includes caries and perio ONLY
In communities where cavities are prevalent, discrimination between individuals may be obtained by counting the number of tooth surfaces affected…. In this case there are __ surfaces counted on anteriors and __ surfaces counted on post teeth
4 on ant and 5 on post
Proposed ICDAS questions (4)
what stages of caries should be measured?
What are the definitions for each selected stage?
What is the best clinical approach to detect each stage in different tooth surfaces?
What protocols of examiners training can provide the highest degree of examiner reliability?
DMFT includes what teeth
ONLY permanent
Teeth which should NOT be counted as missing in a DMF include…
**KNOW THIS
Anything that is not from caries or perio… including
Unerupted teeth
Missing teeth due to accident
Congenitally missing teeth
Teeth that have been extracted for orthodontic reasons
All of the limitations of the caries index
includes 12 things……yay
**KNOW THIS
-Index saturated in other older adults with high
caries activity.
-Difficult to account for sealed teeth.
-DMF data are of little use for estimating treatment
need.
- DMFT value does relate to teeth at risk. It does not have a denominator
- Does not always follow that the (f) component was filled due to caries-overestimate caries experience
-Provides no information on severity, only limited
information on extent of dental caries experience (i.e.,
tooth-rather than surface-related)
-Takes no account of treated and untreated caries, e.g.,
for a filled tooth with a separate untreated lesion
-Allocation of equal weight to the components of the
DMFT index is faulty for many purposes
-Allocation of equal weight to the components of the
DMFT index
- It is more error prone
- An mo or DO will be scored 2 even, though caries was originally present on only one surface
-Extracted tooth scores five, yet only two or three
surfaces might have been involved in the lesion
before extraction
Dietary Fluoride Supplements Dosing Schedule
Just know the whole chart
…
1.0 part per million (ppm) =
1 milligram per liter (mg/l)
2.2 mg sodium fluoride contains
1mg F ion
