International Caries Classification Flashcards

Questions and Answers

What does ICCMS stand for?

International Caries Classification and Management System

What is element 1 of ICCMS?

History - patient level CRA

What is element 2 of ICCMS?

Classification: Staging and lesion activity with intraoral CRAs

What is element 3 of ICCMS?

Decision making: Synthesis and diagnosis Signup and view all the answers

What is element 4 of ICCMS?

Management: Personalized caries prevention, control, and tooth preserving operative care Signup and view all the answers

What are ICCMS sound surfaces in ICDAS codes?

Code 0 Signup and view all the answers

What are ICCMS initial stage caries in ICDAS codes?

Code 1 and 2 Signup and view all the answers

What are ICCMS moderate stage caries in ICDAS codes?

Code 3 and 4 Signup and view all the answers

What are ICCMS extensive stage caries in ICDAS codes?

Code 5 and 6 Signup and view all the answers

What are signs of an active initial or moderate caries stage?

Surface of enamel is white/yellowish, opaque with loss of luster, rough, covered by thick plaque Signup and view all the answers

What are the signs of an inactive initial or moderate caries stage?

Surface of enamel is whitish, brownish, or black, shiny, feels hard and smooth Signup and view all the answers

What are the signs of an active extensive caries lesion stage?

Dentin feels soft or leathery on gentle probing Signup and view all the answers

What are the signs of an inactive extensive caries lesion?

Dentin is shiny and hard on gentle probing Signup and view all the answers

How should you visualize proximal lesions?

Direct visual exam following tooth separation Signup and view all the answers

What stage is RA?

Initial (1-3) Signup and view all the answers

What stage is RB?

Moderate (4) Signup and view all the answers

What stage is RC?

Extensive (5-6) Signup and view all the answers

What does RA1 indicate?

Radiolucency in outer 1/2 enamel Signup and view all the answers

What does RA2 indicate?

Radiolucency in inner 1/2 enamel +/- DEJ Signup and view all the answers

What does RA3 indicate?

Radiolucency limited to outer 1/3 dentin Signup and view all the answers

What does RB4 indicate?

Radiolucency reaching middle 1/3 dentin Signup and view all the answers

What does RC5 indicate?

Radiolucency reaching inner 1/3 dentin; clinically cavitated Signup and view all the answers

What does RC6 indicate?

Radiolucency into the pulp; clinically cavitated Signup and view all the answers

How do you determine if a lesion is active based on a radiograph?

Clinically cavitated or radiographic progression Signup and view all the answers

How do you manage a low caries risk patient?

Brush 2/day with fluoride toothpaste, motivational engagement (including diet), maintain dental visits at risk based intervals Signup and view all the answers

How do you manage moderate caries risk patients?

In addition to low caries risk interventions: could use high fluoride toothpaste, general behavior modification, fluoride mouthrinse, sealants, fluoride varnish 2/year, fluoride gels/solutions, recalls up to every 3 mo, motivational interviewing, dietary intake interventions, altering medication-induced hyposalivation, reducing use of recreational drugs Signup and view all the answers

How do you manage high caries risk patients?

In addition to low and moderate risk interventions: increase fluoride varnish to 4/year, topical fluoride application, counseling to reduce sugar amount and frequency Signup and view all the answers

What radiographs best depict caries progression?

Multiples series of radiographs Signup and view all the answers

Study Notes

ICCMS Overview

ICCMS stands for International Caries Classification and Management System.
Aims to maintain oral health and preserve tooth structure with a personalized, risk-adjusted approach.
Emphasizes preventive care and tooth-preserving management plans.

Components of ICCMS

Element 1: History - Patient Level CRA
- Involves collecting comprehensive patient history for caries risk assessment (CRA).
Element 2: Classification
- Staging of caries and assessment of lesion activity using intraoral CRAs.
Element 3: Decision Making
- Incorporates synthesis of information and accurate diagnosis for effective treatment planning.
Element 4: Management
- Focuses on personalized strategies for caries prevention, control, and tooth-preserving operative care.

ICDAS Classification Codes

Code 0: Sound Surfaces
- No visible evidence of caries when viewed clean or after air drying.
Codes 1 and 2: Initial Stage Caries
- Visual changes in enamel, such as opacity or discoloration without breakdown or dentin shadowing.
Codes 3 and 4: Moderate Stage Caries
- Lesions with localized enamel breakdown; no visible dentin or underlying dentin shadow.
Codes 5 and 6: Extensive Stage Caries
- Distinct cavities in discolored enamel with visible dentin involvement.

Signs of Caries Stages

Active Initial or Moderate Stage:
- Enamel appears white/yellowish, opaque, rough, with loss of luster, and covered by plaque.
Inactive Initial or Moderate Stage:
- Enamel is hard, smooth, shiny, and not covered by plaque, often located away from the gingival margin.
Active Extensive Caries:
- Dentin feels soft or leathery on gentle probing.
Inactive Extensive Caries:
- Dentin feels shiny and hard on gentle probing.

Visualization Techniques

Proximal lesions visualized through direct visual exams following tooth separation.

Radiolucency Stages

RA1: Radiolucency in outer 1/2 of enamel.
RA2: Radiolucency in inner 1/2 of enamel, possibly affecting DEJ.
RA3: Radiolucency limited to outer 1/3 of dentin.
RB4: Radiolucency reaching middle 1/3 of dentin (moderate).
RC5: Radiolucency reaching inner 1/3 of dentin; clinically cavitated.
RC6: Radiolucency extending into pulp; clinically cavitated.

Determining Lesion Activity

Active lesions identified by clinical cavitation or radiographic progression.

Management Strategies

Low Caries Risk Patients:
- Brush twice daily with fluoride toothpaste, engage in motivational activities, and maintain regular dental visits.
Moderate Caries Risk Patients:
- Includes low-risk interventions plus high fluoride toothpaste, mouthrinse, sealants, varnish, and more frequent recalls.
High Caries Risk Patients:
- Further increased fluoride applications, topical fluoride treatments, and dietary counseling to minimize sugar intake.

Radiographic Needs

Multiples series of radiographs are essential for accurate depiction of caries progression.

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Description

This quiz features flashcards that cover key concepts of the International Caries Classification and Management System (ICCMS). Test your knowledge on ICCMS terminology, patient-level caries risk assessment, and lesion classification. It's a great tool for students and professionals in the dental field.