ICDAS

Question 1

ICDAS 0

Answer 1

• Sound tooth surface
• no:
  
  • caries change after air drying (5 secs)
  • hypoplasia
  • wear
  • erosion

Question 2

ICDAS 1

Answer 2

• first visual change in enamel
  
  • limited to pit & fissures
    
    • color: white or brown
• seen only after air drying or colored

Question 3

ICDAS 2

Answer 3

• Distinct visual change in enamel
  
  • wider than fissure/fossa
  • white or brown
• seen when wet

Question 4

ICDAS 3

Answer 4

• Localized enamel breakdown
  
  • no visible dentin or underlying shadow
  • wider than fissure
  • white or brown
• Sealant or minimally invasive restoration

Question 5

ICDAS 4

Answer 5

• Underlying dark shadow from dentin (Gray, blue or brown)
  
  • with or w/o localized enamel breakdown
    
    • no exposed dentin
• Minimally invasive restoration

Question 6

ICDAS 5

Answer 6

• Distinct Cavity w/visible dentin
• frank cavitation
  
  • < ½ of tooth surface

Question 7

ICDAS 6

Answer 7

• Extensive Deep Cavity with dentin
  
  • deep & wide cavity
    
    • involves > ½ of tooth surface

Question 8

Early lesion

Answer 8

• Aka White Spot Lesion

Question 9

Active Lesion

Answer 9

• Yellow or Light Brown
• Soft

Question 10

Slow Progressing Lesion

Answer 10

• Brown to Black
• Leathery

Question 11

Inactive Lesion

Answer 11

• aka Arrested lesion
• Dark brown or black
• shiny, smooth
• Hard

Question 12

Occlusal Site: Which ICDAS lesions are in the initial caries management stage?

Answer 12

• ICDAS 0, 1, 2

Question 13

Occlusal Site: in initial caries management stages, what are the recommended management for each caries risk level?

Answer 13

• Low risk:
  
  • nonsurgical preventative maintenance
  • inactive lesions:
    
    • no sealants
  • deep pits & fissures
    
    • sealants optional
• Moderate risk:
  
  • sealants
• High or extreme risk:
  
  • sealants

Question 14

Occlusal Site: Which ICDAS lesions are in the moderate caries management stage?

Answer 14

• ICDAS 3, 4, 5
• minimally invasive restoration

Question 15

Occlusal Site: in Moderate caries management stages, what are the recommended management for each caries risk level?

Answer 15

• All risk levels:
  
  • minimal removal of tooth structure
  • ensure adequate seal for dental material

Question 16

Occlusal Site: Which ICDAS lesions are in the severe caries management stage?

Answer 16

• ICDAS 6
• conventional restorative approach

Question 17

Occlusal Site: in severe caries management stages, what are the recommended management for each caries risk level?

Answer 17

• all risk levels
  
  • conservative caries removal when near pulp
  • ensure adequate seal for dental material

Question 18

proximal Site: Which radiographic lesions are in the initial caries management stage?

Answer 18

• E0
• E1
• D1 (could be moderate stage)

Question 19

proximal site: Which radiographic lesions are in the moderate caries management stage?

Answer 19

• D1 (outer ⅓ of pulp)
• D2 (middle ⅓ of pulp)

Question 20

proximal site: Which radiographic lesions are in the severe caries management stage?

Answer 20

• D3 (inner ⅓ of pulp)

Question 21

Proximal Site: in initial caries management stages, what are the recommended management for each caries risk level?

Answer 21

• E0, E1, E2
• Chemical Treatment or Preventative maintenance

Question 22

Mobility Classification

Answer 22

Miller’s Classification

• Grade 1:
  
  • < 1 mm
• Grade 2:
  
  • 1 mm > X < 2 mm
  • moderate movement
• Grade 3:
  
  • > 2 mm & depressible/intrudes

Question 23

Furcation Classification

Answer 23

• Class 1 (incipient)
  
  • bone still intact
• Class 2 (patent)
  
  • Bone loss to the furcation
• Class 3 (communicating)
  
  • through and through
• Class 4 (visible)
  
  • through and through & soft tissue recession

Question 24

Recession Classification

Answer 24

Miller Recession Classification

• Type 1
  
  • Gingival Recession w/no Interproximal attachment loss
• Type 2:
  
  • Gingival recession w/interproximal attachment loss
    
    • IP loss ≤ facial recession
• Type 3:
  
  • gingival recession w/interproximal attachment loss
    
    • IP loss > Facial recession

Question 25

Periodontal Classification: Severity

Answer 25

• 1st thing you look at
• Interdental CAL: (primarily based on)
  
  • stage 1:
    
    • 1-2 mm
  • Stage 2:
    
    • 3-4 mm
  • Stage 3 & 4:
    
    • ≥ 5 mm
• Other Factors:
  
  • Radiographic Bone Loss (RBL)
    
    • if CAL not available, use as standard
    • Stage 1:
      
      • coronal ⅓ (<15%)
    • Stage 2:
      
      • Coronal ⅓ (15-33%)
    • Stage 3 & 4:
      
      • extending to/past middle ⅓ (> 33%)
  • tooth loss due to periodontitis
    
    • push to higher level
    • Stage 1 & 2:
      
      • no teeth lost
    • Stage 3:
      
      • ≤ 4 teeth lost
    • Stage 4:
      
      • ≥ 5 teeth lost

Question 26

Periodontal Classification: Complexity

Answer 26

• Local Factors: (primarily based on)
  
  • Pocket Depth (PD)
  • Bone loss (Horizontal vs Vertical)
  • furcation involvement
• Stage 1:
  
  • PD ≤ 4mm
  • mostly horizontal bone loss
• Stage 2:
  
  • PD ≤ 5 mm
  • mostly horizontal bone loss
• Stage 3 & 4:
  
  • PD ≥ 6 mm
  • vertical bone loss ≥ 3mm
  • Furcation Class 2 & 3
  • < 20 teeth remaining= Stage 4