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Questions and Answers
Which class of caries is characterized by pits and fissures on the occlusal surfaces of premolars and molars?
Which class of caries is characterized by pits and fissures on the occlusal surfaces of premolars and molars?
What designation is given to caries affecting previously treated tooth surfaces?
What designation is given to caries affecting previously treated tooth surfaces?
Which class of caries includes the gingival one-third of facial or lingual surfaces?
Which class of caries includes the gingival one-third of facial or lingual surfaces?
What is the term for the first signs of carious activity that have not reached the amelodentinal junction?
What is the term for the first signs of carious activity that have not reached the amelodentinal junction?
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Which class of caries involves proximal surfaces of anterior teeth, including parts of the incisal edge?
Which class of caries involves proximal surfaces of anterior teeth, including parts of the incisal edge?
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What is the primary cause of dental caries?
What is the primary cause of dental caries?
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Why is dental caries classified as a significant healthcare issue worldwide?
Why is dental caries classified as a significant healthcare issue worldwide?
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What percentage of healthcare budgets in industrialized countries is spent on treating dental caries?
What percentage of healthcare budgets in industrialized countries is spent on treating dental caries?
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What is the process of dental caries characterized by?
What is the process of dental caries characterized by?
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Which factor does NOT contribute to the development of dental caries?
Which factor does NOT contribute to the development of dental caries?
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What does the estimated figure of 2.3 billion refer to in relation to dental caries?
What does the estimated figure of 2.3 billion refer to in relation to dental caries?
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What is the consequence of irreversible dental caries?
What is the consequence of irreversible dental caries?
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What does the term 'aetiology' in the context of dental caries refer to?
What does the term 'aetiology' in the context of dental caries refer to?
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What is a primary treatment option for managing root caries when isolation is not achievable?
What is a primary treatment option for managing root caries when isolation is not achievable?
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Which of the following conditions indicates the need to restore a cavitated lesion?
Which of the following conditions indicates the need to restore a cavitated lesion?
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Which of these conditions is categorized under rampant caries?
Which of these conditions is categorized under rampant caries?
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What is the recommended approach for children under 6 years with caries?
What is the recommended approach for children under 6 years with caries?
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What characteristic is typically associated with an active enamel surface?
What characteristic is typically associated with an active enamel surface?
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What is the focus of treatment for patients with rampant caries?
What is the focus of treatment for patients with rampant caries?
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What type of caries occurs specifically between teeth?
What type of caries occurs specifically between teeth?
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Which statement is true regarding dentine in inactive caries?
Which statement is true regarding dentine in inactive caries?
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What is one of the characteristics of rampant caries?
What is one of the characteristics of rampant caries?
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Which measure is NOT suggested for treating arrested caries?
Which measure is NOT suggested for treating arrested caries?
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What is the primary tissue affected by root caries?
What is the primary tissue affected by root caries?
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When is a rubber dam ideally used in treatment?
When is a rubber dam ideally used in treatment?
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Which factor contributes to the risk of root caries?
Which factor contributes to the risk of root caries?
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What term previously referred to early childhood caries?
What term previously referred to early childhood caries?
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What characterizes arrested caries?
What characterizes arrested caries?
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Which type of caries can result from persistent plaque retention?
Which type of caries can result from persistent plaque retention?
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Which of the following is NOT considered a characteristic of early childhood caries?
Which of the following is NOT considered a characteristic of early childhood caries?
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What is a common challenge in providing oral hygiene instruction to elderly patients?
What is a common challenge in providing oral hygiene instruction to elderly patients?
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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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What is indicated when treating root caries with fluoride?
What is indicated when treating root caries with fluoride?
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What follows the exposure of root surfaces due to recession?
What follows the exposure of root surfaces due to recession?
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Which of the following best explains the concept of 'white spot lesions'?
Which of the following best explains the concept of 'white spot lesions'?
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Which of the following is NOT a type of dental caries described?
Which of the following is NOT a type of dental caries described?
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How can radiotherapy indirectly contribute to root caries?
How can radiotherapy indirectly contribute to root caries?
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What is one reason for the shift to favor remineralisation in arrested caries?
What is one reason for the shift to favor remineralisation in arrested caries?
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What should continue for patients with arrested caries?
What should continue for patients with arrested caries?
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How can the balance between demineralisation and remineralisation favor remineralisation?
How can the balance between demineralisation and remineralisation favor remineralisation?
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Which type of caries refers to decay that occurs on the roots of teeth?
Which type of caries refers to decay that occurs on the roots of teeth?
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Which of the following statements is true regarding active and inactive caries?
Which of the following statements is true regarding active and inactive caries?
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What term is used to describe the presence of multiple carious lesions?
What term is used to describe the presence of multiple carious lesions?
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Study Notes
Dental Caries Overview
- Dental caries is a dynamic process of demineralization and remineralization.
- It is caused 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 prolonged exposure makes it irreversible.
GDC Learning Outcomes
- Describe oral diseases and their relevance to prevention, diagnosis, and treatment.
- Explain the etiology and pathogenesis of oral diseases.
- Assess and manage caries, occlusion, and tooth wear; restore dentition with minimal intervention, maintaining function and aesthetics, where appropriate.
Intended Learning Outcomes
- Explain worldwide healthcare issues associated with dental caries.
- Describe dental caries based on causative factors, anatomical location, and stage of progression.
- Explain how basic management principles may vary for different clinical presentations of dental caries.
Aetiology of Dental Caries
- Caries is influenced by the interplay of time, susceptible tooth surface, fermentable carbohydrates, and plaque bacteria.
Histopathology of Enamel and Dentine Caries
- This is a subject of pre-reading material.
Types of Dental Caries
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Arrested/Inactive Caries:
- When the balance between demineralization and remineralization favors remineralization, the carious lesions may heal.
- Reasons for the balance shift to remineralisation can include improved oral hygiene or prevention measures, removal of plaque retention factors.
- Treatments may include fluoride application and restorations for cosmetic reasons.
- Requires continued prevention as arrested caries indicate an increased risk of future caries.
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Root Caries:
- Primary tissue affected (initial stage): cementum
- Rapidly progresses to dentine.
- Occurs when root surfaces are exposed due to recession.
- Followed by bacterial colonization.
- Progresses faster than enamel caries due to cementum's softer nature.
- Etiology (causes): Decreased salivary flow (xerostomia) reduces sugar clearance and mineral reservoir on the tooth surface.
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Treatment:
- Preventative measures: oral hygiene, diet advice (sugar-free sweets), fluoride. Oral hygiene can be challenging for elderly patients due to physical impairments.
- Treatment: restoring with glass ionomer cement (fluoride-releasing) or composite resin, saliva substitutes, medications like pilocarpine, and tooth mousse.
- When to restore: Cavitated lesions posing a risk to pulp (nerves). Uncontrollable sensitivity. Inhibition of plaque control. If active and not arrested.
- Treatment technique: Isolation (ideally rubber dam) if adequate enamel and isolation possible. If not possible composite or glass ionomer cement.
-
Early Childhood Caries:
- Defined by presence of one or more decayed, missing, or filled (due to decay) tooth surfaces in preschool-age children (birth to 71 months).
- Primarily in primary teeth.
- Previously termed bottle caries or nursing caries.
- Essentially refers to any child under 6 who has decay.
- Further information in paediatric dentistry lectures.
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Rampant Caries:
- Extensive form of caries.
- Impacts multiple teeth.
- Characterized by rapid progression.
- Often more immune to decay in select areas (e.g. mandibular incisors)
- Subgroups include: early childhood rampant caries, xerostomia-induced rampant caries, and radiation-induced rampant caries.
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Treatment:
- Extensive prevention.
- Stabilization: using temporary restorations to assess response to prevention prior to definitive restorations.
- Review treatment with conventional management of caries lectures.
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Caries based on anatomical position:
- Smooth surface caries: Described as caries on smooth surfaces.
- Pit and fissure caries: Described as caries in pits and fissures.
- Interproximal caries: Caries between teeth, typically below contact points where bacteria accumulate easily.
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GV Black Classification: Used to technically classify restoration designs related to cavity preparation. Can also be used to describe caries locations for treatment purposes.
- Class I, II, III, IV, V, and VI have different tooth and surface locations.
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Primary/Secondary Caries:
- Primary caries: caries affecting a previously untreated tooth surface.
- Secondary caries: caries affecting a previously treated tooth surface (e.g. after restoration or fissure sealant).
-
Residual Caries:
- Caries remaining after restoration.
- May be intentional (e.g. close to pulp, sealants) or unintentional (e.g., missed decay before restoration).
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White spot lesions/Incipient Caries:
- Initial evidence of carious activity not yet in the dentine.
- Can be remineralized with preventative measures.
- May also be termed reversible caries or present as white spot lesions.
Follow-up Reading
- Detection of dental caries lecture.
- Caries prevention lectures.
- Caries management lectures.
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Description
Explore the dynamic process of dental caries, including its causes, effects, and management techniques. This quiz covers the etiology, prevention, and treatment methods associated with oral diseases, specifically focusing on tooth demineralization and remineralization.
