CS 6 - diagnosing and classifying Flashcards
name the 5 classifications of caries
- Extent
- Cavitation
- Activity
- Site
- Location
explain classification by extent
○ D1 = all visually detectable lesions § Enamel lesion only § Bottom of iceberg, under water § Can be cavitated or uncavitated § Early stages
○ D2
§ Cavitated
§ Just below water level
○ D3 = lesions extending into dentine
§ Enters dentine
§ Tip of the iceberg
how can you tell clinically if there is caries in the dentine?
there is shadowing through the enamel?
explain classification by cavitation
○ Cavitated
§ Thinking on restoration - can’t restore itself (there is an exception)
○ Not cavitated
§ Should be able to stop it cavitating
§ Should be able to remineralise
what instrument should be used when checking for cavitation?
ball ended probe or a perio-probe
> run it along the surface of the tooth and if there is a defect the ball will fall into it
never probe using a sharp probe = it will make the cavitation worse than it is
explain classification by activity
○ Active (demineralising)
§ Soft
○ Inactive (remineralising)
§ Brown leathery, remineralised decay
If a patient can cleanse a lesion then it can be remineralised (exception)
explain classification by site
○ Smooth surface caries
§ Most worrying
§ If they have this they are a high risk
○ Approximal caries
§ On the surface approaching
§ Also called interproximal caries
○ Occlusal surface caries
§ Pits aren’t cleaned properly
○ Root surface caries
§ Recession and exposed dentine = easier to get caries
explain classification by location
○ Primary - de novo
○ Secondary - adjacent to a restoration
explain the scoring / recording system for diagnosing caries
• Surfaces
○ Each surface is considered separately
○ Will look at it this way in clinics
• Tooth
○ Worst surface dictates tooth code
○ Dmft / DMFT
○ Going around schools - probably use this system
in terms of reliability define accuracy
Measures what is claimed
in terms of reliability define precision
Consistency of measurement
How accurate you are at measuring what you are measuring
in terms of accuracy, define sensitivity
percentage of disease found correctly
ie if there are 2 teeth with decay and they are both correctly identified this is 100%
if only one of these is identified it is 50%
in terms of accuracy, defensive specificity
percentage of health found correctly
ie if there are 30 healthy teeth and all 30 teeth are identified as healthy this is 100%
what are the basics of clinical examination for caries?
• Good light • Dry the tooth ○ Saliva hinders ○ 3 in 1 syringe - blow air on it • Take your time ○ Have a system doing it - always use same order • Don’t use a sharp probe
how can you improve accuracy of caries diagnosis?
• ICCMS (formerly ICDAS) • Radiographs • Magnification • FOTI ○ Fibre-Optic Transillumination
