Detection and diagnosis of dental caries

Here's a presentation about how we can detect and diagnose the carious lesion. Uploaded

  1. Ghaith Abdulhadi
    Here's a presentation about how we can detect and diagnose the carious lesion.

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    Detection and diagnosis of dental caries
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    • 1. Detection And Diagnosis of Dental Caries Presented By: 1- Ghaith Abdulhadi 2- Mahommed Naif Supervision By: Dr. Mahammed H. Nabulsi
    • 2. What is diagnosis? Diagnosis is an art and science that results from the synthesis of scientific knowledge, clinical experience, intuition & common sense Caries diagnosis implies deciding whether a lesion is active, progressing rapidly or slowly or whether is already arrested.
    • 3. ASSESSMENT TOOLS Stepwise progression toward diagnosis & treatment planning depends on thorough assessment of the following Patient History  Clinical examination  Nutritional analysis  Salivary analysis  Radiographic assessment
    • 4. HIGH RISK LOW RISK Social History Socially deprived High caries in siblings Low knowledge of caries Middle class Low caries in sibling High dental aspirations Medical History Medically compromised Xerostomia Long-term cariogenic medicine No such problem Dietary habits Sugar intake: frequent Infrequent
    • 5. HIGH RISK LOW RISK Use of fluoride Non-fluoridated area No fluoride supplements Fluoridated area Fluoride supplements used Plaque control Poor oral hygiene maintenance Good oral hygiene maintenance Saliva Low flow rate& buffering capacity  S.mutans & lactobacillus counts Normal flow rate& buffering capacity  S.mutans & lactobacillus counts
    • 7. VISUAL-TACTILE METHODS Visual methods:  Detection of white spot, discoloration / frank cavitations Magnification loupes- Head worn prism loupes (X 4.5) or surgical microscopes(X 16) may be used comfort, relatively inexpensive, available in various magnification  Use of temporary elective tooth separation
    • 8. Tactile methods:  Explorers are widely used for the detection of carious tooth structure  Dental floss
    • 9. Use of explorer is not advocated because;  Sharp tips physically damage small lesions with intact surfaces  Probing can cause fracture & cavitation of incipient lesion. It may spread the organism in the mouth  Mechanical binding may be due to non-carious reasons Shape of fissure Sharpness of explorer Force of application Path of explorer placement
    • 10. Use of explorer • Explorer is useful to remove plaque and debris and check the surface characteristics of suspected carious lesions. • gentle pressure just required to blanch a fingernail without causing any pain or damage • All surfaces of a tooth are cleaned of debris and plaque, using an air syringe and examined visually.
    • 11. SMOOTH SURFACE CARIES Non- cavitated: • No signs of cavitation after visual or tactile examination. • Location: where dental plaque accumulates (gingival margin). • Surface characteristics: Matted (not glossy) when a tooth is dried.
    • 12. not active non-cavitated carious lesions. • Visual enamel opacity under sound marginal ridge indicate undermined enamel due to dental caries
    • 13. Non-cavitated carious lesion ENAMEL DENTIN
    • 14. Cavitated Lesions: • Where there is visual breakdown of a tooth surface, it is classified as cavitated carious lesion. An active cavity on a smooth surface has soft walls or floors shown below:
    • 15. Caries in Pit or Fissure Surfaces • All discolored areas should be explored using gentle pressure. • There is no need to penetrate a suspected lesion with an explorer. • If a discolored and non-cavitated area is soft when explored, it is recorded as non-cavitated carious pit or fissure. • A cavity is detected when there is an actual hole in the tooth in which an explorer could easily enter the space. • An active cavity has soft walls or floors (detected using gentle exploring).
    • 16. • If there is visual enamel opacity under an ostensibly sound or stained pit or fissure, then the enamel is undermined because of dental caries and the tooth surface is classified with a non-cavitated carious lesion in dentin.
    • 17. Pit and Fissure Caries Non-cavitated carious lesion Enamel Enamel Dentin Enamel
    • 18. Cavitated Carious lesion • If a discolored area is hard when gently explored then it should be marked as questionable.
    • 19. Root Caries • Root surface caries comprises of a continuum of changes ranging from minute discolored areas to cavitation that may extend into the pulp For diagnostic purpose; they may be:  Active root surface lesion: • well-defined area showing yellowish or light brown discoloration • covered by visible plaque • presence of softening/ leathery consistency on probing with moderate pressure
    • 20.  Inactive root surface lesion (arrested): • well-defined dark brown/ black discoloration • smooth and shiny • hard on probing with moderate pressure Active lesion Questionable
    • 21. Arrested Caries • Arrested (remineralized) lesions can be observed clinically as intact, but discolored, usually brown or black spots. • The change in color is presumably due to trapped organic debris and metallic ions within the enamel. • These discolored, remineralized lesions are intact and are highly resistant to subsequent caries . The arrested caries need not be removed.
    • 22. Recurrent caries • It is diagnosed whenever there is softness due to caries at a defective margin, and when the tip of a periodontal probe can enter the defect without any resistance. • A restoration with a discolored margin or a small marginal ditch (
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