Lecture 7 - Caries Diagnosis and Management Flashcards
with a visual exam, one should observe
frank cavitation
decalcification (white spot) - early stage caries due to partial demineralization
opalescence (deep caries)
T/F black/brown staining is not reliable indicator of caries
T
T/F diagnosis of fissure caries is easier than smooth surface caries
F - more difficult
reliability
relates to the reproducibility of measurements
validity
degree to which a measurement expresses the true value
what is the gold standard validity test for caries?
histologic exam
what validity test do we use for caries in vivo?
bitewing radiograph
sensitivity
proportion of people with caries with a positive test result
probability of disease when its there
P(T+/D+) a/a+C
specificity
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
reliability
inter-observed agreement
determined by measuring how often the same answer is achieved
kappa = 1 = perfect agreement
summary for diagnosis of fissure caries
diagnostic accuracy of probing and visual inspection similar sensitivity LOW specificity HIGH reliability less than excellent radiographs helpful
method of choice for diagnosis of fissure caries
visual inspection with appropriate radiograph
T/F
small lesions on radiographs are likely to be cavitated
F - not likely
T/F hidden, sealed caries will progress
FALSE!!!
Early enamel lesion
___________ sensitivity; ____________ specificity
low sensitivity
high specificity
(equivalent with visual exam vs explorer use)
false positives of caries detection dyes
DEJ
cirumpulpal
DIAGNOdent ________ specificity and ___________ sensitivity
decreases specificity - false positives
increases sensitivity - reliably establishes absence of disease
DIAGNOdent readings are related to the _____________ and _______________ of demineralization. NOT the ______ of lesion
degree
intensity
depth
INSPEKTOR PRO monitors what?
caries progression
name some fluorescent bacteria
veillonella
prevotella
(they fluoresce when substrate (sugar) is present)
QLF utility finds what? and determine what?
hidden caries
determines absence of disease
Canary number reflects what two things?
1 state of mineralization
2 crystallization
Saliva Check mutans test strip
SM tests have not been shown to be good risk predictors on individual basis
CRT caries risk test
Cultivation for s. mutans and lactobacilli
CariScreen Caries Susceptibility Test
measures ATP bioluminescence
detects levels of acid-producing, decay-causing bacteria
assesses caries risk
