Interpretation of dental caries Flashcards

1
Q

what are caries?

A

the localized destruction of teeth by microorganisms

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2
Q

how can we detect caries?

A
  • clinical exam

- radiographic exam

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3
Q

what are the benefits of radiographs regarding caries?

A
  • enable the dental professional to identify carious lesions that are not visible clinically
  • also allows dental professional to evaluate the extent and severity of carious lesions
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4
Q

visible characteristics of clinically visible caries

A

colour changes

  • occlusal surfaces may show dark staining in fissures, pits and grooves
  • smooth surfaces may exhibit a chalky white spot or opacity
  • an interproximal ridge may appear discoloured
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5
Q

how does a carious lesion appear on a radiograph?

A
  • radiolucent because of decreased density that allows for greater penetration in the carious area
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6
Q

what type of radiographs are helpful in detecting caries and why?

A
  • bite wings: provide the dental professional with the greater amount of diagnostic info
  • periapical: taken with paralleling technique can also be used
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7
Q

tips for interpreting radiographs

A
  • proper mounting is important
  • viewing in a room with subdued light that is free of distractions
  • an illuminator or view box
  • masking light around mount films
  • a pocket sized magnifying glass can also help
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8
Q

what is a factor that may influence caries interpretation

A

radiographs must be of diagnostic quality

- ex. improper angulation on a bitewing, errors in exposure with improper contrast and density

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9
Q

radiographic classification of caries (6):

A
  • interproximal caries
  • occlusal caries
  • buccal and lingual caries
  • root surface caries
  • recurrent caries
  • rampant caries
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10
Q

what are interproximal caries?

A
  • between 2 adjacent surfaces
  • typically seen on dental radiographs at or just below the contact point (as caries progress through enamel, it usually assumes a triangular shape, and when it reaches the DEJ, it speeds laterally and progresses through dentin)
  • classified as incipient, moderate, advanced and severe
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11
Q

what are incipient caries?

A
  • extend less than halfway through the enamel (could also be called Class I)
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12
Q

what are moderate caries?

A
  • extends more than halfway through enamel but does not involve the DEJ (could also be called Class II)
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13
Q

what are advanced caries?

A
  • extends to or through the DEJ and into the dentin, but does not extend into dentin more than half the distance toward the pulp (could also be called Class III)
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14
Q

what are severe caries?

A
  • extends through enamel and dentin more than half the distance to the pulp
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15
Q

what are occlusal caries?

A
  • caries that involve the chewing surface of posterior teeth
  • ‘a thorough clinical exam is the method of choice for the detection of occlusal caries’
  • early occlusal caries is difficult to see on a dental radiograph
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16
Q

how can we detect the 4 types of caries on the occlusal surface?

A
  • incipient: cannot be seen on a dental radiograph, must be detected with an explorer
  • moderate: extends into dentin, appears as a thin radiolucent line
  • severe: extends into dentin and appears as a radiolucency, the radiolucency extends under the enamel of the occlusal surface of the tooth
17
Q

what are buccal and lingual caries?

A
  • there are difficult to detect on a radiograph because they are superimposed on tooth structure
  • if seen on film, they appear as a circular radiolucent area
18
Q

what are root surface caries?

A
  • involves only the roots of teeth
  • on a radiograph, it appears as a cupped-out or crater-shaped radiolucency below the CEJ
  • early lesions may be difficult to detect on radiograph
19
Q

what are recurrent caries?

A
  • occurs adjacent to an existing restoration
  • it appears as a radiolucent area just beneath a restoration
  • most often located beneath the interproximal margins of a restoration
20
Q

what are rampant caries?

A
  • advanced and severe caries affecting a number of teeth

- associated with children with poor diets and adults with decreased salivary flow