Podcast
Questions and Answers
What is the primary reason we focus on dental caries in healthcare budgets?
What is the primary reason we focus on dental caries in healthcare budgets?
What characterizes arrested or inactive caries?
What characterizes arrested or inactive caries?
Which of the following is NOT a reason that can contribute to arrested caries?
Which of the following is NOT a reason that can contribute to arrested caries?
What percentage of 5-year-olds in the UK have experienced dental caries?
What percentage of 5-year-olds in the UK have experienced dental caries?
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Which type of caries is characterized as a common cause of hospitalization in children?
Which type of caries is characterized as a common cause of hospitalization in children?
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What initiates the process of dental caries?
What initiates the process of dental caries?
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Which statement accurately describes dental caries?
Which statement accurately describes dental caries?
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How does the World Health Organization classify dental caries?
How does the World Health Organization classify dental caries?
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What is the first stage of dental caries progression?
What is the first stage of dental caries progression?
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Which factor is NOT considered a causative factor in dental caries?
Which factor is NOT considered a causative factor in dental caries?
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What is the relationship between dental caries and tooth decay prevalence?
What is the relationship between dental caries and tooth decay prevalence?
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What principle should vary based on clinical presentations of dental caries?
What principle should vary based on clinical presentations of dental caries?
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Which of the following is a key factor affecting the management of dental caries?
Which of the following is a key factor affecting the management of dental caries?
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What characteristic of enamel indicates that it is in an active state?
What characteristic of enamel indicates that it is in an active state?
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Which of the following is not a recommended treatment for arrested caries?
Which of the following is not a recommended treatment for arrested caries?
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What primary tissue is affected by root caries?
What primary tissue is affected by root caries?
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What indicator suggests that dentine is in an active caries state?
What indicator suggests that dentine is in an active caries state?
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Which factor contributes to the incidence of root caries?
Which factor contributes to the incidence of root caries?
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Which of the following is a challenge in maintaining oral hygiene for elderly patients susceptible to root caries?
Which of the following is a challenge in maintaining oral hygiene for elderly patients susceptible to root caries?
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Why is continued prevention important for patients with arrested caries?
Why is continued prevention important for patients with arrested caries?
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What is often a result of radiotherapy that can increase the risk of root caries?
What is often a result of radiotherapy that can increase the risk of root caries?
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What is the primary treatment for cavitated lesions that may endanger the pulp?
What is the primary treatment for cavitated lesions that may endanger the pulp?
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Which of the following is considered part of the management plan for patients with rampant caries?
Which of the following is considered part of the management plan for patients with rampant caries?
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In which situation should a tooth be restored with glass ionomer cement (GIC)?
In which situation should a tooth be restored with glass ionomer cement (GIC)?
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Early childhood caries is defined for children of what age range?
Early childhood caries is defined for children of what age range?
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Which feature can be commonly associated with the treatment of rampant caries?
Which feature can be commonly associated with the treatment of rampant caries?
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What characterizes pit and fissure caries?
What characterizes pit and fissure caries?
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Why might mandibular incisors be considered more immune to decay in cases of rampant caries?
Why might mandibular incisors be considered more immune to decay in cases of rampant caries?
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Which treatment is typically used for patients with uncontrollable sensitivity due to caries?
Which treatment is typically used for patients with uncontrollable sensitivity due to caries?
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What is the primary location of Class I caries?
What is the primary location of Class I caries?
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What distinguishes Class II caries from Class I?
What distinguishes Class II caries from Class I?
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Which statement accurately describes secondary caries?
Which statement accurately describes secondary caries?
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Where are Class V caries typically found?
Where are Class V caries typically found?
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What characterizes incipient caries?
What characterizes incipient caries?
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Which class of caries includes incisal edges?
Which class of caries includes incisal edges?
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What is residual caries?
What is residual caries?
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Which type of caries affects the cusp tips of posterior teeth?
Which type of caries affects the cusp tips of posterior teeth?
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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
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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.
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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.
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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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