Caries Diagnosis and Management

Question 1

Define “caries”

Answer 1

Dental caries is an infectious microbiologic disease of the teeth that results in localized dissolution of the calcified tissues

Question 2

Define dental plaque

Answer 2

a gelatinous mass of bacteria adhering to the tooth surface

Question 3

___ is involved in caries initiation, while ____ are able to withstand acidic environment and lead to progression of caries

Answer 3

STREPTOCOCCUS MUTANS is involved in caries initiation, while LACTOBACILLI are able to withstand acidic environment and lead to progression of caries

Question 4

Tightly packed enamel rods are made up of ____

Answer 4

hydroxyapatite

Question 5

Each enamel rod originates at ___ an terminates at the ____

Answer 5

Each enamel rod originates at DEJ an terminates at the EXTERNAL SURFACE

Question 6

What is Straie of Retzius?

Answer 6

The core of enamel rods. It is higher in organic content

Question 7

What allows for the dissolution of underlying dentin even before actual cavitation of enamel occurs?

Answer 7

Porosity of enamel rods, which allow for the movement of small molecules and ions

Question 8

What area of the tooth is least resistant to caries ttack?

Answer 8

DEJ - which is why lateral spreading of caries occurs once bacteria have invaded enamel

Question 9

Why is dentin more prone to acid attack?

Answer 9

because it contains higher organic content than enamel (ie. less mineral)

Question 10

Dentinal tubules provide a direct pathway for the ingress of ___ and the egress of ___

Answer 10

Dentinal tubules provide a direct pathway for the ingress of ACIDS and the egress of MINERALS

Question 11

The time for progression from incipient caries to clinical caries (cavitation) on smooth surfaces is estimated to be:

Answer 11

18 months, plus or minus 6 months

Question 12

caries are classified into 4 categories:

Answer 12

1. incipient
2. moderate
3. advanced
4. extensive

Question 13

The class of caries which is the first evidence of carious activity within enamel is called

Answer 13

incipient carious lesions

Question 14

T/F: incipient caries have not reached the DEJ

Answer 14

true

Question 15

In which class of caries is remineralization possible?

Answer 15

incipient

Question 16

How do incipient caries appear clinically?

Answer 16

• opaque white when dried, disappears when wet

- may only appear as a faint radiolucency on radiograph

Question 17

When the carious lesion has advanced into dentin and remineralization is no longer possible, this is known as

Answer 17

moderate caries

Question 18

At which point is remineralization no longer possible and tooth must be restored?

Answer 18

Once caries have reached the DEJ

Question 19

What are advanced caries?

Answer 19

When the lesion is advancing towards the pulp.
Treatment is required (prep and resto)
May require a root canal or extraction

Question 20

Define extensive caries

Answer 20

• acute or rampant caries, infectious disease process causing rapid damage to teeth.
• numerous soft, light coloured lesions in the mouth

Question 21

How to treat extensive caries?

Answer 21

Root canal if restorable, exo if not

Question 22

Clinical characteristics of normal enamel when hydrated, dessicated, surface texture, and surface hardness

Answer 22

Hydrated: translucent
Dessicated: translucent
Surface texture: smooth
Surface hardness: hard

Question 23

Clinical characteristics of hypocalcified enamel when hydrated, dessicated, surface texture, and surface hardness

Answer 23

Hydrated: opaque
Dessicated: opaque
Surface texture: smooth
Surface hardness: hard

Question 24

Clinical characteristics of incipient caries when hydrated, dessicated, surface texture, and surface hardness

Answer 24

Hydrated: translucent
Dessicated: opaque
Surface texture: smooth (could be roughened too)
Surface hardness: softened

Question 25

Clinical characteristics of active caries when hydrated, dessicated, surface texture, and surface hardness

Answer 25

Hydrated: opaque Dessicated: opaque Surface texture: cavitated Surface hardness: very soft

Question 26

Clinical characteristics of arrested caries when hydrated, dessicated, surface texture, and surface hardness

Answer 26

Hydrated: opaque, dark Dessicated: opaque, dark Surface texture: roughened Surface hardness: hard

Question 27

Where does recurrent decay typically occur?

Answer 27

at the cavosurface junction

Question 28

What types of caries involve the cementum and are commonly associated with periodontal disease?

Answer 28

root caries

Question 29

Color of arrested decay

Answer 29

brown or black. Shiny

Question 30

Define Cervical Burnout

Answer 30

Diffuse radiolucency with ill defined borders of proximal surfaces between CEJ and alveolar crest

Question 31

When a uniformly dark shade meets a uniformly light shade, what occurs?

Answer 31

Mach Band effect is observed in which the dark shade looks darker and the light shade looks lighter

Question 32

dark shades in xrays are ___ and light shades are ___

Answer 32

dark - radiolucent | light - radiopaque

Question 33

Best diagnostic tool for class II caries?

Answer 33

BW

Question 34

As it moves towards the pulp, what shape does a class ii lesion follow radiographically?

Answer 34

2 cone tips (big small big small....or tip of dark cone on enamel to head of cone in dentin)

Question 35

How are Class III lesions diagnosed?

Answer 35

primarily clinically, with radiographs as an adjunct

Question 36

etiology of class IV lesions

Answer 36

usually trauma

Question 37

Etiology of non carious class V lesions

Answer 37

Erosion - chemical dissolution due to acid exposure Abrasion - physical dissolution due to frictional forces Abfraction - loss of tooth structures due to flexural forces

Question 38

Where are abrasion lesions typically observed?

Answer 38

They typically start around the CEJ where enamel is thin and progress to cementum. V-shaped with apex pointing apically

Question 39

What might you observe in gingival tissue due to abrasion lesions?

Answer 39

increased keratinization due to chronic trauma of tissues

Question 40

In abfraction, what shape is the lesion due to tension and compression?

Answer 40

tension - V | compression - C