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Questions and Answers
What is the main purpose of caries investigations?
What is the main purpose of caries investigations?
Information gathering and making a final diagnosis.
Which of the following factors measure the effectiveness of an investigation?
Which of the following factors measure the effectiveness of an investigation?
- Specificity (correct)
- Reproducibility
- Sensitivity (correct)
- Ease of use
What is the primary method used to detect caries in patients?
What is the primary method used to detect caries in patients?
- Percussion tests
- Clinical examination
- Radiographs (correct)
- Pulp vitality test
Radiographs are always reliable in detecting caries immediately.
Radiographs are always reliable in detecting caries immediately.
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The radiographic appearance of caries is ___ months behind the actual histologic spread.
The radiographic appearance of caries is ___ months behind the actual histologic spread.
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What is a disadvantage of bitewing radiographs?
What is a disadvantage of bitewing radiographs?
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Match the following radiographic types with their uses:
Match the following radiographic types with their uses:
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Study Notes
Caries Investigations
- Caries investigations gather information to assist with diagnosis and identify the potential cause of tooth decay.
- All investigations are prone to both false positive and false negative results.
Factors for Evaluating Investigations
- Sensitivity: Measures how well an investigation can detect a true disease
- Specificity: Measures how well an investigation can determine true health
Common Caries Investigations
- Radiographs: Used to visualize tooth structures that cannot be readily seen clinically.
- Intraoral Radiographs: Most common type, including bitewing radiographs for assessing interproximal surfaces.
- Extraoral Radiographs: Primarily for orthodontic treatment and situations where the patient cannot open their mouth widely
- Periapical Radiographs: Used to examine structures surrounding the tooth root, including the alveolar bone (the bone that supports the teeth).
- Periapical radiographs can also reveal the presence of restorations and potential problems in the periapical area (the area at the tip of the root).
- Pulp Vitality Test: Assesses the health of the tooth's nerve (pulp).
- Percussion Tests: Used to evaluate the sensitivity of the tooth to tapping.
Radiographs for Caries Detection
- Bitewing Radiographs: Preferred for detecting lesions on the proximal surfaces (sides) of posterior teeth.
- Proper film holder and beam aiming techniques are essential for accurate angled images.
- The beam should be perpendicular to the contact points between teeth for more reliable results.
- Periapical Radiographs: Used to assess the depth of proximal lesions on anterior teeth.
- Radiographic Limitations:
- Incipient (early) occlusal lesions are difficult to detect on radiographs.
- Later stage occlusal lesions are clearly visible.
- Radiographs cannot accurately depict the depth of proximal lesions on anterior teeth.
- Radiographic Time Lag:
- A significant time lag exists between the actual histologic spread of caries and its appearance on radiographs (at least 6 months).
- This is because caries must progress to a certain extent to become radiolucent (black) on the image.
- This means that caries may be present before it becomes detectable on a radiograph.
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