Lecture 7 - Caries Diagnosis and Management

Question 1

with a visual exam, one should observe

Answer 1

frank cavitation
decalcification (white spot) - early stage caries due to partial demineralization
opalescence (deep caries)

Question 2

T/F black/brown staining is not reliable indicator of caries

Answer 2

T

Question 3

T/F diagnosis of fissure caries is easier than smooth surface caries

Answer 3

F - more difficult

Question 4

reliability

Answer 4

relates to the reproducibility of measurements

Question 5

validity

Answer 5

degree to which a measurement expresses the true value

Question 6

what is the gold standard validity test for caries?

Answer 6

histologic exam

Question 7

what validity test do we use for caries in vivo?

Answer 7

bitewing radiograph

Question 8

sensitivity

Answer 8

proportion of people with caries with a positive test result
probability of disease when its there
P(T+/D+) a/a+C

Question 9

specificity

Answer 9

proportion of healthy people with negative test result
how likely to say disease is absent when it is not there
P(T-/D-) d/B+D

Question 10

reliability

Answer 10

inter-observed agreement
determined by measuring how often the same answer is achieved
kappa = 1 = perfect agreement

Question 11

summary for diagnosis of fissure caries

Answer 11

diagnostic accuracy of probing and visual inspection similar
sensitivity LOW
specificity HIGH
reliability less than excellent
radiographs helpful

Question 12

method of choice for diagnosis of fissure caries

Answer 12

visual inspection with appropriate radiograph

Question 13

T/F

small lesions on radiographs are likely to be cavitated

Answer 13

F - not likely

Question 14

T/F hidden, sealed caries will progress

Answer 14

FALSE!!!

Question 15

Early enamel lesion

___________ sensitivity; ____________ specificity

Answer 15

low sensitivity
high specificity
(equivalent with visual exam vs explorer use)

Question 16

false positives of caries detection dyes

Answer 16

DEJ

cirumpulpal

Question 17

DIAGNOdent ________ specificity and ___________ sensitivity

Answer 17

decreases specificity - false positives

increases sensitivity - reliably establishes absence of disease

Question 18

DIAGNOdent readings are related to the _____________ and _______________ of demineralization. NOT the ______ of lesion

Answer 18

degree
intensity
depth

Question 19

INSPEKTOR PRO monitors what?

Answer 19

caries progression

Question 20

name some fluorescent bacteria

Answer 20

veillonella
prevotella
(they fluoresce when substrate (sugar) is present)

Question 21

QLF utility finds what? and determine what?

Answer 21

hidden caries

determines absence of disease

Question 22

Canary number reflects what two things?

Answer 22

1 state of mineralization

2 crystallization

Question 23

Saliva Check mutans test strip

Answer 23

SM tests have not been shown to be good risk predictors on individual basis

Question 24

CRT caries risk test

Answer 24

Cultivation for s. mutans and lactobacilli

Question 25

CariScreen Caries Susceptibility Test

Answer 25

measures ATP bioluminescence
detects levels of acid-producing, decay-causing bacteria
assesses caries risk