Cariology-Dental Caries

According to Sturdevant

Dental Caries is a infectious microbiologic disease of the teeth that results in localized dissolution and destruction of calcified tissues.

According to W.H.O

It is defined as localized post eruptive ppathological process of external origin involving softening of the hard tooth tissue and proceeding to formation of cavity.

According to Shafer, Gine, Levy

It is defined it as a "microbial disease of the calcified tissues of the teeth characterized by demineralization of the inorganic portion and destruction of the organic substance of the tooth.

(APVED NC G TWO)

1. Based on ANATOMICAL SITE

2. Based on PROGRESSION

3. Based on VIRGINITY of lesion

4. Based on EXTEND of caries

5. Based on DIRECTION of caries attack

6. Based on NUMBER OF TOOTH SURFACES INVOLVED

7. Based on CHRONOLOGY

8. Based on G.V. BLACK

9. Based on TISSUE invoved

10. Based on W.H.O. System

11. Other Classification

Classification of Dental Caries (11)

-Pit and fissure caries

-Occlusal

-Buccal or lingual pit

-Smooth surface Caries

-Proximal

-Buccal surface Caries

-Root Caries

-Interproximal caries

Based on ANATOMICAL SITE

-Occlusal

-Buccal or lingual pit

What anatomical structure of the tooth do we found PIT AND FISSURE CARIES?

-Proximal

-Buccal or Lingual surface

What anatomical structure of the tooth do we found SMOOTH SURFACE CARIES?

Acute Progression of Caries

-Rapidly invading process

-Involves several teeth

-lesions are soft + light colored

-usually pulp is involved at early stage

Acute

Chronic

Example of caries Based on PROGRESSION

-Rampant caries

-Nursing bottle caries

-Radiation caries

Examples of Acute Caries

Rampant Caries

-Suddenly appearing

-Widespread

-Resulting in early involvement of pulp

-Nursing caries

-Nursing bottle mouth

-Nursing bottle syndrome

-Bottle-Propping caries

-Comforter caries

-Baby bottle tooth decay

-Tooth cleaning neglect

Other names for NURSING BOTTLE CARIES?

Maternally Derived Streptococcus Mutant Disease(MDSMD)

New Names for Nursing Bottle Caries

Radiotherapy

xerostomia

___________ is frequently associated with ____________ due to decreased salivary secretion

rampant form of caries

saliva in preventing caries

This and other cause of decreased salivation may lead to a ______ _____ __ _______ , indication the significance of __________ __ _________ ________.

Chronic progression of caries

-Lesion are long standing

-few in number

-smaller than acute caries

-pain not a common feature

-Decalcified dentin is dark brown and leathery

Arrested progression of caries

-Caries which becomes stationary or static and does not shoe any tendency for further progression

-large open cavities

-brown-stained polished appearance + hard

-Initial/Primary caries

-Secondary Caries/recurrent

Based on VIRGINITY of lesion

Initial/Primary caries

-First attack on tooth surface

-Designation of this is based on the initial location of lesion on the surface rather than the extent of damage.

Secondary Caries/ recurrent

-Observed around the edges and under the restoration

-Common locations are the rough or overhanging margin fracture place in all locations of the mouth.

-Incipient caries

-Occult caries

-Cavitated caries

Based on EXTENT of caries

INCIPIENT CARIES

"white spot"

-Early caries lesion, best seen on smooth surface of teeth, is visible as a "_____ _____"

- Can undergo remineralization and thus the lesion perse is not an indication for restorative treatment

occult caries

also called hidden caries

Cavitated

-Most common

-obvious cavity found on the tooth

-Forward Caries

-Backward Caries

Examples of based on DIRECTION of caries attack

Forward Caries

-This type of caries proceeds from ENAMEL to DENTIN.

-lesion is triangle in shape with BASE of triangle at enamel surface + APEX towards dentin

-in pits + fissures base is at DEJ + apex is in the pit

Backward Caries

-This type of caries proceeds from DEJ towards the ENAMEL surface

-Also triangle shape with BSE at DEJ + APEX towards the enamel surface

-Simple

-Compound

-Complex

Examples of caries Based on Number of Surfaces Involved

Simple

-Only ONE surface is involved by caries

Compound

TWO Surfaces are involved

Complex

MORE THAN THREE surfaces involved

-Early Childhood caries

-Adolescent Caries/Teenage caries

-Adult Caries

Examples based on CHRONOLOGY

Early Childhood Caries

4-8 years

Nursing caries and Rampant caries

Adolescent Caries/ Teenage Caries

11-19 years

Caries is also described to be of a rapidly burrowing type, with small enamel opening

Adult Caries

55-65 years

Decreased salivary flow, root/cervical caries, associated with clasp

Type I(Mild)

Type II(Moderate)

Type III(Severe)

Types of Early Childhood Caries

Type I (Mild)

-Molars and incisors

-2-5 years

-Cariogenic semisolid food, lack of oral hygiene

Type II (Moderate)

-Unaffected mandibular incisors

-Soon after first tooth erupts

-Inappropriate feeding, lack of oral hygiene

Type III ( Severe)

-All teeth, cause: multitude of factors.

Class I - Class VI

GV Black Classification

Class I

-begin in pits, fissures +

defective grooves

-seen in occlusal surface

-occlusal two-thirds of molars

-lingual pits of incisors

Class II

-lesions seen on proximal

aspects of molars +

premolars

Class III

-lesions involving proximal

aspects of incisors

-do not involve or necessitate

removal of incisal edge

Class IV

-lesions involving proximal

aspects of incisors

-involve or require

removal of incisal edge

Class V

-lesions present on gingival

third of all teeth

Class VI

-esions found on incisal

edges + cusp tips

Enamel Caries

Dentinal Caries

Cemental Caries

Based on Tissue involved

WHO Classification

In this classification the shape depth of the caries lesion scored on a four point scale

D1

Clinically detectable enamel lesions with intact(non cavitated) surfaces

D2

clinically detectable cavities limited to enamel

D3

Clinically detectable cavities in dentin

D4

Lesions extending into the pulp

Senile Caries

Residual Caries

Other Classification

Senile Caries

-caries associated with aging

-almost exclusively seen on root surface

Residual Caries

-not removed during restorative

procedure

Mount G.J (1997)

He classified dental caries based on site and size

Site 1

includes lesion on PIT and FISSURES of posterior teeth ,buccal grooves of mandibular molars, palatal grooves of maxillary molars and erosion lesions on incisal edges.

Site 2

includes lesion in CONTACT AREAS of POSTERIOR and ANTERIORS

Site 3

includes lesion originating in GINGIVAL THIRD of all teeth

Size 0

SMALL and EARLY enough to be remineralized lesion with only residual stain

Size 1

(mild) includes lesions which have passed just beyond remineralization

Size 2

(moderate) Includes larger lesions, With adequate tooth structure to support restoration.

Size 3

(enlarged) includes lesions in which tooth structure and restoration are susceptible to fracture

Size 4

(severe) Includes lesions which have destroyed the major portion of the tooth structure

-Superficial caries

-Simple caries

-Deep seated caries

-Caries with almost exposed pulp

-Caries with pulp involvement

-Caries with perforation laterally or through the floor of the pulp

-Loss of Crown

-Caries of remaining root

Classification according to Mc Ghee (SSD CCC LC)

Superficial caries

Surface of enamel affected

Simple caries

penetration to DEJ

Deep seated caries

cavity of sufficient depth

Caries with almost exposed pulp

large well defined cavity