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100 Cards in this Set

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What is the range of caries severity on radiographs?
R1-R4
Which is worse, R1 or R4?
R4
Enamel caries less than half through enamel

R1, 2, 3 or 4?
R1
Enamel caries at least half through enamel but NOT involving DEJ

R1, 2, 3 or 4?
R2
Caries through DEJ but less than half way through dentin?

R1, 2, 3 or 4?
R3
Caries more than half way through dentin to pulp

R1, 2, 3 or 4?
R4
What classification (R1, 2, 3 or 4) describes incipient caries?
R1
What area of the tooth are caries most common?
occlusal surface
What type of caries are more common in kids and adolescents in posterior teeth?
occlusal caries
True or False, irregularities of pits and fissures of teeth can make someone more inherently prone to occlusal caries
True
Occlusal caries have a triangle shape in the enamel. The "base" of the triangle is towards the dentin or the outer surface?
towards dentin
When are occlusal caries visible on a radiograph?
when it reaches DEJ
True or False, radiographs are a solid way to diagnose occlusal caries
False, you'll catch it too late
Why are occlusal caries often invisible on radiographs?
they are "hidden" by surrounding enamel that don't allow the carious lesion to be detected due to a lack of contrast
Occlusal caries spread along what line?
DEJ
Occlusal caries are (RO/RL) line between enamel and dentin
RL (duh...)
When occlusal caries break through the DEJ, what pattern to they create as they spread further towards the pulp
spherical (remember, they were triangular shaped in the enamel, but once they pass the DEJ, they spread like a sphere)
How can occlusal caries eventually lead to collapse of enamel that was not initially diseased?
Caries invades dentin and basically carves out under the enamel, giving it little support. Then, you bite down and collapse the enamel in the area.
Radiographs can detect occlusal caries as a fine grey shadow under the ___
DEJ
Radiographs are only effective for occlusal caries once the caries reach the ___
dentin (or DEJ)
True or False, R1 occlusal caries are not typically visible on a radiograph
True (must hit dentin before they can be seen)
True or False, for occlusal caries, the enamel may appear intact even though there is clearly decay in the dentin
True! You only need a very small hole for caries to spread and widen into the dentin. Enamel might look normal!
For occlusal caries, you'll first notice a (narrow/wide) based RL zone in the dentin
wide
A band of increased opacity between lesion and pulp chamber in dentin is likely what?
reparative dentin
True or False, severe occlusal caries can be seen on radiographs only
False, radiographs AND visually (duh, they're "severe")
Interproximal caries develop (fast/slow)
slow
It takes __ years for interproximal caries to become clinically apparent
3-4years
What two areas do interproximal caries typically develop?
1. just below contact point
2. on enamel between contact point and height of free gingival margin
Interproximal caries will appear chalky-white and rough. Explain both of these findings.
chalky-white due to demineralization of enamel, and rough for the same reason. Enamel breaks down and becomes rough and chalky.
interproximal caries in the enamel create a triangle shape. The 'base' of this triangle is (towards the dentin/ towards the outer surface)
towards the outer surface (this is OPPOSITE of direction in occlusal caries)
What % of demineralization is needed before caries are seen on a radiograph?
30-40%
Why are incipient caries hard to detect on a radiograph?
Not much demineralization so there's hardly any (if any at all) contrast for the X-ray to pick up on
True or False, incipient caries are like all other caries and must be restored
False! They can be reversed and remineralized
True or False, once a lesion is more than halfway through the enamel, it is no longer considered incipient
True (it's now an R2)
R3 caries are when the lesion has invaded what area?
dentin or past the DEJ (same thing)
Why can caries that spread to dentin still affect the enamel?
They can undermine the integrity of the enamel above it and lead to it's collapse
Once caries have spread more than half way through the dentin, they are called:

R1, 2, 3 or 4?
R4
True or False, you can remineralize any lesion as long as it has not reached the DEJ
False! Once it gets halfway through the enamel, it's no longer incipient!
What type of caries appear as a dark thin RL line running through interproximal enamel into dentin, where the caries then spreads along DEJ?
Lamellar caries
True or False, because of the antimicrobial properties of the pulp, caries can technically never get all the way through the dentin to the pulp
False, I completely made that up. You're welcome.
True or False, if caries are severe enough to get into the pulp, you will know it from the radiograph
False, caries are always worse clinically than radiographically and if it has just reached the pulp, you may not be able to tell on radiograph alone
Occlusal caries are identifiable on a radiograph when they are:

R1
R2
R3
R4
R3 and worse (So R3 and R4 only...)
Why is it hard to detect caries interproximally of you have overlapping contacts?
The contacts may cover up a carious lesion and it won't show up
What is commonly misdiagnosed as caries around the gum line?
cervical burn out
What causes cervical burnout?
the area between neck of tooth and root absorb less xrays... not related to disease
On (posterior/anterior) teeth, cervical burnout is a RL triangle on proximal cervical neck
posterior
On (posterior/anterior) teeth, cervical burnout is a RL band across cervical neck of teeth
anterior
What type of treatment is needed if cervical burnout is detected?
Nothing
Why will cervical burnout sometimes show up or not show up in the same patient?
often depends on horizontal angulation
Facial and lingual caries are often seen as "___ ___"
black holes (most worthless flashcard ever)
The periphery of facial or lingual caries is often (poorly/well) demarcated
well
Cervical caries on the facial or lingual are often ___ shaped
crescent
Cemental caries are known by what two other names?
1. root caries
2. radicular caries
cemental caries start near the ___
CEJ
Cemental caries are (poorly/well) defined
poorly
Cementum is relatively (more/less) resistant to caries
less
What is a common medical cause of root caries in elderly?
Xerostomia
Cementum can slowly be exposed due to what in elderly people?
gingival recession
How do cemental caries look radiographically?
ill-defined
saucer-shaped
"scooped-out"
discolored
(acute/chronic) caries are often seen in childhood and ages 15-25
acute
People that frequently snack or have poor hygiene often have (acute/chronic) caries
acute
What spreads faster, acute or chronic caries?
acute
(acute/chronic) caries are initially small with rapid penetration and spread at DEJ
acute
What type of caries are described by poor diet, and extensive caries
rampant caries
sudden and uncontrollable destruction is a sign of ___ caries
rampant
Who gets rampant caries the most?
young kids/teens
adults w/Xerostomia
(acute/chronic) have a large surface entrance at initial stages
chronic
(acute/chronic) caries are more common in adults
chronic
The slow progress of (acute/chronic) caries allows time for sclerosis of tubules and 2ndary dentin
chronic
True or False, pain is very common in chronic caries
False
(primary/secondary) caries are defined as a new lesion with no prior cavity preparation
primary
What is another name for recurrent caries
secondary caries (hmmm go figure...)
What type of caries (primary/secondary) develop at margins of existing restorations?
secondary
If someone gets secondary caries, what might this indicate
1. susceptible to caries
2. bad hygiene
3. poor restoration
Why are secondary caries often hard to see?
The existing restoration can "hide" them
Caries are usually (more/less) severe than they look on a radiograph
more
(over/under) exposure can mask proximal caries
over
What type of non-carious phenomenon is mistaken for cervical caries?
cervical burnout
Bad (vertical/horizontal) angulation results in foreshortening or elongation
vertical
Bad (vertical/horizontal) angulation results in overlap of contacts
horizontal
List a few types of restorations that appear RL and may mimic caries
1. older silicates
2. older Ca(OH)2
3. resins
4. some composites
True or False, hypoplastic teeth (or enamel hypoplasia) can mimic caries
True
True or False, abrasion and attrition are the same thing
false, abrasion is mechanical wear, attrition is physiologic wear
If you brush too hard, you can get (abrasion/attrition) of the tooth structure
abrasion
What type of caries are indicated by the red arrow? purple arrow?
Red - R3 (mesial)
Purple - R2 (distal)
What opaque region is indicated by the green arrow?
Reparative dentin
What level are all three carious lesions?
R1
These caries can all be classified as interproximal and what level?
R2
The orange and blue box are what level of caries? (not the same)
orange - R4
blue - R3
These caries are at what level?
R4
What is the likely cause of this little area of radiolucency?
cervical burnout
What is indicated by the white arrows?
Cervical burnout
What is wrong with the root of this tooth?
cemental caries
What is wrong with the root of this tooth?
Cemental caries
A patient comes in and you take this radiograph. It is an adult with xerostomia and the claim they didn't have cavities like this a year ago. What is your diagnosis?
rampant caries
A patient comes in and you take this radiograph. You notice that the caries indicated by the black arrow have looked nearly identical on radiographs for this patient for a few years now. What is your diagnosis? (bonus: what does the orange arrow indicate?)
Chronic caries, reparative dentin
What kind of caries are indicated by the green arrows?
Recurrent (aka secondary) caries. Notice that they are UNDER an existing restoration!
What is indicated by the red arrow? purple arrow?
red - recurrent caries
purple - R1 (incipient) interproximal carious lesion
One of these is attrition and one is abrasion. Which is which?
green - attrition
blue - abrasion
What is indicated by the blue arrow?
Gutta percha (root canal material)