M EASURING D ENTAL C ARIES

C LINICAL C ARIES DIAGNOSIS Originally, it was by visual-tactile methods (i.e. using vision and an explorer). The current understanding of caries, indicates that routine use of the explorer is likely to damage the enamel matrix of non-cavitated lesions where remineralization is taking place. As a result, the criteria for diagnosing caries has moved to become exclusively visual. Caries diagnosis can be complicated by hidden caries (detected radiographically only). However, radiographs are not used in large studies: For ethical reasons (unnecessary exposure) Cost Risk of bias from refusing participants

O THER D IAGNOSTIC A IDS Fiberoptic transillumination A light is shined behind the teeth. Softened (demineralized) tooth areas can appear darker than healthy areas, so dentists can use the images to help them find early problems.

O THER D IAGNOSTIC A IDS Electrical conductance In dental systems, there is generally a probe, from which the current is passed, a substrate, typically the tooth, and a contra-electrode, usually a metal bar held in the patient’s hand. Measurements can be taken either from enamel or exposed dentine surfaces. This increased porosity results in a higher fluid content resulting in decreased electrical resistance.

O THER D IAGNOSTIC A IDS Laser fluorescence Using a small laser the system produces an excitation wavelength of 655 nm which produces a red light. This is carried to one of two intra-oral tips; one designed for pits and fissures, and the other for smooth surfaces. It displays a numerical value on two LED displays. The first displays the current reading while the second displays the peak reading for that examination.

R OOT C ARIES Criteria for diagnosing root caries: A discrete, well-defined, and discolored soft area is present. The explorer enters easily and displays some resistance to withdrawal. The lesion is located either at the cemento-enamel junction or wholly on the root surface. Restored root lesions are counted only if it was obvious that the lesion originated at the CEJ or is confined to the root surface.

R OOT C ARIES Although most lesions occur on exposed root surfaces, around 15% of all root lesions are found on surfaces without gingival recession (where there is LPA). The extent of root caries can be expressed as Simple prevalence Mean number of restored or carious teeth per person (DFS count) Root Caries index: takes into account the teeth at risk (i.e. teeth with enough gingival recession occurred to expose part of the cemental surface. Root Surfaces (D+F)/Root Surfaces with LPA (S+D+F) X 100

E ARLY C HILDHOOD C ARIES ECC Extensive carious attack in infants and young children, usually associated with regular exposure to sugar, often from fluids in a bottle. Age (mo)Early Childhood Caries Severe Early Childhood Caries <121 or more dmf surfaces1 or more smooth dmf surfaces or more dmf surfaces1 or more smooth dmf surfaces or more dmf surfaces1 or more smooth dmf surfaces or more dmf surfaces1 or more smooth dmf surfaces in pri max ant teeth, or dmfs ≥ or more dmf surfaces1 or more smooth dmf surfaces in pri max ant teeth, or dmfs ≥ or more dmf surfaces1 or more smooth dmf surfaces in pri max ant teeth, or dmfs ≥ 6

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