the localized destruction of teeth by microorganisms
Dental caries (tooth decay)
Normal mineralized tooth structure, which consists of_____________, __________________, and________________ is altered and destroyed by dental caries
enamel
dentin
cementum
The term caries comes from the Latin_____________, which means________________.
cariousus
rottenness
a carious lesion, or an area of tooth decay, is often referred to as a____________.
cavity
In dentistry, what term refers to a hole in the tooth that is the result of the caries process?
cavity
true or false. Dental examination for caries cannot be complete without radiographs.
true
Dental radiographs are used to determine the______________and________________of dental caries
extent
severity
true or false. Some carious lesions can be detected by simply looking in the mouth, while others can not.
true
All teeth must be examined clinically for dental caries with a____________and______________
mirror
explorer
What are 3 functions of the mouth mirror in clinical examination?
reflect light
indirect vision
retract tongue
What is the function of the explorer in clinic examination?
tactile to detect changes in consistency (catches or tug-backs) in pits, grooves, and fissures of teeth
What are 3 visible color changes that may indicate dental caries that are seen during a clinical examination?
pit stains
chalky white or opacities (demineralization)
interproximal discoloration
demineralization and destruction of hard tooth structures results in a loss of tooth_______________.
density
________________and_________________of hard tooth structures result in a loss of tooth density.
demineralization
destruction
Do dental caries appear radiolucent or radiopaque on a radiograph? Why is this?
Radiolucent
because decreased density of the caries allows greater penetration of x-ray
What is the type of x-ray recommended for the detection of caries?
bitewing x-ray
What are 3 helpful interpretation tips for the interpretation of caries on a radiograph?
correctly mounted films
correctly viewed films (light box)
magnifying glass
Where should the films be viewed and interpreted?
infront of the patient
What are 3 factors that may influence caries interpretation?
diagnostic quality
technical errors
exposure errors
What is a technical error that has a big effect on the diagnostic quality of a film?
horizontal angulation
What are 2 exposure factors that will influence caries interpretation?
contrast
density
caries found between 2 adjacent teeth
interproximal caries
Where are interproximal caries typically seen?
at or just below (apical to) the contact area.
Which area is difficult, if not impossible, to examine clinically with an explorer?
Interproximal spaces
What shape do caries exhibit when they are confined to the enamel?
triangular configuration with the point seen at the dentinoenamel junction (DEJ)
What happens as the caries reach the DEJ?
they spread laterally and continue through the dentin, forming another triangular configuration with the point towards the pulp chamber
Dental interproximal caries are classified by____________and_________________through the enamel and dentin
depth
penetration
What are the 4 classification types of interproximal carious lesions?
incipient
moderate
advanced
severe
interproximal carie that extends less than half way through the enamel, this is seen only in enamel.
incipient interproximal carie
class I
interproximal carie that extends more than half way through the thickness of enamel, but does not involve the DEJ, occurs only in enamel
moderate interproximal carie
class II
Interproximal carie that extends to or through the DEJ and into the dentin, but does not extend through the dentin more than half the distance towards the pulp, affects both enamel and dentin
advanced interproximal carie
class III
Interproximal carie that extends through enamel, through the dentin and more than half the distance towards the pulp, involves both the enamel and the dentin, and may be seen clinically as a cavitation in the tooth
severe interproximal carie
class IV
Caries that involve the chewing surface of the posterior teeth
occlusal caries
What is the method of choice for detection of occlusal caries?
clinical examination
Why are occlusal caries difficult to see on radiographs? When can you see them on radiographs?
because of the dense buccal and lingual enamel cusps
when it involves the DEJ
What are the 3 classification types of occlusal caries?
incipient
moderate
severe
occlusal caries that cannot be seen on a radiograph, you must detect with an explorer
incipient occlusal caries
Occlusal caries the extend into the dentin and appear as a thin radiolucent line located under the enamel, little or no change is seen in the enamel
Moderate occlusal caries
Occlusal caries the extend into dentin and appear as a large radiolucency that extends under the enamel of the occlusal surface of the tooth, it is seen clinically and appears as a cavitation in a tooth
severe occlusal carie
________________involves the buccal tooth surface, whereas___________________involves the lingual tooth surface.
buccal caries
lingual caries
Why are buccal and lingual caries so difficult to detect radiographically and must be clinically examined with an explorer?
because of the superimposition of the densities of normal tooth structure
How do caries that involve the buccal or lingual surface of the tooth appear radiographically?
as small, circular radiolucencies
Involves only the roots of teeth (not enamel) the cementum and dentin located just below the cervical region of the tooth.
root surface caries
__________________and corresponding______________________precede the root surface caries process and result in______________________.
bone loss
gingival recession
exposed root surfaces
true or false. Clinically, root surface caries is easily detected on exposed root surfaces
true
What are the most common locations for root surface caries?
exposed roots of:
-mandibular premolar areas
-mandibular molar areas
On a dental radiograph, what types of caries appear as a cupped-out or crater-shaped radiolucency just below the CEJ?
root surface caries
Caries that occur adjacent to a preexisting restoration
recurrent caries
What are 3 things that cause recurrent caries?
inadequate cavity preparation
defective margins
incomplete removal of caries before placement of restoration
Where is the most common place for recurrent caries?
beneath the interproximal margins of a restoration