Caries Risk and Detection Methods
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Questions and Answers

What is a common daily saliva production range for individuals?

  • 2.5 L - 3 L
  • 1.5 L - 2.5 L
  • 0.1 L - 0.5 L
  • 0.5 L - 1.5 L (correct)

A pH level below 6.5 indicates a high risk for cavities.

True (A)

What is xerostomia?

Reduced salivary function or dry mouth

Monomers are transformed into large polymer chains through a process called ______.

<p>polymerization</p> Signup and view all the answers

Match the disease indicators to their associated risks:

<p>Old Age = Increased risk for xerostomia Female Sex = Higher predisposition to oral diseases Anticholinergic medications = Potential for dry mouth Neurologic disease = Associated with reduced saliva production</p> Signup and view all the answers

Which fluorescence method uses red light at a wavelength of 655 nm?

<p>Diagnodent (B)</p> Signup and view all the answers

The ICDAS system includes stages ranging from 0 to 6.

<p>True (A)</p> Signup and view all the answers

What does QLF stand for in terms of a caries detection method?

<p>Quantitative Light Fluorescence</p> Signup and view all the answers

The _____ method reacts to porphyrins produced by biofilm.

<p>Diagnodent</p> Signup and view all the answers

Match the following caries assessment systems with their respective descriptions:

<p>ICDAS = Stages of caries based on visual examination Radiographic = Stages based on X-ray interpretation ADA = Stages categorized as sound, initial, moderate, advanced</p> Signup and view all the answers

What does a reading of 11-20 on the Diagnodent indicate?

<p>Outer half of Enamel (B)</p> Signup and view all the answers

Quantitative Light Fluorescence indicates health with no fluorescence.

<p>True (A)</p> Signup and view all the answers

What laser wavelength does SIROInspect utilize?

<p>405 nm</p> Signup and view all the answers

Which light cure unit uses a range from 450-480 nm?

<p>Gen I LED Curing Unit (C)</p> Signup and view all the answers

BHT is the least common photoinhibitor used in light-cured resins.

<p>False (B)</p> Signup and view all the answers

What is the main advantage of having a refractive index of the filler match that of the matrix?

<p>Better penetration of light</p> Signup and view all the answers

The __________ is better because the battery in the wireless option can reduce irradiance over time.

<p>wired LED curing unit</p> Signup and view all the answers

Match the following light cure units with their spectra:

<p>Gen I LED = 450-480 nm Halogen Curing Unit = 390-520 nm Plasma Curing Unit = 420-490 nm Pulsed Blue Laser = N/A</p> Signup and view all the answers

Which of the following statements regarding dentin and enamel shades is true?

<p>Dentin shade is darker than enamel shade. (C)</p> Signup and view all the answers

Light-curing units with high irradiance typically require a filter for UV light.

<p>True (A)</p> Signup and view all the answers

What is the primary disadvantage of the halogen curing unit?

<p>Bulb needs to be frequently replaced</p> Signup and view all the answers

Which method has the highest sensitivity for caries detection?

<p>Transillumination / NIDIT (C)</p> Signup and view all the answers

Dyes used in caries detection specifically stain bacteria in the affected area.

<p>False (B)</p> Signup and view all the answers

What are the two categories of caries based on the presence of pulp exposure?

<p>Caries Infected and Caries Affected</p> Signup and view all the answers

The sensitivity of visual examination for caries detection is ______.

<p>0.12</p> Signup and view all the answers

Match the following caries detection methods with their sensitivity ranges:

<p>Visual Examination = 0.12 Visible Light = 0.5-0.85 Radiography = 0.45-0.7 Impedance = 0.67-0.96</p> Signup and view all the answers

What activates MMPs that lead to the destruction of exposed dentin?

<p>Lactic acid from acidogenic bacteria (D)</p> Signup and view all the answers

Sclerotic dentin forms due to the occlusion and hypermineralization of superficial tubules.

<p>True (A)</p> Signup and view all the answers

What is the main difference between reactionary dentin and reparative dentin?

<p>Reactionary dentin is a mild response to stimuli, while reparative dentin forms in response to severe challenges like pulp exposure.</p> Signup and view all the answers

__________ Dentin is softer and more susceptible to caries.

<p>Demineralized</p> Signup and view all the answers

Match the following types of dentin with their descriptions:

<p>Sclerotic Dentin = Hypermineralization of tubules Reactionary Dentin = Mild calcification response Reparative Dentin = Response to pulp exposure Demineralized Dentin = Softer and more vulnerable to decay</p> Signup and view all the answers

What is the primary response triggered in the pulp by air or temperature changes according to Brannstrom’s Hydrodynamic Theory?

<p>Movement of odontoblasts in tubules (A)</p> Signup and view all the answers

ICDAS stage 5 indicates cavitation to dentin where more than half the tooth surface is affected.

<p>True (A)</p> Signup and view all the answers

List the ICDAS stages of lesion formation.

<p>1, 2, 3, 4, 5, 6</p> Signup and view all the answers

What is the mixing time for GC Fuji IX (GIC) recommended in the lab?

<p>7 seconds (A)</p> Signup and view all the answers

Dabbing Dycal onto the exposed site is the last step in the procedure.

<p>False (B)</p> Signup and view all the answers

What is the setting time for GC Fuji IX (GIC)?

<p>6 minutes</p> Signup and view all the answers

The final step in the procedure includes polishing with ______.

<p>composite polishers</p> Signup and view all the answers

Match the ICDAS stage descriptions with their respective numbers:

<p>Sound = 0 Distinct visual change = 1 Visible enamel opacity/discoloration = 2 Visible dentin = 5 Extensive dentin = 6</p> Signup and view all the answers

Which stage in the ICDAS system indicates extensive dentin exposure?

<p>Stage 5 (B)</p> Signup and view all the answers

GC Fuji Liner is applied after dabbing Dycal onto the exposed site.

<p>True (A)</p> Signup and view all the answers

What is the powder to liquid ratio for mixing GC Fuji IX (GIC)?

<p>0.4/0.11</p> Signup and view all the answers

Flashcards

Diagnodent

A fluorescence method for caries detection that uses red light (655 nm).

QLF (Quantitative Light Fluorescence)

A fluorescence method that uses blue light to assess caries.

ICDAS 0

Healthy tooth. No visual enamel change.

ICDAS 3

Visible dentin caries, affecting less than half of the tooth surface.

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Radiographic E2

Large enamel cavitation or wedge shadow on enamel.

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Radiographic D2

Moderate dentin. Funnel shape shadow, involving some dentin.

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ICDAS Stages

A caries detection method, categorized from 0 to 6 based on visual signs.

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ADA Stages

Stages for caries detection based on severity categorized into sound/initial/moderate/advanced stages

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Xerostomia

Reduced salivary function, also known as dry mouth.

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Cavities

A disease indicator potentially suggesting oral health problems.

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Salivary Function Test

A test to measure saliva production, including unstimulated and stimulated flow rates and pH.

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Photoinitiators

Chemicals activating polymerization with light exposure.

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Polymerization

Chemical reaction turning small molecules into large chains.

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Caries Detection Sensitivity

The ability of a caries detection method to accurately identify diseased teeth (true positive rate).

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Caries Detection Specificity

The ability of a caries detection method to accurately identify healthy teeth (true negative rate).

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Magnification and Sensitivity

Increasing magnification can lead to more false negatives, meaning it may miss some caries.

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Magnification and Specificity

Increasing magnification can lead to fewer false positives, meaning it's less likely to identify healthy teeth as diseased.

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Visual Caries Detection

Simple visual examination using the naked eye, often with a perio probe.

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LED Curing Unit Generations

Different generations of LED curing units with varying wavelengths and irradiance.

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LED Curing Unit Spectra

The range of light wavelengths emitted by an LED curing unit.

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Halogen Curing Unit Irradiance

The power of light emitted by a halogen curing unit, measured in mW/cm2.

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Halogen Curing Unit Type

Curing unit that uses quartz-tungsten-halogen (QTH) bulbs and emits white light.

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Plasma Curing Unit Irradiance

The power of the light emitted by a plasma curing unit, measured in mW/cm2.

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Shade Match Importance

Matching the shade of uncured and cured resin.

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Dentin/Enamel Shade Difference

Curing dentin longer than enamel because dentin shade is darker.

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Photoinhibitor Examples

Materials that reduce the sensitivity/activity of light curing.

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Zone of Destruction

A layer of dentin damaged by acidogenic bacteria, characterized by the breakdown of dentin by MMPs (matrix metalloproteinases) and loss of structure.

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Demineralized Dentin

Softer dentin that has lost minerals due to acid attack, making it more susceptible to further damage.

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Sclerotic Dentin

Hardened dentin that forms as a protective response to repeated stimuli like occlusion, resulting in hypermineralization of dentinal tubules.

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Brannstrom's Hydrodynamic Theory

Explains how changes in fluid pressure within dentinal tubules, caused by air, temperature, or pressure variations, trigger nerve responses in the pulp.

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Reactionary Dentin

A mild response to stimuli like caries, abrasion, or erosion, resulting in increased calcification by odontoblasts.

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Reparative Dentin

A more severe response to pulp exposure, often due to rapid caries or loss of saliva, involving formation of new dentin by pulp cells.

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Dycal

A calcium hydroxide-based material used as a base to protect the pulp from irritation during restorations.

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GC Fuji Liner

A dual-cured glass ionomer cement used as a liner under restorations, releasing fluoride.

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GC Fuji IX

A glass ionomer cement used for restorations, releasing fluoride.

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Resin Infiltration

A minimally invasive treatment for early caries lesions using a resin to seal the affected enamel.

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Study Notes

Caries Risk

  • Protective factors include saliva, sealants, antibacterials, fluoride, and effective habits considered in a risk-based reassessment.
  • Risk factors include bad bacteria, lack of saliva, and destructive habits.
  • Disease indicators include white spots, restorations under 3 years old, enamel lesions, cavities in dentin, high-risk areas (pits/fissures, root, cervical, interproximal), and plaque stagnation areas (restorations/ortho).
  • Caries detection methods include visual, visual + perio probe, visible light, transillumination/NIDIT, impedance, radiography, and dyes.
  • Sensitivity is the true positive rate, calculated by dividing true positives by the sum of true positives and false negatives.
  • Specificity is the true negative rate, calculated by dividing true negatives by the sum of true negatives and false positives.
  • Magnification can increase sensitivity but decrease specificity for some methods of caries detection.

Caries Detection Methods

  • Visual: Visual examination; sensitivity 0.12, specificity 0.93
  • Visual + Perio Probe: Visual exam with probing; sensitivity 0.14–0.80, specificity 0.93.
  • Visible Light: Visual exam with visible light; sensitivity 0.5–0.85, specificity 0.95.
  • Transillumination/NIDIT: Uses IR light (780 nm); sensitivity 0.68, specificity 0.93.
  • Impedance: Uses closed circuit AC Impedance Spectroscopy Technique (ACIST); sensitivity 0.67–0.96, specificity 0.71–0.98.
  • Radiography: X-rays; sensitivity 0.45–0.7, specificity 0.70–0.97.
  • Dyes: Stains demineralized dentin (e.g., methylene blue, fuchsin red); sensitivity 0.71–0.74, specificity 1.00.

ICDAS Stages

  • Stages 0-6: Described visually and radiographically
  • Stage 1: First visual enamel change
  • Stage 2: Small enamel cavity
  • Stage 3: Large enamel cavity, wedge shape, visible dentin shadow
  • Stage 4: Dentin affected visible shadow
  • Stage 5: Visible dentin funnel to pulp shadow
  • Stage 6: Extensive visible dentin, more than half of tooth surface affected

Risk Assessment

  • High, Medium, and Low Risk Categories
  • Factors include white spots, restorations, destructive habits, reduced salivary function, absence of saliva, age, sex, anticholinergic/sympathomimetic medications, and frequency of xerostomia.

Caries Risk Management

  • Different risk levels have different management strategies for recalls, radiographs, antibacterial treatments, fluoride therapies, diet, and saliva.

Sugar Consumption

  • Children (2-19 y/o) - girls have 15 teaspoons, boys have 18 teaspoons
  • Adults (20+ y/o) - girls have 15 teaspoons, boys have 19 teaspoons
  • Daily Average Intake: 17 teaspoons/71.14 g
  • WHO Guideline - < 10% of total energy intake
  • AHA Guideline - < 6 teaspoons per daily (for girls), < 9 teaspoons per daily (boys).

Sugar Types

  • Polysaccharides (e.g., fiber, glycogen, starch, amylose, amylopectin, etc.)
  • Disaccharides (e.g., sucrose, lactose, maltose)

Artificial Sweeteners

  • Much stronger than sugars (or sugar alcohols)
  • High Acceptable Daily Intake amounts (ADI)

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Description

This quiz explores the critical factors involved in assessing caries risk, including protective and risk factors, disease indicators, and various detection methods. Test your knowledge on the sensitivity and specificity of these methods and their implications in dental practices. Understand how to effectively assess caries risk for better oral health outcomes.

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