Caries Detection and Diagnosis

Study Notes

Diagnosis of Caries

Diagnosis involves identifying disease through signs and symptoms, primarily informed by lesion detection and patient caries risk evaluation.
Clinicians make the final diagnosis decision based on initial findings and further assessments.

Methods of Caries Detection

Visual and Tactile Examinations
- Visual inspection is the most common but subjective; relies on color and texture.
- Limited detection ability for early, noncavitated lesions in enamel.
- Tactile examination uses explorers but rigorous probing can lead to further cavitation and bacterial invasion.
- Dental floss is effective for detecting caries, but can be misled by dental calculus.
- Methods are quick, easy, and don’t require expensive tools.
Radiographic Techniques
- Utilizes traditional and digital x-rays to locate caries, including proximal and secondary caries.
- Non-invasive method essential for assessing caries proximity to the pulp chamber.
- Common radiographs include periapical and bite-wing; identifies radiolucency indicating demineralization.
- Digital radiography enhances diagnostic yield and reduces radiation exposure; facilitates easy archiving and replication.
- Misdiagnosis can arise from superimposition, cone angulation, and film positioning issues.
Electrical Current Measurement
- Increased porosity in carious tissue results in higher fluid content, detectable by electrical resistance changes.
- The Electronic Caries Monitor (ECM) measures the "bulk resistance" of tooth tissue using fixed-frequency alternating current.
- Factors affecting ECM readings include tooth temperature, tissue thickness, hydration, and surface area.
- Provides objective data for monitoring lesion progression, arrest, or remineralization.
Visible Light Techniques
- Techniques include Fiber Optic Transillumination (FOTI), Digital image Fiber Optic Transillumination (DiFOTI), and Quantitative Light-induced Fluorescence (QLF).
- FOTI and DiFOTI exploit light scattering in sound versus carious enamel for detection.
Other Techniques
- Additional methods include the use of dyes, ultrasound techniques, and photo-thermal radiometry to detect caries.

Importance of Accurate Detection

Early detection is crucial for effective treatment and prevention of caries progression.
Different techniques provide a multi-faceted approach to diagnosing caries, enhancing overall dental care outcomes.

Description

Learn about the methods of caries detection and diagnosis, including visual and tactile examinations, radiographic techniques, and electrical current measurements. Understand the importance of caries risk assessment and the role of clinicians in making a final diagnosis.