Diagnosis & treatment of Dental caries, Traditional methods Recent methods Careful examination of the patients teeth under clean & dry conditions using good illuminations may reveal visual signs of caries

1. Dental caries

2. Diagnosis & treatment of Dental
caries

3. Diagnosisofdentalcaries
Traditional
methods
Recent methods
Clinical operative dentistry principles & practice Ramyya raghu pg no 70-73

4. Patient
complaint
Meticulous
clinical
examination
Tactile
examination
Clinical operative dentistry principles & practice Ramyya raghu pg no 70-73
Traditional methods

5. Radiographic
examination
Dental floss Fiberoptic
transillumination
Clinical operative dentistry principles & practice Ramyya raghu pg no 70-73
Traditional methods

6. Patient complaint
Patients complaint itself provide a hint about the presence
of caries .
Clinical operative dentistry principles & practice Ramyya raghu pg no 70-73

7. Meticulous clinical examination
Careful examination of the patients teeth under
clean & dry conditions using good illuminations
may reveal visual signs of caries like:
Brownish discoloration of pits & fissures
Frank cavitation of tooth surface
Clinical operative dentistry principles & practice Ramyya raghu pg no 70-73

8. Use of dental explorer may help in detection of dental caries
.Tactile findings suggestive of caries are :
a. Softness at the base of pit or fissure & discontinuity of
enamel surface
b. ‘binding’ or ‘catch’ of the explorer tip
c. Cavitation at the base of pit or fissure
Tactile examination
Clinical operative dentistry principles & practice Ramyya raghu pg no 70-73

9. • Excessive pressure with a sharp
explorer tip can cause cavitation
where its not present earlier
• Infective microorganisms may be
transferred to uninfected areas
However
tactile
examination
has to be
done
carefully:

10. IOPA radiographs Bitewing
radiographs
-proximal caries
Radiographic examination

11. To detect initial proximal caries,
separation of the contacting teeth
can be achieved using wedge or
mechanical separator
Tooth separation

12. Whenever its sawed through
contact areas, it it frays it’s a
sign of proximal caries
Dental floss

13. Fiberoptic transillumination
If caries is present, its evident as a dark shadow .
After drying the tooth ,a Fiberoptic probe can be placed
in the buccal or lingual embrasure directly beneath the
contact area between two adjacent teeth
When teeth are examined with a Fiberoptic light
source, caries appears as a darkened shadow
Clinical operative dentistry principles & practice Ramyya raghu pg no 70-73

14. Xeroradiography Digital
radiographs
Computer-
aided
radiographic
method
Digital Fiberoptic
transillumination
Clinical operative dentistry principles & practice Ramyya raghu pg no 70-73
Recent methods

15. Dyes Electrical
conductance
measurements
Endoscopic
filtered
fluorescence
method
Quantitative
laser
fluorescence
Clinical operative dentistry principles & practice Ramyya raghu pg no 70-73

16. Alternating current
impedance
spectroscopy
technique
ACIST
Ultrasonic imaging Optical coherence
tomography (OCT)
Clinical operative dentistry principles & practice Ramyya raghu pg no 70-73

17. Consists of Aluminum
plate coated with
selenium particles
Charged uniformly &
stored in a unit called
Conditioner
When x rays are passed
onto the film ,it causes a
latent image
Its converted into a positive
image by a process
development in the processor
unit
Xeroradiography

18. The 1st direct digital radiography system in dentistry
was the Radio Visio Graphy (RVG) introduced in 1989
It records image produced by conventional x-rays &
stores it in computer memory
Digital radiographs
Clinical operative dentistry principles & practice Ramyya raghu pg no 70-73

19. Advantages
Reduced radiation dose
Instant image visualization
No need of dark room
No processing error
Image can be magnified
Contrast & density of image can be
enhanced
Disadvantages
Expensive
Small image
areas
Clinical operative dentistry principles & practice Ramyya raghu pg no 70-73

20. This method uses the measurement potential
of computers in assessing & recording the size
of carious lesions
Computer software have been developed for
automated interpretation of digital
radiographs in order to standardize image
assessment .
Computer-aided radiographic method
Clinical operative dentistry principles & practice Ramyya raghu pg no 70-73

21. Image captured by camera sent
to computer for analysis ,which
produces a digital image
It’s a new technique which
combines FOTI & a digital
camera
Digital Fiberoptic transillumination
Clinical operative dentistry principles & practice Ramyya raghu pg no 70-73

22. Various dyes like procion have been used to detect
enamel caries but have not been successful for clinical use
Dyes are useful to detect carious dentin
Calcein, 0.5% basic fushion
Dyes
Clinical operative dentistry principles & practice Ramyya raghu pg no 70-73

23. Electrical conductance measurements
The theory behind the use ofelectrical conductance measurements is
Sound enamel is a
insulator due to its high
inorganic content.
Carious enamel has a
measurable conductivity
which increases with
degree of demineralization
Based on the differences
in electrical conductance
of sound enamel &
Carious enamel ,two
devices were developed:
a. Vanguard electronic
caries detector
b. Caries meter
Clinical operative dentistry principles & practice Ramyya raghu pg no 68

25. Advantages
More accurate in diagnosing early
occlusal caries than visual, radiographs or
FOTI
Can monitor the progress of caries
Disadvantages
Time consuming procedure
Hypomineralized areas,
enamel cracks can mislead
the reading
Requires sharp metal explorers
which can cause traumatic
defects in pits & fissure
Clinical operative dentistry principles & practice Ramyya raghu pg no 70-73

26. Endoscopic filtered
fluorescence method
Tooth is illuminated with blue
light
When viewed through a filter
White spot lesion appear darker
than sound enamel
Camera can be used to store the
image

27. Advantages
Early diagnosis of
incipient enamel caries
More accurate than
radiographs
Disadvantages
Expensive
Time consuming
Clinical operative dentistry principles & practice Ramyya raghu pg no 70-73

28. Quantitative laser fluorescence
Its related to Endoscopic
filtered fluorescence
method
Kavo-DIAGNOdent
Clinical operative dentistry principles & practice Ramyya raghu pg no 70-73

29. • This system has a
range of 0 to 99. • The value 0
indicates the
healthiest state of
the tooth.
• It is an effective
method in
detecting initial
lesions without
cavitation
Meandros Med Dent J 2018;19:1-8

30. • The fiber optic
probe directed
on to the
occlusal surface
of the tooth
• emits a light of
wavelength 655
nm.
• changes caused by
demineralization
are converted into
numeric values and
displayed on the
screen
Meandros Med Dent J 2018;19:1-8

31. Advantages
Reliable method for
early occlusal caries
Convenient & fast
method
Disadvantages
Expensive
Cannot differentiate
between caries, stains
,calculus ,hypoplasia
Clinical operative dentistry principles & practice Ramyya raghu pg no 69

32. Another new
technology is
DIAGNOdent pen
(KaVo Dental,
Biberach, Germany).
Meandros Med Dent J 2018;19:1-8

33. It can be used to detect early caries on
smooth surfaces.
Ultrasonic probe is used to send & receive
sound waves from the surface of the tooth
Normal enamel produces no echo & white
spot lesions produces weak surface echoes
Ultrasonic imaging

34. Optic coherence tomography
(OCT) generates high-
resolution cross-sectional
images of the oral structures.
Optical coherence tomography (OCT)

35. Caries risk assessment
Risk assessment is a valuable tool for the prevention and management of
dental caries
The International Caries Detection and Assessment System is an evidence-
based, preventively oriented strategy that classifies the visual appearance
of a lesion monitoring of the lesion once detected(i.e., assessment)
The system is scored on clean, dry teeth and cautions against using sharp
explorers or probes in order to prevent iatrogenic damage to the tooth.
Clinical operative dentistry principles & practice Ramyya raghu pg no 70-73

36. 0 Clinically sound
1 to 2 Clinically detected “intact” enamel lesions (initial stage
decay)
3 to 4 Clinically detectable early, shallow, or microcavitations
(moderate decay)
5 to 6 Clinically detectable late or deep cavitations (extensive
decay)

37. Prevention of dental
caries
Measures to improve oral hygiene
Diet modification
Salivary stimulants
Fluorides
Pit & fissure sealants
Current methods of caries
prevention
Clinical operative dentistry principles & practice Ramyya raghu pg no 70-73

38. Measures to improve oral
hygiene
Toothbrushes Interdental
cleaning aids
Dentifrices Disclosing
agents
Professional
tooth
cleaning
measures
chemical
agents for
plaque
control
Clinical operative dentistry principles & practice Ramyya raghu pg no 70-73

39. Modified bass
method
Charter’s
method
Fones/Circular
method
Sulcular
method
Clinical operative dentistry principles & practice Ramyya raghu pg no 70-73

40. Dental
floss
Interdental
brushes
Single
tufted
brush
Clinical operative dentistry principles & practice Ramyya raghu pg no 70-73

41. Clinical operative dentistry principles & practice Ramyya raghu pg no 70-73

42. In order to remove plaque
effectively, it must be stained for
the patient to see it clearly.
Disclosing agents are solutions, tablets,
or wafers containing a red vegetable
dye like erythrosine
When applied on tooth surfaces with
cotton swab or diluted in mouth washes
they can stain the bacterial plaque .
Clinical operative dentistry principles & practice Ramyya raghu pg no 70-73

43. Its selective removal of plaque by the
dentist using mechanically driven
instruments
Clinical operative dentistry principles & practice Ramyya raghu pg no 70-73

44. Several antimicrobial agents have
been suggested. Out of these
chlorhexidine is most effective
Clinical operative dentistry principles & practice Ramyya raghu pg no 70-73

45. Food with anticariogenic effects
Milk Cheese
Fibrous
food, raw
vegetables
& grains
Sugar
substitutes
& artificial
sweeteners
Tea
Diet modification
Clinical operative dentistry principles & practice Ramyya raghu pg no 70-73

46. In patients with
xerostomia ,salivary
stimulants like paraffin
waxes can be
prescribed
Salivary
stimultants
Clinical operative dentistry principles & practice Ramyya raghu pg no 70-73

47. Fluoride delivery methods
Systemic
1.Fluoridated
community water
2.water
fluoridation
3.Fluroide tablets
& drops
Topical
Professionally
applied
1.Prophylactic paste
2.Solutions
3.Varnishes & gels
Self applied
1.Dentrifrice
2.Mouthrinses
Fluorides

48. Pit & fissure sealants
Clinical operative dentistry principles & practice Ramyya raghu pg no 70-73

49. Lasers
Polymeric coatings
Caries vaccine
Passive immunization
Current methods of caries prevention
Clinical operative dentistry principles & practice Ramyya raghu pg no 70-73

50. Managementofdentalcaries
Preventive management
Operative management
Clinical operative dentistry principles & practice Ramyya raghu pg no 78

51. Cavity preparation
Air abrasion
Ozone treatment
Chemomechanical caries removal
Lasers