Detection and Diagnosis

Question 1

Detection

Answer 1

Discriminating between a tooth surface affected by a carious lesion and a tooth surface that is healthy or affected by a different condition (presence).

Question 2

Diagnosis

Answer 2

Involves assessment to characterise the lesion once detected (severity/staging & activity).
This is after detection happens.

Question 3

Severity

Answer 3

assessment of what stage of the disease process a lesion has progressed to.

Question 4

Activity

Answer 4

assessment of likelihood of transition over time

(if the caries is still progressing or not)

Question 5

Where will coronal carious lesions most commonly develop?

Answer 5

in areas with pits & fissures

at gingival margins

approximal surfaces just apical to the contact point

Question 6

What does ICDAS and ICCMS stand for?

Answer 6

International Caries Detection and Assessment System II

International Caries Classification and Management System (the one used at Uni Melb)

Question 7

What is the ICDAS scale?

Answer 7

0: sound dentine

1: first visible change in enamel
2: distinct visible change in enamel

3: localized enamel breakdown. No visible dentine.
4: underlying shadowing of dentine.

5: distinct cavity with visible dentine
6: extensive distinct cavity with visible dentine.

Question 8

What is the ICCMS scale?

Answer 8

ICCMS 0: No visible changes / sound

ICCMS A: Visible surface / enamel changes

ICCMS B: Enamel cavitation and/or Dentine shadowing

ICCMS C: Dentine cavitation

Question 9

What are signs of an active lesion?

Answer 9

Enamel: yellow/white, matte/dull, rough

Dentine: rough, matte, soft/leathery, discolouration (brownish).

General: in a plaque stagnation area or a recently erupted tooth (<3 years)

Longitudinal: changes in severity over time.

Question 10

How do we measure severity for contacting approximal lesions?

Answer 10

Cleansability (key diagnostic criteria)

Cleansible: non surgical management

Non-cleansible: surgical management

Question 11

Radiographs detect and diagnose which surfaces?

Answer 11

Occlusal and approximal (used in detection and diagnosis)

buccal lingual (detection only)

Question 12

What is the radiographic severity scale?

Answer 12

R1: outer 1/2 of enamel
R2: inner 1/2 of enamel
R3: JUST into dentine (earliest detection of an occlusal lesion)
R4: outer 1/3 of dentine
R5: inner 2/3 of dentine