UNIT 4 - Caries

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How is dental caries classified as a disease?

A multifactorial, biofilm-dependent, diet-mediated disease.

What processes characterize dental caries?

Episodes of demineralization and remineralization of dental tissues.

What does the term "caries" refer to exclusively?

The disease.

What should the term "caries" not be confused with?

The caries process or the resulting clinical lesion.

What does the caries process consist of?

A dynamic sequence of interactions between dental biofilm, the tooth surface, diet and host factors.

What type of diet contributes to the caries process?

A diet rich in fermentable carbohydrates.

What cycles does the caries process cause?

Repeated cycles of demineralization and remineralization.

What happens when mineral loss predominates during the caries process?

It may lead to the development of a caries lesion over time.

What is a caries lesion?

The consequence or clinical manifestation of the disease.

What causes the structural alteration seen in a caries lesion?

The caries process.

What determines the severity of a caries lesion?

The degree of progression.

What are the two main forms of caries lesions?

Initial non-cavitated lesions and cavitated lesions.

Which dental tissues can cavitated caries lesions affect?

Enamel and dentin.

What determines the clinical expression of a caries lesion?

The stage of lesion progression.

Are all caries lesions detectable during clinical examination?

no

Which caries lesions may go unnoticed during visual inspection?

Lesions located on proximal surfaces.

What are hidden caries lesions?

Lesions that progress beneath an apparently intact enamel surface.

What is the role of radiographic examination in detecting hidden caries?

It is an essential complementary tool.

What three purposes does radiographic examination serve in caries detection?

Detection, assessment of lesion extent and treatment planning.

What type of representation does radiography provide?

A two-dimensional representation of a three-dimensional structure.

What occurs because of the superimposition of different dental structures?

The actual extent of a caries lesion may not be fully appreciated.

How may radiography represent the size or depth of a caries lesion?

It may underestimate its size or depth.

How should radiographic examination be considered in relation to clinical examination?

As a complementary method.

What must be integrated to establish an accurate diagnosis of caries?

Information from both clinical and radiographic examinations.

Can clinical examination alone correctly detect and assess all caries lesions?

No.

Can radiography alone correctly detect and assess all caries lesions?

No.

When does a caries lesion become radiographically visible?

When mineral loss reaches a sufficient degree to produce a detectable difference in density on the image.

Why may initial caries lesions not be visible on radiographs?

They may not have sufficient mineral loss to produce a detectable difference in density.

Which initial caries lesions are particularly likely to be invisible on radiographs?

Lesions limited to enamel.

Can initial enamel caries be clinically present despite being invisible on radiographs?

yes

classification according to caries activity

What does the activity of a caries lesion refer to?

The likelihood that the lesion will continue to progress or that its progression has stopped.

classification according to caries activity

What is the primary method for assessing caries lesion activity?

Clinical examination.

classification according to caries activity

What two aspects are considered when assessing caries activity?

The characteristics of the lesion surface and its relationship with biofilm accumulation.

classification according to caries activity

What three characteristics of a caries lesion can radiography determine?

Location, depth and extent.

classification according to caries activity

What can radiography determine about a caries lesion's relationship with the pulp?

Its proximity to the pulp chamber.

classification according to caries activity

What else can radiography identify about a caries lesion?

Possible involvement of adjacent structures.

classification according to caries activity

Can radiography reliably classify a caries lesion as active or inactive?

no

classification according to caries activity

Which three surface characteristics are assessed when determining caries activity?

Colour, lustre and texture.

classification according to caries activity

What other factor is considered when assessing caries activity?

The presence of biofilm.

classification according to caries activity

Where is the lesion location assessed in relation to when determining caries activity?

Areas of bacterial plaque retention.

classification according to caries activity

What should the definitive diagnosis of caries be based on?

The integration of clinical and radiographic findings.

classification according to caries activity

• ACTIVE CAIRES LESION

What does an active caries lesion indicate?

An ongoing demineralization process.

classification according to caries activity

• ACTIVE CAIRES LESION

What colour can the enamel surface of an active caries lesion appear?

Whitish or yellowish.

classification according to caries activity

• ACTIVE CAIRES LESION

What is the appearance of the enamel surface in an active caries lesion?

Opaque.

classification according to caries activity

• ACTIVE CAIRES LESION

What happens to the natural lustre of enamel in an active caries lesion?

It loses its natural lustre.

classification according to caries activity

• ACTIVE CAIRES LESION

How does the surface of an active caries lesion feel when gently explored?

Rough or coarse.

classification according to caries activity

• ACTIVE CAIRES LESION

Which instrument is used to gently explore an active caries lesion?

A ball-ended probe.

classification according to caries activity

• ACTIVE CAIRES LESION

How much pressure should be applied when exploring an active caries lesion?

No pressure should be applied.

classification according to caries activity

• ACTIVE CAIRES LESION

Where are active caries lesions usually located?

In biofilm-retentive areas.

classification according to caries activity

• ACTIVE CAIRES LESION

Where can active caries lesions occur around pits and fissures?

At the entrance to pits and fissures.

classification according to caries activity

• ACTIVE CAIRES LESION

Where can active caries lesions occur near the gingiva?

At the gingival margin.

classification according to caries activity

• ACTIVE CAIRES LESION

Where can active caries lesions occur on proximal surfaces?

Immediately below or above the contact point.

classification according to caries activity

• ACTIVE CAIRES LESION

What is usually visible on an active caries lesion before cleaning?

An accumulation of dental plaque.

classification according to caries activity

• INACTIVE CAIRES LESION

What is an inactive caries lesion?

A lesion whose progression has stopped.

classification according to caries activity

• INACTIVE CAIRES LESION

What causes the progression of an inactive caries lesion to stop?

Restoration of the balance between demineralization and remineralization processes.

classification according to caries activity

• INACTIVE CAIRES LESION

What colour can the surface of an inactive caries lesion have?

Brown or black.

classification according to caries activity

• INACTIVE CAIRES LESION

What is the appearance of the enamel in an inactive caries lesion?

Usually shiny.

classification according to caries activity

• INACTIVE CAIRES LESION

How does the enamel surface of an inactive caries lesion feel when gently explored?

Smooth and hard.

classification according to caries activity

• INACTIVE CAIRES LESION

Which instrument is used to gently explore an inactive caries lesion?

A ball-ended probe.

classification according to caries activity

• INACTIVE CAIRES LESION

Where are inactive caries lesions usually located on smooth surfaces?

At some distance from the gingival margin.

classification according to caries activity

• INACTIVE CAIRES LESION

What does the location of inactive lesions away from the gingival margin reflect?

Better hygiene and biofilm control.

classification according to caries activity

• INACTIVE CAIRES LESION

Is there usually a significant accumulation of dental plaque on inactive lesions before cleaning?

No.

classification according to caries activity

• RAMPANT CARIES

What is rampant caries?

A clinical form characterized by multiple active, rapidly progressing lesions.

classification according to caries activity

• RAMPANT CARIES

How many teeth can rampant caries affect?

Numerous teeth simultaneously.

classification according to caries activity

• RAMPANT CARIES

Can rampant caries affect surfaces normally less susceptible to caries?

Yes.

classification according to caries activity

• RAMPANT CARIES

In which age groups is rampant caries observed more frequently?

Children and adolescents.

classification according to caries activity

• RAMPANT CARIES

What dietary factor is associated with rampant caries?

High consumption of fermentable sugars.

classification according to caries activity

• RAMPANT CARIES

What hygiene factor is associated with rampant caries?

Poor oral hygiene.

classification according to caries activity

• RAMPANT CARIES

What level of caries risk is associated with rampant caries?

High caries risk.

classification according to caries activity

• RAMPANT CARIES

What may rampant caries correspond to in early childhood?

Early childhood caries.

classification according to caries activity

• RAMPANT CARIES

What was early childhood caries previously called?

"Baby bottle caries"

classification according to caries activity

• RAMPANT CARIES

How is the term "baby bottle caries" currently considered?

Imprecise.

classification according to caries activity

• RAMPANT CARIES

What is usually observed radiographically in rampant caries?

Multiple radiolucent lesions in different teeth.

classification according to caries activity

• RAMPANT CARIES

Which two dental regions are frequently involved in rampant caries?

Cervical and proximal regions.

classification according to caries activity

• RAMPANT CARIES

How quickly can extensive lesions progress in rampant caries?

They rapidly reach the dentin.

DAGNOSIS AND DETECTION OF CARIES

What is diagnosis?

The process by which a disease is identified.

DAGNOSIS AND DETECTION OF CARIES

What is diagnosis based on?

Integration of clinical signs, symptoms and complementary tests.

DAGNOSIS AND DETECTION OF CARIES

What does caries diagnosis involve beyond detecting the presence of a lesion?

Assessing its extent, the risk and the activity of the cariogenic process.

DAGNOSIS AND DETECTION OF CARIES

Why must the extent, risk and activity of caries be assessed?

They are essential for establishing the most appropriate treatment plan.

DAGNOSIS AND DETECTION OF CARIES

What is the role of dental radiography in caries diagnosis?

A highly useful complementary tool for detection and assessment of caries lesions.

DAGNOSIS AND DETECTION OF CARIES

Which caries lesions are particularly useful to detect using dental radiography?

Lesions that are not clinically visible.

DAGNOSIS AND DETECTION OF CARIES

Where are clinically invisible caries lesions particularly likely to be located?

On proximal surfaces.

DAGNOSIS AND DETECTION OF CARIES

Can radiography determine whether a caries lesion is active or inactive?

No.

DAGNOSIS AND DETECTION OF CARIES

How must the activity of a caries lesion be assessed?

Through clinical examination.

DAGNOSIS AND DETECTION OF CARIES

How do caries lesions appear radiographically?

As radiolucent areas.

DAGNOSIS AND DETECTION OF CARIES

Why do caries lesions appear radiolucent on radiographs?

Due to mineral loss from the dental tissues.

DAGNOSIS AND DETECTION OF CARIES

What effect does demineralization have on the ability of dental tissues to absorb X-rays?

It decreases their ability to absorb X-rays.

What happens to the amount of radiation reaching the image receptor when dental tissues are demineralized?

A greater amount of radiation reaches the image receptor.

What radiographic density is produced by demineralized dental tissues?

Lower radiographic density.

Why must the limitations of dental radiography be understood?

To correctly interpret radiographic images.

What should always accompany radiographic interpretation of caries?

Clinical examination.

What can radiography detect in caries diagnosis?

Hidden lesions.

What can radiography assess about caries lesions?

Their location and extent.

What does radiography not provide information about?

Lesion activity.

Why does radiography have inherent limitations?

Because of limitations related to image formation.

How does the actual extent of a caries lesion usually compare with its radiographic appearance?

It is usually greater than that observed on the radiograph.

When does a caries lesion become radiographically visible?

When it has lost a sufficient amount of mineral content.