March 24- Dental Caries Final Flashcards
What are dental caries?
“Pathologic process of localized destruction of dental hard tissues by organic acids produced by microbial deposits adhering to teeth.” This is a dynamic process fluctuating between demineralization and mineralization.
What is ICDAS?
‘International Caries Detection and Assessment System. It’s purpose is to stage caries to help dentists assess and mange caries appropriately. It is a common language for staging.
What’s the ICDAS severity codes?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/138/804/782/a_image_thumb.png?1659457836)
What do the different stages of caries look like?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/138/804/783/a_image_thumb.png?1659457837)
What do caries look like on a radiograph?
Radiolucent (dark). In enamel, there is decreased mineral content so more x rays pass through and hit the sensor. And in dentin, there is a decrease in th eattenuation of the x ray beam so more x rays pass through to hit the sensor in a similar way.
remember that radiographs are an aid to the clinical exam.
Why are radiographs important when diagnosing caries?
It is non invasive
can see parts of the tooth that are inaccesible in the clinical exam.
can assess lesion depth
successive images allow us to see progression
what are the classifications of caries by location?
• Smooth surface
- Interproximal
- Buccal or lingual surfaces
- Root
• Pit or Fissure
- Occlusal
- Buccal or lingual pit
• Recurrent
what’s an anterior inperproximal carie? what does it look like?
interproximal caries are between two adjacent teeth obviously. An anterior periapical radiograph would be most useful.
![](https://s3.amazonaws.com/brainscape-prod/system/cm/138/804/787/a_image_thumb.png?1659457837)
Sometimes an interproximal carie looks a lot like a restoration. How can you tell the difference?
Old resorations may look like a carie, but look at the shape of the carie, if it is rounded from a burr it is likely an old resoration, if irregular, more likely to be a carie. New restorations are composite and don’t look like caries.
![](https://s3.amazonaws.com/brainscape-prod/system/cm/138/804/788/a_image_thumb.png?1659457837)
what type of radiograph would be most useful for a posterior interproximal carie?
bitewings
can also see with a periapical
ideally we want to see all of the interprocimal contacts to be visible on the radiograph.
use film holdres and BID
![](https://s3.amazonaws.com/brainscape-prod/system/cm/138/804/789/a_image_thumb.png?1659457837)
How should you angle the x ray beam (appriximately) in order to get open contacts on premolars vs molars?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/138/804/790/a_image_thumb.png?1659457838)
How much demineralization is required for an interproximal lesion to be detected radiographically?
30-50%. the thickness of the tooth buccolinguallt could mask a carious lesion when it is very small. So lesions may actually be deeper clinically then they look on a radiograph.
What stage of caries can be detected by a radiograh?
Interproximal surfaces: ICDAS 2-6
Occlusal surfaces: ICDAS 4-6 (sometimes 2 and 3)
Digital radiology allows post-exposure manipulation to enhance the image.
changes in density and size of the lesion can be monitored
over time “subtraction radiography” but difficult in private practice setting
When does a lesion neeed restorative intervention?
- Continuing debate!
- Depends on the individual patients wants, needs
and circumstances
• Focus currently is on cavitation (surface
discontinuity) rather than dentine involvement
(lesion depth)
What is cavitation?
When a radiographic lesion has moved into the dentin.
if there is cavitation, it is not likely that the lesion will heal.
here, radiographs can give us info about lesion depth.
Radiographic lesion depth and density of the dentine are inaccurate in distinguishing cavitated and noncavitated interproximal lesions.