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Caries diagnosis

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Various techniques of dental caries diagnosis in clinical practice

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CARIES DIAGNOSIS
What is diagnosis? ,[object Object],[object Object]
ASSESSMENT TOOLS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
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
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
HIGH RISK LOW RISK Clinical evidence New lesions Premature extractions Anterior caries restorations Multiple/repeated restorations No fissure sealants Multi-band orthodontics No new lesions No extraction for caries Sound anterior teeth No/few restorations Fissure sealed No appliances
CONVENTIONAL METHODS OF CARIES DETECTION ,[object Object],[object Object],[object Object],[object Object],[object Object]
VISUAL-TACTILE METHODS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
SMOOTH SURFACE CARIES ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Non-cavitated carious lesion ENAMEL DENTIN
[object Object],[object Object]
[object Object],[object Object]
Non-Carious Enamel Opacities Opacity not fluorosis Mild Fluorosis Moderate Fluorosis Severe Fluorosis
Caries in Pit or Fissure Surfaces ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object]
Pit and Fissure Caries Non-cavitated carious lesion Enamel Enamel Dentin Enamel
[object Object],Cavitated Carious lesion
Root Caries ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],Active lesion Questionable
Arrested Caries ,[object Object],[object Object],[object Object]
Recurrent caries ,[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
Advanced Recurrent Carious lesions
[object Object],Specific form of rampant caries Acute, widespread caries with early pulpal involvement of teeth that are usually immune to decay Primary dentition affected Both dentitions affected C/F: specific pattern- maxillary incisor  molars Mandibular incisors not affected Rapid appearance of new lesions Mandibular incisors also affected
RADIOGRAPHY ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],PIT & FISSURE CARIES
[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
PROXIMAL CARIES ,[object Object],[object Object],[object Object],[object Object], Density along the proximal surface is high which does not permit the detection of loss of small amounts of mineral content
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
Facial & Lingual Caries ,[object Object],[object Object],[object Object],[object Object]
ROOT SURFACE CARIES ,[object Object],[object Object],[object Object],[object Object]
RECURRENT CARIES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
OTHER RADIOGRAPHIC SHADOWS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pitfalls Of Radiography ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
XERORADIOGRAPHY ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
DIGITAL IMAGING ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
DIGITAL IMAGING Schick System Digora System Trophy System
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SUBTRACTION RADIOGRAPHY ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
COMPUTER IMAGE ANALYSIS ,[object Object],[object Object],[object Object],[object Object],[object Object]
DYES FOR CARIES DETECTION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
FIBEROPTIC TRANSILLUMINATION ,[object Object],[object Object],[object Object],[object Object],[object Object]
ELECTRIC MEASUREMENTS FOR CARIES ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
RECENT ADVANCES IN CARIES DETECTION ,[object Object],[object Object],[object Object],[object Object],[object Object]
CARIES RISK ASSESSMENT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
Caries Activity Tests ,[object Object],[object Object],[object Object],No.of org/ ml Degree of caries activity 0 – 1000 Little / none 1000 – 5000 Slight 5000 – 10,000 Moderate > 10,000 marked
[object Object],[object Object],[object Object],24 hrs  48 hrs  72 hrs If yellow Marked caries activity If yellow Definite caries activity If yellow Limited caries activity If green Observe – 48hrs If green Observe –72hrs If green Caries inactive
[object Object],[object Object],[object Object],[object Object],[object Object],pH 4.1or less Marked caries activity pH 4.2 – 4.4 Active pH 4.5 – 4.6 Slightly active pH 4.6 0r more Caries inactive
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],Buffering capacity analysis: Results 5 min Color change on each of the test pad is noted & points are assigned accordingly Green – 4 pts Blue/ Red – 1 pt Green/ blue – 3 pts Red – 0 pt Blue – 2 pts Color change pH range Red 5.0 – 5.8 Yellow 6.0 – 6.6 Green 6.8 – 7.8
[object Object],Combined total Buffering ability 0 – 5 Very low 6 – 9 Low 10 – 12 Normal/ high
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Caries Susceptibility Test ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],Color Caries conduciveness Blue in 15 min Non- Conducive Orchid in15 min Slightly Conducive Red in 15 min Moderately Conducive Red immediately on mixing Highly Conducive Colorless in 15 min Extremely Conducive
CARIOGRAM ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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Caries diagnosis

  • 2.
  • 3.
  • 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
  • 6. HIGH RISK LOW RISK Clinical evidence New lesions Premature extractions Anterior caries restorations Multiple/repeated restorations No fissure sealants Multi-band orthodontics No new lesions No extraction for caries Sound anterior teeth No/few restorations Fissure sealed No appliances
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  • 17. Non-Carious Enamel Opacities Opacity not fluorosis Mild Fluorosis Moderate Fluorosis Severe Fluorosis
  • 18.
  • 19.
  • 20. Pit and Fissure Caries Non-cavitated carious lesion Enamel Enamel Dentin Enamel
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  • 45. DIGITAL IMAGING Schick System Digora System Trophy System
  • 46.
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