Operative dentistry aje qualtrough, jd satterthwaite la morrow, pa brunton

Electrical conduction methods
This principle is based on electrical conductance and the fact that
sound enamel is a good electrical insulator; however, carious teeth
(with porosities) allow the passage of an electrical current more 
readily, resulting in a drop in the electrical resistance. The degree to
which the resistance drops is an indicator of the extent of caries.
Caries risk assessment
During the initial history, examination and treatment planning for
every patient, it is important that there is also an assessment of the
patient’s individual risk of developing further carious lesions or 
progression of existing lesions
7
. This procedure is termed caries risk
assessment. Assuming that all aetiological factors remain equal, this
should help in identification of the main causative factors and aid
with recommending specific preventive or restorative measures 
for that individual patient’s needs. Dental management of caries 
may involve operative intervention, but should always incorporate
preventive measures. Caries risk assessment carried out during 
treatment can serve as a monitoring aid for the success of treatment.
This assessment should be based upon:
• Caries experience
—
the extent and number of previous restorations (indicator
of past disease)
—
the extent and number of new lesions
—
the progression of new lesions.
• Fluoride use – type and frequency.
Basic principles


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• Oral hygiene and the extent of plaque present.
• Dietary factors – eating habits, number of main meals, snacks, 
frequency of fermentable carbohydrate intake.
• Bacterial activity – the presence and amount of cariogenic bacteria,
specifically Lactobacillus and Streptococcus mutans. This may include
special laboratory tests.
• Saliva – both the amount (quantity) and buffering capacity (quality).
• Socio-economic status – to evaluate the patient for compliance.
Caries tends to be a disease of deprivation and is more prevalent in
patients with lower socio-economic status.
The patient’s risk of developing further caries can be classified
according to the number of caries risk factors present as being high,
moderate or low. It is important to bear in mind that a patient’s risk
assessment can change with time and periodically the assessment of
their caries risk should be re-evaluated.