1. Radiographic
Interpretation

2. Dental Radiography Questions
How does the radiographic examination contribute to the detection of caries?
What factors may influence caries interpretation?
What is the radiographic appearance of: incipient, moderate, advanced and severe caries?

3. Detection of Caries
Clinical examination and radiographs are necessary to detect dental caries
Radiographs enable the dental professional to identify carious lesions that are not visible clinically
It also allows the dental professional to evaluate the extent and severity of carious lesions

4. Clinical Examination
Some carious lesions can be detected simply by looking in the mouth, and others cannot
The mirror can be used to reflect light, allow for indirect vision, and retract the tongue
The explorer can be used to detect changes in consistency in pits, grooves, and fissures of teeth

5. Clinical Examination Color changes may be observed
Occlusal surfaces may show dark staining in fissures, pits, and grooves
Smooth surfaces may exhibit a chalky white spot or opacity
An interproximal ridge may appear discolored

7. Radiographic Examination
A carious area appears radiolucent because decreased density allows for greater penetration in the carious area
The bite-wing radiograph provides the dental professional with the greatest amount of diagnostic information
A periapical radiograph taken with paralleling technique may also be used

8. Factors Influencing Caries Interpretation
Radiographs must be of diagnostic quality
Examples may include
Improper horizontal angulation on a bitewing film
Errors in exposure with improper contrast and density

9. Interproximal Caries Interproximal Between two adjacent surfaces
Typically seen on dental radiographs at or just below the contact point
As caries progresses through the enamel, it typically assumes a triangular configuration
When it reaches the DEJ, it spreads laterally and progresses through dentin
Classified as incipient, moderate, advanced, and severe

14. Incipient Interproximal Caries
Extends less than halfway through the thickness of enamel
An incipient or Class I lesion is seen only in enamel

17. Moderate Interproximal Caries
Extends more than halfway through enamel but does not involve the DEJ
A moderate or Class II lesion is seen only in enamel

20. Advanced Interproximal Caries
Extends to or through the DEJ and into dentin, but does not extend into dentin more than half the distance toward the pulp
An advanced or Class III lesion affects both enamel or dentin

23. Severe Interproximal Caries
Extends through enamel and dentin more than half the distance toward the pulp
A severe or Class IV lesion involves both enamel and dentin and may appear clinically as a cavitation in the tooth

26. Occlusal Caries
Caries that involve the chewing surface of posterior teeth
“A thorough clinical exam is the method of choice for the detection of occlusal caries”
Early occlusal caries is difficult to see on a dental radiograph

31. Incipient Occlusal Caries
Cannot be seen on a dental radiograph
Must be detected with an explorer or DiagnoDent

32. Buccal and Lingual Caries
These are difficult to detect on radiograph because they are superimposed on tooth structure
If seen on film, they appear as a circular radiolucent area

35. Root Surface Caries Ivolves only the roots of teeth
On radiograph, it appears as a cupped-out or crater-shaped radiolucency below the CEJ
Early lesions may be difficult to detect on radiograph

38. Recurrent Caries Occurs adjacent to an existing restoration
It appears as a radiolucent area just beneath a restoration
It is most often located beneath the interproximal margins of a restoration

40. Rampant Caries Advanced and severe caries affecting a number of teeth
Associated with children with poor diets and adults with decreased salivary flow