diagnosis and classification Flashcards
how is caries classified
by extent
by cavitation
by activity
by site
by location
what are D1 caries
all visually detectable lesions, white demineralisation, decay only extends to but does not reach the adj
what is D3 caries
this is when the decay is at or beyond the adj, meaning caries has extended into the dentine
which kind of caries is cavitated enamel
D2
how is caries classified by activity
looking at whether it is active, demineralising or if it is inactive, remineralising
how to check if a cavity is a cavity
use a perio probe or a blunt dental one, if it catches when u run over the surface then it is cavitated
how is caries classified by site
smooth surface
occlusal
root surface
approximal
how is caries classified by location
is it primary or secondary
what is primary caries
where there are no restorations, known as 1 with the little degree circle
what is secondary caries
happens adjacent to a restoration
what is the scoring system for caries done according to
done according to the surface of the tooth, with each tooth considered separately. the worse surface will dictate the tooth code
what is accuracy
measures what is claimed
what is precision
consistency of measurement
what is the sensitivity accuracy
this is the % of disease found correctly
what is the specificity accuracy
the % of health found correctly
what the basics of clinical examination
good light
dry tooth
take time
don’t use a sharp probe
how often does normal examination with good light and a dry tooth find caries
only finds a third of the caries present
how do improve accuracy of caries diagnosis
ICCMS
radiographs
magnification
FOTI
what are the advantages of radiographs
permanent record
can see between the teeth
can see underneath restorations
what are the disadvantages of radiographs
radiation exposure
are bitewing radiographs good for all caries
hard to identify occlusal caries
advantages of using magnification to aid in the diagnosis of caries
easy, uses only eyesight
disadvantages of magnification in aiding caries diagnosis
expensive and reduces the field of view
what are some other techniques that can be used to aid caries diagnosis
fibre optic transillumination
diagnodent
electrical techniques
what are the two main things necessary for caries diagnosis
dry tooth and good light
what is IDCAS
simple, logical evidence based system for detecting and classifying caries.
what are the merged IDCAS values
0 is a sound tooth
A is intial stage decay
B is moderate decay
C is extensive decay
what are the modified IDCAS values
0 = 0 no evidence of caries
A I sinitial caries
3 localised enamel breakdown due to caries with no visible dentine
4 underlying dark shadow from dentine
5 distinct cavity with visible dentine
6 extensive distinct cavity with visible dentine
what are the full IDCAS values
0 no evidence of caries
1 initial cares
2 distinct visual change in enamel
3 localised enamel breakdown due to caries with no visible dentine
4 underlyiung dark shadow from dentine
5 distinct cavity with visible dentine
6 extensive cavity with visible dentine
primary caries prevention involves
prevent
arrest
reverse
secondary caries prevention involves
deep scaling
restoration
periodontal surgery
exodontics
endodontics
tertiary caries prevention
prosthodontics
orthodontics
describe pit and fissure caries
highest prevalence of all caries
bacteria rapidly colonise the pits and fissures and form a bacterial plug
appearance of s mutans in pits and fissures is followed by caries 6-24 months later
sealing of pits and fissures just after the tooth eruption may be the most important event in their resistance to caries
shape and morphological variation of the pits and fissures contributes to the susceptibility to caries
why does dentine involvement commonly occur in pit and fissure caries
the enamel in the bottom of the pits and fissures is very thin, so early dentine involvement frequently occurs
what is the direction of caries in pits and fissures
follows the direction of the enamel rods
triangular in shape with the apex facing the surface of the tooth
greater cavitation than seen in the undermining of enamel
describe smooth surface caries
this is a less favourable site for plaque attachment and will usually attach on the smooth surface that is near the gingiva or under the proximal contact
earliest manifestation of caries is seen beneath the plaque as white spots which is decalcification
why are proximal surfaces susceptible to caries
extra shelter provided to resident plaque owing to the proximal contact area immediately occlusal to the plaque
lesion has a broad area of origin
what shape is smooth surface caries
V, with tip pointed to ward the dentine enamel junction
describe root surface caries
proximal root surface, particularly near the cervical line, is unaffected by the action of hygiene procedures
if there is gingival recession this can favour the formation of mature, caries producing plaque and proximal root surface caries
why is caries originating on the root alarming
- comparatively rapid progression
- closer to the pulp
- more difficult to restore
caries can be classified based on progression. what is acute caries
an active caries that is progressing. rapid process involving a large number of teeth.
lighter in colour, pulp exposure and sensitivity is common.
little opportunity for buffering or neutralisation due to saliva not easily entering the opening to the carious lesion
describe chronic caries
long standing involvement affecting a few teeth, smaller than acute.
pain is not common, due to protection to the pulp by secondary dentine.
decalcified dentine is dark brown.
describe arrested caries
inactive carious lesion that may have formed years previously but stopped further progression
it becomes static and shows no tendency for further progression
what does arrested caries involving dentine look like
marked brown pigmentation with sclerosis of dentinal tubules and secondary dentine formation being common
what are the two virginity options for carious lesions
initial/primary
recurrent/secondary
what is primary caries
lesions on unrestored tooth surfaces
primary caries is one in which the lesion constitutes the initial attack on the tooth surface
designation of primary is based on the initial location of the lesion rather than the extent of the damage
what are the common locations for secondary caries
rough or overhanging margins
fractures
what can lead to secondary caries
poor adaptation of a restoration which allows for marginal leakage, or it may be due to inadequate extension of the restoration
if there is not adequate excavation of the original lesion, which later may appear as a residual or recurrent caries
caries can be classified based on tissue involvement. what are the different classifications for this
initial caries
superficial caries
moderate caries
deep caries
deep complicated caries
what is initial caries
demineralisation without a structural defect which can be reversed by fluoridation and enhanced mouth hygiene
what is superficial caries
enamel caries, that has not yet penetrated the dentine
what is moderate caries
dentine cares with extensive structural defect
caries has penetrated up to the dentine and spreads two dimensionally beneath the enamel defect where the dentine offers little resistance
describe deep caries
deep structural defect where the caries has penetrated up to the dentine layers of the tooth close to the pulp
describe deep complicated caries
caries has led to the opening of the pulp cavity
what is simple caries
involving only one tooth surface
what is compound caries
involving two surfaces of a tooth
complex caries
involving more than two surfaces of a tooth
