Overview of Dental Caries Flashcards
(24 cards)
what is the dental caries process?
localized destruction of susceptible dental hard tissues by acid-by-products from bacterial fermentation of dietary carbs
what are the strategic public health considerations for caries (upstream to downstream)?
- legislation/industry regulation (trade, manufacturing etc)
- fiscal measures (taxes)
- healthy communities (water fluoridation, availability of sugary foods/drinks)
- healthy settings (dietary guidelines in schools/work)
- media campaigns
- school based programs (fluoride, toothbrushing and oral health education)
- professional applications (fluoride, fissure sealants etc)
how does a lesion form?
- critical pH of 5.5
- saliva is undersaturated with respect to hydroxyapatite
- HA dissolves from enamel interior and fluoroapatite will deposit in surface enamel
- subsurface caries lesion forms
when was it determined that caries are not cavities? what is the definition of caries we use today?
- 1948 consensus conference
- a disease of the calcified tissue of teeth caused by acids which leads to decalcification of the inorganic portion and accompanied or followed by disintegration of the organic substance of the tooth
why do fillings not treat dental caries??
bc dental caries is a DISEASE
- fillings treat CAVITIES that are a result of dental caries
is the dental caries disease reversible? how?
yes, it is INITIALLY reversible and can be halted at any stage even when some dentin or enamel is destroyed (cavitation) provided that enough biofilm can be removed
what is Tideglusib and Curodont?
- tideglusib is an experimental drug that may stimulate stem cell differentiation in the pulp to create NEW dentin
- curodont is a peptide for enamel regeneration
what are some caries disease indicators, risk factors and protective factors?
- white spots, restorations <3, enamel lesions, cavities dentin
- bad bacteria, absence of saliva, poor dietary habits
- saliva and sealants, antibacterial, fluoride, effective diet
what is the first step in early prevention?
early detection
what are considered the 6 risk factors for dental caries?
- social class
- income
- attitude
- knowledge
- behaviour
- education
the biofilm formed in the presence of sucrose has?
low concentrations of calcium, phosphate and fluoride
what is the diagnostic threshold and what are the levels?
determines what is recorded as diseased or sound
- subclinical initial lesions in a dynamic state of progression/regression
- lesions detectable only with traditional diagnostic aids
- D1: clinically detectable enamel lesions with “intact” surfaces
- D2: clinically detectable cavities limited to enamel
- D3: clinically detectable lesion in dentine
- D4: lesions into pulp
which ICDAS Detection codes correlate to D1, D2, D3 and D4?
- D1 = code 1/2
- D2 = code 3
- D3 = code 4/5
- D4 = code 6
when is caries scored and why?
after cleaning of the teeth, otherwise they can be underscored
why are explorers not recommended to check for caries?
may produce traumatic defects
what does each code state for the ICDAS?
0: sound tooth surface
1: first visual change in enamel
2: distinct visual change in enamel
3: localized enamel breakdown due to caries with no visible dentine
4: underlying dark shadow from dentine (with or without enamel breakdown)
5: distinct cavity with visible dentin
6: extensive distinct cavity with visible dentin
what is considered initial, moderate and extensive caries?
- codes 1 and 2
- codes 3 and 4
- codes 5 and 6
the ICDAS detection system scores were devised related to ?
histological depth
what is the histological classification system?
code 0: no demineralization
code 1: demineralization limited to outer 1/2 of enamel
code 2: demineralization in inner 1/2 enamel to outer 1/3 of dentin
code 3: demineralization middle 1/3 of dentin
code 4: demineralization inner 1/3 of dentin
what is the radiographic classification system?
0: no radiolucency
RA: Initial stage
- radiolucency to outer 1/2 of enamel
- radiolucency in inner 1/2 enamel to EDJ
RB: Moderate
- radiolucency limited to the outer 1/3 of dentin
- radiolucency reaching the middle 1/3 of dentin
RC: Extensive
- radiolucency reaching the inner 1/3 of dentin, clinically cavitated
- radiolucency into the pulp, clinically cavitated
what are the signs of an active lesion for the ICDAS initial and moderate stage?
- surface of enamel is white/yellowish; opaque with loss of luster; feels rough when the tip of the probe is moved gently across the surface
- lesion is in a plaque stagnation area
what is considered primary prevention at the patient level by the ICDAS?
caries risk assessment including staging of the severity of the lesion and additional information that informs diagnosis
what is considered secondary prevention by the ICDAS?
- no treatment
- remineralize
- arrest
- sealant
what is considered tertiary prevention by the ICDAS?
- minimal surgery
- traditional surgical
- endodontic treatment
- extraction
