management of caries Flashcards
caries assessment workflow
assessment diagnosis and risk assessment care planning preventative care operative care
what happens in the caries assessment
history taking
examination
special investigatons
dental caries
instigated by bacteria on fermentable carbohydrates in the plaque biofilm on tooth surfaces
leads to acid demineralisation and proteolytic destruction ( in dentine of organic component of dental tissues
Keyes triad
tooth
bacteria
diet
time
restoration of pits and fissures of posterior teeth
class I
proximal caries restoration type
posterior class II anterior class III prep
non carious lesiosn
balance of protective and pathologic factors remain stable overtime
what bacteria is found in higher quantities with caries
streptococcus mutans
how do coronal caries ddevelop
starts in enamel, bacteria retained in plaque
breakdown sugars in diet and release acid
demineralisation
loss of calcium and phosphate from the surface
demineralsiaoton leads to carious lesion
- white spot lesiojs
which ph leads to demineralsiaon
below 5.5
common areas for white spot lesions
around dental brackets
plaque retention around the brakets
white spot lesion progression
if OH does not improbe demineralsiaon of enamel progresses weakens enamel and will reach ADJ caries reaches the dentine and spreads along ADJ laterallu enamel breaks under occlslusal force
dental caries layers
carious enamle
infected dentine
affected dentiene
sound dentine
infected dentien
dentine that we want to remove clinically(outermost layer) cannot be repaired - necrotic zone of destruction -dark coloir - soft mushy wet - denatured collagen matrix - extensive mineral loss - tubular structure destroyed
affected dentine
inner layer of carious dentine
- paler brown, harder
- demineralised
- collagen still damaged but lesser exent
- tubular structure foundations remain
non operative caries control
- OH instructiosn Plaque control diet advice fluoride casein phospopeptide antimicrobial agents
Plaque control
removal of plaque retentive factors
calculus
restorations with poor borders
denture
when should you use operative caries manaagment
only when lesion is cavitated
lesion that renders plaque removal difficult or impossible
aims of operative manamgent
aid plaque control and thereby manage caries activity at location
protect pulp dentine complex and arrest lesion by sealing it
restore functional and aesthetic form
