CARIES DIAGNOSIS(D)

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Diagnosis of caries in simple way

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CARIES DIAGNOSIS: 

CARIES DIAGNOSIS RISK ASSESSMENT DETERMINING DISEASE STATE OF TOOTH PRIMARY GOAL: “Early detection of incipient caries and limitation of caries activity prior to significant tooth destruction”

RISK ASSESSMENT: 

RISK ASSESSMENT MEDICAL HISTORY FACTORS age, gender, fluoride exposure, smoking, alcohol, general health, medication CLINICAL EXAMINATION FINDINGS general appearance, mental/ physical disability, mucosa, active caries, plaque, gingiva, restorations

CARIES DIAGNOSIS: 

CARIES DIAGNOSIS IDENTIFICATION OF SUBSURFACE DEMINERALISATION BACTERIAL TESTING ASSESSMENT OF ENVIRONMENTAL CONDITIONS (No single test is 100% predictive, thus concept of ‘caries risk’ used.)

IDENTIFICATION OF SUBSURFACE LESIONS: 

IDENTIFICATION OF SUBSURFACE LESIONS Inspection/ radiographic/ dye uptake methods Visual Evidence – cavitation, surface roughness, opacification, discolouration Tactile Evidence – roughness, softness of tooth surface ( probe??) Pit & Fissure vs Smooth Surface vs Root Caries Diagnosis

B) BACTERIAL TESTING: 

B) BACTERIAL TESTING Caries Activity Tests - Reliability ? Plaque Index Scores Krasse – Microbiological Testing + Analyses of diet and saliva (individual caries activity tests can be used to make decisions on control measures, recall appt. timing, restorative procedures & materials and determining prognosis)

C) ASSESSMENT OF ENVIRONMENTAL CONDITIONS : 

C) ASSESSMENT OF ENVIRONMENTAL CONDITIONS Assessment of pH, salivary flow, saliva buffering capacity. Effects of medications, radiotherapy, systemic illness on oral environment Role of saliva in caries prevention - physical , chemical

CARIES PREVENTION: 

CARIES PREVENTION Designed to limit demineralisation by cariogenic bacteria - limiting pathogen growth & metabolism - increasing resistance of tooth surface Caries Control Methods

CARIES PREVENTION: 

CARIES PREVENTION Consider Host Resistance General Health Fluoride Immunisation Diet Oral Hygiene Pit & Fissure Sealants and Restorations

CARIES PREVENTION: 

CARIES PREVENTION Host Resistance - health status - immunological system - immunocompromised patients General Health - acute/ chronic illnesses - multiple medications

CARIES PREVENTION: 

CARIES PREVENTION Fluoride Treatment - optimal levels ------ Fluorosis - anticaries effects - methods (systemic vs topical) - Topical Fluorides (types, concerntrations, indications,)

CARIES PREVENTION: 

CARIES PREVENTION Immunization - anti-caries vaccine - potential side-effects - cost – effectiveness (cf fluoride) Diet - dietary sucrose (freq vs quantit) - dietary counselling

CARIES PREVENTION: 

CARIES PREVENTION Oral Hygiene - role of plaque(Specific vs Non-specific) - mechanical removal of plaque - brushing - flossing - interdental cleaning aids - professional tooth cleaning

CARIES PREVENTION: 

CARIES PREVENTION Pit & Fissure Sealants - material composition - indications - technique Restorations - restorations defects - recurrent caries - replacement of restorations ? * Tooth Alignment