Classification of Caries and ICDAS

Question 1

Class I

Answer 1

• Cavities in occlusal pits or fissures on molars and premolars.
• Buccal and lingual surfaces of molars.
• Lingual surfaces of maxillary incisors.

Question 2

Class II

Answer 2

Cavities on proximal surfaces of molars and premolars.

Question 3

Class III

Answer 3

Cavities on proximal surfaces of incisors and canines that do NOT involve the incisal surface.

Question 4

Class IV

Answer 4

Cavities on proximal surfaces of incisors or canines that DO involve the incisal surface.

Question 5

Class V

Answer 5

Cavities on the cervical third of the buccal/labial/lingual surface of any tooth.

Question 6

ICDAS

Answer 6

International Caries Detection and Assessment System.

Question 7

ICDAS 0

Answer 7

• Sound tooth surface.

- No detectable demineralisation after 5 seconds of air drying.

Question 8

ICDAS 1

Answer 8

• Demineralised enamel lesion extending up to half its thickness.
• Visible only after >5 seconds of air drying.
• Opacity or white/brown discolouration.
• Matte.
• Restricted to the pit/fissure.

Question 9

ICDAS 2

Answer 9

• Distinct change in enamel.
• Seen when tooth is wet or dry.
• Lesion often wider than the pit or fissure.
• Involves the enamel up to the EDJ (Enamel-Dentine Junction).

Question 10

ICDAS 3

Answer 10

• Localised enamel breakdown is visible when tooth is wet or dry.
• No clinical VISUAL signs of dentine involvement.
• Demineralisation may involve the outer or middle third of dentine.

Question 11

ICDAS 4

Answer 11

• Non-cavitated established lesions.
• No clinically visible dentine.
• Dark underlying shadow demonstrates dentine involvement.
• Poor relationship between visual appearance and level of infection, so minimally invasive option is better.

Question 12

ICDAS 5

Answer 12

• Distinct cavity with exposed dentine.
• Cavitation cannot be reversed.
• The presence of an active biofilm that cannot be removed by oral hygiene procedures means that lesion progression is inevitable.
• May result in gross cavitation if dentine caries undermines the overlying enamel.
• PRR may be successful but most likely to use traditional restorative technique.

Question 13

ICDAS 6

Answer 13

• Extensive cavity with distinct dentine involvement.
• 50% of occlusal surface.
• Demineralisation likely to extend to inner third of dentine.
• Lesion may extend to the pulpal chamber

Question 14

Benefits of ICDAS

Answer 14

• Good intra- and inter- examiner reproducibility.
• Improved diagnostic accuracy.
• Allows diagnostic information to be simply communicated.
• More predictable evidence-based treatments.
• Good for lesion monitoring.
• Acts as a medico-legal record.

Question 15

Radiographic classification system for carious lesions

Answer 15

• E1 - Outer half of enamel.
• E2 - Inner half of enamel.
• D1 - Outer third of dentine.
• D2 - Middle third of dentine.
• D3 - Inner third of dentine.