How do we classify/diagnose caries Flashcards
what are the different classifications of caries
extent cavitation activity site location
how do we classify caries by extent
D1
(D2)
D3
what is D1
all visually detectible lesions
what do D1 lesions extend into
enamel
what is D2 lesions
cavitated but limited to enamel
what is D3 lesions
lesions extending into dentine. once the progression hits dentine it spreads
what is the lowest level of caries
demineralization
How do we classify caries by cavitation
cavitated
non cavitated
what should we never do to a cavity and why
probe it with a sharp probe
if there is a micro cavity probing it as such will make it worse
what type of probe should we use when probing a caivty
perioprobe or round ended probe
run it against the surface – if there is a defect then the probe will run into it.
how can we classify caries by activity
active
inactive
what is the appearance of an inactive lesion
once caries has a brown ‘leathery’ appearance it is arrested meaning it is remineralised caries.
When can we leave caries and not restore it
if the lesion is accessible and cleanable then we can arrest it
how do we classify caries by site
smooth surface
occlusal
root surface
approximal
how do we classify caries by location
primary
secondary
what is a secondary caries
adjacent to restoration
how can we score caries
surfaces - each surface is considered separately
tooth - worst surface dictates tooth code
what is accuracy
measure of what is claimed
what is precision
consistency of the measurement
what is sensitivity
% of disease found correctly
what is the specificity
% of health found correctly
what are the clinical examination basics
good light
dry the tooth
take your time
don’t use a sharp probe
what is the sensitivity and specificity for a normal examination
sensitivity is low but specificity is high for both D1 and D3
how can we improve accuracy
ICCMS
radiographs
magnification
FOTI
what is ICCMS
we dry the tooth for 30 seconds and very carefully look at each surface
what is the ICCMS sensitivity/specificity compared to a normal examination
sensitivity is higher
specificity is lower
what is the advantage of radiographs
permanent record
what are the disadvantages of radiographs
ionizing radiation
not good on all surfaces
why is caries darker on radiographs
less mineral in tooth so more X-ray beams get through
what is the sensitivity/specificty for approximal caries in bitewing radiographs
sensitivity is lower for D1 but higher for D3
specificity is lower
what are the advantages of magnification
easy
cheap
what is the disadvantages of magnification
takes getting used to
field of view is much smaller
what is the specificity/accuracy for magnification
sensitivity is higher for D1 and D3 but not significantly for D3
specificity is higher
what is the other techniques
fiberoptic transillumination
diagnodent
electrical techniques
what is fibrooptic transillumination
it uses the principle of illuminating teeth to detect the presence of caries. The principle behind transilluminating teeth is that demineralized areas of enamel or dentine scatter light more than sound areas
