Describing Dental Caries
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Questions and Answers

What is the primary reason we focus on dental caries in healthcare budgets?

  • They account for a significant portion of health care costs. (correct)
  • They are a leading cause of chronic diseases.
  • They contribute to cosmetic dental issues.
  • They only affect children in developing countries.

What characterizes arrested or inactive caries?

  • The balance favors remineralisation, often leaving a 'scar'. (correct)
  • They are predominantly found in primary teeth.
  • They progress rapidly and require immediate treatment.
  • They can completely heal without any intervention.

Which of the following is NOT a reason that can contribute to arrested caries?

  • Increased plaque retention. (correct)
  • Improved oral hygiene.
  • Increased awareness about dental health.
  • Removal of plaque-retaining factors.

What percentage of 5-year-olds in the UK have experienced dental caries?

<p>23% (B)</p> Signup and view all the answers

Which type of caries is characterized as a common cause of hospitalization in children?

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

What initiates the process of dental caries?

<p>Acids produced by bacteria digesting carbohydrates (B)</p> Signup and view all the answers

Which statement accurately describes dental caries?

<p>It is a dynamic process involving demineralisation and remineralisation. (D)</p> Signup and view all the answers

How does the World Health Organization classify dental caries?

<p>As a non-infectious disease. (A)</p> Signup and view all the answers

What is the first stage of dental caries progression?

<p>Reversible demineralisation (D)</p> Signup and view all the answers

Which factor is NOT considered a causative factor in dental caries?

<p>Diet high in protein (A)</p> Signup and view all the answers

What is the relationship between dental caries and tooth decay prevalence?

<p>Tooth decay is the most prevalent form of dental caries. (C)</p> Signup and view all the answers

What principle should vary based on clinical presentations of dental caries?

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

Which of the following is a key factor affecting the management of dental caries?

<p>The patient's age (B)</p> Signup and view all the answers

What characteristic of enamel indicates that it is in an active state?

<p>Enamel surface is shiny (C)</p> Signup and view all the answers

Which of the following is not a recommended treatment for arrested caries?

<p>Root canal therapy (C)</p> Signup and view all the answers

What primary tissue is affected by root caries?

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

What indicator suggests that dentine is in an active caries state?

<p>Dentine feels rough and wet on probing (B)</p> Signup and view all the answers

Which factor contributes to the incidence of root caries?

<p>Exposure of root surfaces due to recession (A)</p> Signup and view all the answers

Which of the following is a challenge in maintaining oral hygiene for elderly patients susceptible to root caries?

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

Why is continued prevention important for patients with arrested caries?

<p>The factors causing the initial lesion may return (D)</p> Signup and view all the answers

What is often a result of radiotherapy that can increase the risk of root caries?

<p>Damage to salivary glands (C)</p> Signup and view all the answers

What is the primary treatment for cavitated lesions that may endanger the pulp?

<p>Restoration with composite resin (A)</p> Signup and view all the answers

Which of the following is considered part of the management plan for patients with rampant caries?

<p>Extensive prevention measures (D)</p> Signup and view all the answers

In which situation should a tooth be restored with glass ionomer cement (GIC)?

<p>When isolation is not possible and there is no remaining enamel (D)</p> Signup and view all the answers

Early childhood caries is defined for children of what age range?

<p>Birth to 71 months of age (B)</p> Signup and view all the answers

Which feature can be commonly associated with the treatment of rampant caries?

<p>Temporary restorations for stabilization of tooth condition (D)</p> Signup and view all the answers

What characterizes pit and fissure caries?

<p>Develops in the grooves of teeth where plaque can accumulate (A)</p> Signup and view all the answers

Why might mandibular incisors be considered more immune to decay in cases of rampant caries?

<p>Other teeth are more prone to rapid progression of decay (B)</p> Signup and view all the answers

Which treatment is typically used for patients with uncontrollable sensitivity due to caries?

<p>Restoration of the cavity (D)</p> Signup and view all the answers

What is the primary location of Class I caries?

<p>Occlusal surfaces of premolars and molars (D)</p> Signup and view all the answers

What distinguishes Class II caries from Class I?

<p>Class II occurs on proximal surfaces (D)</p> Signup and view all the answers

Which statement accurately describes secondary caries?

<p>It occurs on a previously treated surface (C)</p> Signup and view all the answers

Where are Class V caries typically found?

<p>Gingival 1/3 of facial and lingual surfaces (A)</p> Signup and view all the answers

What characterizes incipient caries?

<p>It is the initial sign of carious activity (A)</p> Signup and view all the answers

Which class of caries includes incisal edges?

<p>Class IV (C)</p> Signup and view all the answers

What is residual caries?

<p>Caries that remains after a restoration (C)</p> Signup and view all the answers

Which type of caries affects the cusp tips of posterior teeth?

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

Flashcards

Arrested/Inactive Caries

A type of tooth decay where the balance between tooth dissolving (demineralization) and tooth rebuilding (remineralization) shifts in favor of rebuilding.

White Spot Lesion

A white spot that appears on the tooth surface, indicating early tooth decay.

Pit/Fissures Caries

The most common type of tooth decay, affecting the outer layer of the tooth, usually around the chewing surfaces.

Smooth Surface Caries

Tooth decay that occurs on the smooth surfaces of the tooth, typically where the tooth is exposed to sugars.

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Root Caries

A form of tooth decay that affects the root of the tooth, often occurring in older adults with receding gums.

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What is dental caries?

A dynamic process of demineralization and remineralization of tooth enamel caused by acids produced from bacterial digestion of carbohydrates on the tooth surface. This process can be reversible in its initial stages but becomes irreversible as it progresses.

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Define Dental Caries

The breakdown of tooth enamel and dentin caused by acids produced by bacteria in plaque.

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Why is dental caries a significant health concern?

The most prevalent non-communicable disease in the world, affecting a large portion of the global population.

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What is the initial stage of dental caries?

The initial stage of dental caries where the enamel is affected, and the process can still be reversed.

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What is the advanced stage of dental caries?

When the caries progresses beyond the enamel and penetrates into the dentin. This stage requires intervention as it is irreversible.

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What is the management of dental caries?

The process of removing decayed tooth structure and restoring it with filling materials, crowns or other appropriate treatments.

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Define minimal intervention in the context of dental caries management.

The process of removing decay and restoring the tooth with minimal intervention. This aims to preserve as much tooth structure as possible.

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What are the causative factors of dental caries?

The factors that cause or contribute to the development of dental caries. This includes factors such as bacterial presence, sugar intake, and individual susceptibility.

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Arrested Caries

Caries that has stopped progressing due to a shift in the balance towards remineralization. This doesn't mean it's cured, it's just stable for now.

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Arrested Caries Treatment

Treatment for arrested caries includes measures to prevent further decay, like fluoride application, and may involve restoration for aesthetic concerns.

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Root Caries: Cause

Root caries is often caused by decreased salivary flow, which reduces the mouth's ability to clear sugars and minerals.

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Root Caries Progression

Root caries, unlike enamel decay, progresses quickly due to the softer nature of cementum compared to enamel.

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Root Caries Prevention

Preventing root caries involves maintaining good oral hygiene, reducing sugar intake, and using fluoride products.

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Root Caries Treatment

Root caries treatment aims to manage the decay and prevent further progression, often through procedures like fillings or crowns.

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Radiotherapy and Root Caries

Radiotherapy can damage salivary glands leading to decreased saliva and making root caries more likely.

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What is Class I caries?

Caries occurring on the chewing surfaces of premolars and molars, the occlusal 2/3 of buccal and lingual surfaces and the palatal surfaces of anterior teeth.

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What is Class II caries?

Caries located on the surfaces between premolars and molars.

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Describe Class III caries.

Caries on the surfaces between the front teeth (incisors and canines), not involving the biting edge.

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What is Class IV caries?

Caries on the surfaces between the front teeth, involving the biting edge.

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What is Class V caries?

Caries on the gum line of all teeth, affecting the facial, lingual or palatal surfaces.

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Describe Class VI caries.

Caries on the biting edges of front teeth or the points of back teeth, not affecting any other surface.

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What is primary caries?

Caries on a tooth surface that has never been treated before.

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What is secondary caries?

Caries on a tooth surface that has previously been treated with a restoration.

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Early Childhood Caries (ECC)

The presence of decay, missing, or filled tooth surfaces in any primary tooth in a child between birth and 71 months old.

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Rampant Caries

An extensive form of caries where multiple teeth are affected by rapidly progressing decay. Often affects typically more immune teeth.

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Stabilization (Rampant Caries)

A treatment approach for rampant caries, where temporary restorations are placed to assess response to prevention before definitive restorations.

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Pit and Fissure Caries

Caries that occurs in the pits and fissures (grooves) of the tooth surface, usually around the chewing surfaces.

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Interproximal Caries

Caries that occurs between the teeth, affecting the interproximal surfaces.

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Prevention (Rampant Caries)

A treatment approach for rampant caries that focuses on extensive preventative measures to halt the progression of decay.

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Study Notes

Dental Caries

  • Dental caries (decay) is a dynamic process of demineralization and remineralization.
  • Decay is initiated by acids produced when bacteria in the mouth digest carbohydrates on the tooth surface.
  • These acids demineralize the tooth surface, leading to the destruction of dental tissues.
  • Initially, the process is reversible, but it can become irreversible.

GDC Learning Outcomes

  • Describe oral diseases and their relevance to prevention, diagnosis, and treatment.
  • Explain the aetiology and pathogenesis of oral disease.
  • Assess and manage caries, occlusion, and tooth wear. Restore the dentition using minimal intervention to maintain function and aesthetics.

Intended Learning Outcomes

  • Explain the worldwide healthcare issues associated with dental caries.
  • Describe dental caries based on its causative factors.
  • Describe dental caries based on its anatomical location.
  • Describe dental caries based on its stage of progression.
  • Explain how basic management principles may vary for different clinical presentations of dental caries.

Aetiology of Dental Caries

  • Caries formation involves susceptible tooth surfaces, plaque, bacteria, and fermentable carbohydrates.
  • Time, fermentable carbohydrates, plaque, and bacteria are all involved in the process.

Histopathology of Enamel and Dentine Caries

  • Information about the microscopic structure of enamel and dentine in carious lesions.

Types of Dental Caries

  • Arrested/Inactive: Demineralization and remineralization are balanced. The lesion may have healed, leaving a scar.
    • Reasons for arrest: improved oral hygiene or removal of a plaque retention cause.
    • Characteristics: White or slightly discoloured area, smooth and hard texture on probing
    • Treatment: Fluoride application, composite or glass ionomer cement (if discolouration is a concern).
  • Root Caries: Affects cementum and dentine, primarily occurs when roots are exposed due to recession. Progression is faster due to the softer cementum. This results from decreased salivary flow, xerostomia, and frequent consumption of sugar. -Treatment: Preventative measures (oral hygiene instruction, fluoride use, diet advice). Treatment (restorations with glass ionomer cement (fluoride releasing) or composite resin). -Treatment considerations: isolation is challenging (ideal use of rubber dam); if adequate enamel is present, use of composite; if enamel is absent, use of GIC materials
  • Early Childhood Caries: Presence of one or more decayed, missing, or filled primary teeth in preschool-aged children (0–71 months). Often related to prolonged exposure to sugary liquids from bottles/nursing.
  • Rampant Caries: Extensive decay affecting several teeth, due to rapid progression or immune characteristics in certain teeth.
    • Treatment needs vary; some need extensive preventive measures, others need stabilisation with temporary restorations to assess response to interventions.
  • Caries Based on Anatomical Position: Caries are classified by location:
    • Class I: Pit and fissure caries on occlusal surfaces of premolars and molars.
    • Class II: Proximal caries on premolars and molars.
    • Class III: Proximal caries on incisors and canines, not involving the incisal edge.
    • Class IV: Proximal caries on incisors and canines, involving the incisal edge.
    • Class V: Gingival caries on the facial and lingual surfaces of all teeth.
    • Class VI: Incisal or cusp tip caries on anterior or posterior teeth without affecting another surface..
  • Primary/Secondary: Primary caries targets untreated surfaces. Secondary caries targets previously treated surfaces (e.g., a filling).
  • Residual Caries: Remaining caries after restoration. This can be accidental or intentional (e.g., close to pulp, sealing with fissure sealant).
  • White Spot Lesions/Incipient Caries: The initial evidence of carious activity. These lesions may reverse with proper preventative procedures, exhibiting as white spots.

Follow up Reading

  • Detection of dental caries
  • Caries prevention lectures
  • Caries management lectures

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