Lecture 1 Flashcards
Surface condition code for partial sealant:
1
Surface condition code for stainless steel crown:
5
Surface condition code for provisional restoration:
8
Surface condition code for a tooth that is not restored or sealed:
0
Surface condition code for a full sealant:
2
Surface condition code for amalgam restoration:
4
Surface condition code for lost or fractured restoration:
7
Surface condition code for metal or ceramic crowns and veneers:
6
Surface condition code for tooth colored restorations:
3
The first code is _____ and the second code is _______.
surface condition, caries code
Caries code for a sound tooth, no evidence of caries after air drying the tooth for five seconds
0
Caries code for a tooth with:
- First visual change in enamel
- Seen ONLY AFTER AIR DRYING for 5 sec
1
Caries code for a tooth with:
- distinct visual change in enamel
- see on WET OR DRY TOOTH SURFACE
- presents as white opacity or brown discoloration
- Lesion base is wider than pit and fissure area
2
Main coding system we focus on in video:
ICDAS
This type of caries is difficult to see in the wet condition:
1
The lesions are wider than the pit and fissures in this type of caries:
2
Caries code for a tooth with:
- Localized ENAMEL BREAKDOWN due to carries with NO VISIBLE DENTINE
- Presents as white opacity or brown discoloration when wet
- Drying and gently examining with ball-end probe confirms the surface discontinuity of enamel:
3
This caries code codes for a tooth with the first sign of enamel breakdown:
3
Caries of this code have no underlying shadow:
3
Caries code for a tooth with underlying discolored DENTINAL SHADOW (gray, blue, brown) through enamel:
4
Caries code for a tooth with a distinct cavity with VISIBLE DENTINE and a lesion that extends LESS THAN HALF of the tooth surface
5
Caries code for a tooth with EXTENSIVEC distinct cavity with visible dentine and that extends MORE THAN HALF of the tooth surface:
6
Father of Operative Dentistry:
G V Black
What is Blacks Classifiction of Caries based on?
intended operative outcome, cavitated lesions only, not non-cavitated bc there was no preventative dentistry
Class I:
Affecting pits and fissures of posterior tooth, lingual pits of anterior tooth
Class II:
Proximal surface of posterior teeth involving 2 or more surfaces
Class III:
Proximal surface of anterior teeth without involving the incisal edge
Class IV:
Proximal surface of anterior teeth involving incisal edge
Class V:
Cervical 1/3 of the facial surface of tooth, gingival 1/3 of the lingual surface of the tooth
Class VI:
incisal edge of anterior tooth, cusp tip of posterior tooth
Year that Blacks classification system came out:
1896 - no preventative dentistry, not addressing non-cavitated legions
American Dental Assoc Caries Classification System:
Includes non-cavitated legions and cavitated
4 groups w/in ADA Caries Classification System:
Sound
Initial
Moderate
Advanced
Which Black Classifications are categorized under the sound group of the ADA Caries Classification System?
Class 0
Which Black Classifications are categorized under the initial group of the ADA Caries Classification System?
Class I and Class II
Which Black Classifications are categorized under the moderate group of the ADA Caries Classification System?
Class III and Class IV
Which Black Classifications are categorized under the advanced group of the ADA Caries Classification System?
Class V and Class VI
T or F? We typically see infected dentine in the initial lesion.
F. Typically do not see infected dentine
Moderate demineralized dentine and possibly infected dentin is found in this category of the ADA Caries Classification System:
Moderate
This group shows infected dentine:
Advanced
Dental caries is localized _____ dissolution of tooth surface.
chemical
Dental caries is caused by:
acid produced from metabolic actions of cariogenic bacteria in biofilm or dental plaque
2 most cariogenic bacteria:
Streptococcus mutans and Streptococcus sobrinus
6 cariogenic bacteria:
Streptococcus mutans Streptococcus sobrinus Streptococcus sanguis Streptococcus salivarius Lactobacilius Actinomyces
composition of biofilm:
bacteria, their byproduct, extra-cellular matrix and water
When does acquired pellicle formation occur in biofilm formation?
30min-1hr
When does a cocci covering surface formation occur in biofilm formation?
12 hrs - 1 day
When does filamentous bacteria formation occur in biofilm formation?
1-3 days
When does a complex colony of cocci and filamentous bacteria occur in biofilm formation?
1 wk
When do “corn cobs” occur in biofilm fomration?
3 wks
What forms the pellicle?
salivary glycoproteins
function of the pellicle:
helps bacteria attach to tooth surface
To where does filamentous bacteria attach?
to the cocci (i.e., streptococci)
What is required for metabolic activity when a thick biofilm is present?
carbs
metabolically produced acids start demineralization after how long after accumulation of biofilm?
2 days
This model is used to model the factors controlling caries:
Keyes’ Triad
According to Keyes’ Triad, what is required for the formation of caries?
Host (tooth surface) and teeth, microflora (bacteria) , and substrate (fermentable carb) or diet - all 3
Strictly biological model of caries formation:
Keyes’ Triad
4 major additional factors beyond Keyes’ Triad affecting the formation of caries:
salivary flow
buffering capacity
sugar clearance rate
socio-behavioral factors
Model of factors controlling caries that includes all of Keyes’ factors as well as numerous additional:
Fejerskov and Manji Model - 1990
attitude, behavior, social class, income, education, knowledge, salivary composition, fluoride, diet, microbial species, salivary flow, buffering capacity, sugar clearance rate, socio-behavioral factors
Why does more salivary flow help prevent cavity formation?
it washes the acidity away
Would we prefer to have a high or low buffering capacity of our saliva?
high
how does an increased sugar clearance rate help prevent caries formation?
lowers microbial metabolism bc the bacteria won’t have the required nutrients
T or F? Both salivary composition and flow rate can vary.
T
Instruments for caries exam:
mirror, explorer, perio brobe
T or F? Teeth should be wet for the caries exam.
F. Dry
Example of pattern to always follow while examining each tooth:
O, B, L, M, D
T or F? The tip of the explorer should be used to remove the biofilm that has accumulated on the tooth structure.
F. The side of a sharp explorer
T or F? During the caries exam you should poke or stick the sharp edge of the explorer into the pit and fissure.
F
What could happen if you used the sharp explorer in the caries exam?
non-cavitated lesion may be turned cavitated
Addition exam aid
Fiberoptic transillumination (FOTI)
At what angle should the FOTI be placed against the contact points of the teeth?
45’
What color light is used with FOTI?
white
What absorbs and scatters more light, the carious legion or sound enamel/dentin?
carious legion, creating a shadow
How to do exam bw 2 adjacent teeth that are very tight:
orthodontic elastic separator are placed for 2-3 days
Limitations to placing orthodontic elastic separators
pt discomfort and additional appt.
Caries are diagnosed as _______ areas on radiographs.
radiolucent
Major Caries Lesion Detection Systems:
WHO (1979) WHO basic NIDRC/ NHANES BASCD NYVAD et al ICDAS
This Caries Lesion Detection Systems is (used with?) incipient lesions and Frank lesions:
NIDRC/ NHANES
This Caries Lesion Detection Systems is (used with?) arrested decay, caries in dentine, and decay with plural involvement:
BASCD
This Caries Lesion Detection Systems is (used with?) inactive lesion with intact surface, surface discontinuity, cavity ; active lesion with intact surface discontinuity, cavity:
NYVAD
ICDAS stands for:
International Caries Detection and Assessment System
T or F? ICDAS is used only for non-cavitated teeth.
F. Both caveated and non-cavitated
How many stages of caries extension are there?
6
The use of a sharp explorer can cause ____ defects on _______ lesions.
iatrogenic, incipient
How should you explore incipient lesions?
with the ball-end of a perio probe
What does a tooth that has a partial sealant look like?
??
PFM crown, ceramic crowns and veneers are coded as what for surface condition?
6
How would you classify a carious legion bw 2 adjacent posterior teeth that does not cover 2 surfaces?
Is this even possible?
Another name for early carious legion:
non-cavitated legion
How many groups is the ADA classification system broken down to?
4
