“The mouth is the gateway to the rest of the body, a mirror of our overall well-being.”


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Chapter 013

Diagnosis of Dental Caries

  • Detectable explorer “stick”
  • Radiographs
  • Visual
  • Laser caries detector

Laser Caries Detector

  • The laser caries detector is used to diagnose caries and reveal bacterial activity under the enamel surface.
  • Carious tooth structure is less dense and gives off a higher reading than non- carious tooth structure.

Fig. 13-10 Visual and radiographic appearance of seemingly intact molar

Fig. 13-11 Cross section of molar showing decay

Methods of Caries Intervention

  • Fluoride: A variety of types are available to strengthen the tooth against solubility to acid.
  • Antibacterial therapy: Products such as chlorhexidine rinses are effective.
  • Fermentable carbohydrates: Reduce the amount and frequency of ingestion.
  • Salivary flow can be increased by chewing sugarless gum, for example, those with a non-sugar sweetener such as xylitol.

Fig. 13-12 Preventive measures against caries. A, Fluoride rinse. B, Chlorhexidine rinse. C, Xylitol gum.

Risk Assessment for Dental Caries

  • If the patient’s risk for developing dental caries can be determined, it is possible to prevent the caries from developing by beginning appropriate preventive treatment.
  • Caries risk assessment tests are based on the amount of mutans streptococci and lactobacilli present in the saliva.
  • High bacterial counts indicate a high caries risk, low counts indicate a low risk for caries. If the preventive measures are not provided, carious lesions are likely to develop.

Indication for Using a Caries Risk Test

  • New patients with signs of caries activity
  • Pregnant patients
  • Patients experiencing sudden increase in incidence of caries
  • Individuals taking medications that may affect the flow of saliva
  • Xerostomic patients

Indication for Using a Caries Risk Test-cont’d

  • Patients about to undergo chemotherapy
  • Patients who consume fermentable carbohydrates frequently
  • Patients suffering from diseases of the autoimmune system

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