Tooth Center

PREVENTION OF CARIES BY PLAQUE CONTROL
4.2.1 The individual site
Strong evidence suppor ting the effect of oral hygiene on caries comes from
experimental studies carried out
in vivo
. For instance, it was reported in (more…)

Plaque is the cause of caries, and a
tooth which is completely free of plaque will not decay
.
However, it is not always possible to demonstrate a strong association
between the presence of dental plaque and caries, and there are some obvious
reasons for this. For one thing, people are not able to completely remove plaque (more…)

Following history, clinical, and radiographic examination the dentist should
categorize the patient as:
•
caries inactive
—no active lesions or history of recent restorations
•
caries active
—active lesions and or an annual increment of two or more
new, progressing or filled lesions.
In the caries active patient it is sensible to try to list the factors that seem to
be responsible. Some of these may be amenable to change, e.g. improving
oral hygiene or diet. Others may be difficult to modify, e.g. an essential medi-
cation that also reduces salivary  ow. Some factors may seem impossible to
alter. Social factors such as poverty and education cannot be altered by the
dentist.

Once a dentist has assessed a patient’s caries activity status as high, an
attempt should be made to identify the relevant risk factors because it may be
possible to modify these and thus slow down disease progression. Some of (more…)

The distribution of caries is highly uneven among contemporary popu-
lations. How convenient it would be if those at risk of developing carious
lesions could be identified, both at the level of the individual in the surgery
and the population. The dentist could then target expensive non-operative
treatments appropriately and at a community level preventive effor ts could (more…)

Secondary or recurrent caries is
primary caries at the margin of a
restoration
. The clinical diagnostic criteria are thus identical to those for (more…)

It is difficult to see the white spot lesion on an approximal surface because
the lesion forms just cervical to the contact area and vision is obscured by the
adjacent tooth. The lesion is usually only discovered at a relatively late stage
when it has already progressed into dentine and is seen as a pinkish-grey (more…)

Caries on free smooth
enamel
surfaces can be diagnosed with sharp eyes at
the stage of the white or brown spot lesion (see Figures 1.4 and 2.7) before
cavitation has occurred provided the teeth are clean, dry, and well lit. Drying (more…)

The diagnosis of caries requires
good lighting
and
dry, clean teeth
. If deposits
of calculus or plaque are present, the mouth should be cleaned before attempt- (more…)

Carious lesions may be diagnosed at any level of the carious process. For con-
venience the levels are graded D (for decay) followed by a number. The higher
the number, the more advanced the lesion. Thus:
• D1 are clinically detectable enamel lesions with intact surfaces
• D2 are clinically detectable cavities limited to enamel
• D3 are clinically detectable lesions in dentine (more…)