Caries thresholds

Caries thresholds
Simple oral health surveys usually apply criteria from WHO guidelines, recording the signs of disease only at an advanced stage, on a dichotomous principle (yes or no);
that is, the surface can be recorded only as either sound or carious (caries is recorded as present when a lesion in a pit or fissure, or on a smooth tooth surface, has a detectably softened floor, undermined enamel, or a softened wall. A tooth with a provisional restoration should also be included in this category. On approximal surfaces, the examiner must be certain that the explorer has entered a lesion. Where any doubt exists, the surface is recorded as sound.
In surveys, some compromise is inevitable, and this factor is not inconsequential. 
Because the criteria are established for practicality and convenience under specific conditions, a surface that does not fulfill the minimum criterion for a positive diagnosis is not necessarily sound. For convenience and practicality, a number of false-negative results will be accepted; along with the truly sound surfaces, surfaces with some degree of caries will also be denoted as sound. In other words, the true number of carious teeth and surfaces is considerably underestimated in epidemiologic studies conducted according to WHO criteria.
Pitts (1997) has pointed out that noncavitated enamel lesions (D1 and D2) are about three times more common than are lesions in dentin (D3 and D4), particularly those with cavitation into the dentin. The precision of caries diagnosis is illustrated as an iceberg in Fig 231; the level at which the iceberg “floats” will depend on the selected threshold. In this figure, the water level is at the threshold used in classic dental epidemiologic studies; caries into dentin (D3); ie, the examiner ignores all signs of lesions less severe than clinically detectable lesions in dentin and records such
surfaces as “caries free.” The iceberg has been stratified into discrete levels, or diagnostic thresholds, from the most severe D4 (lesions extending into the pulp chamber) to subclinical lesions, less advanced than even clinically detectable D1 lesions (enamel lesions with apparently intact surfaces). 
The D1 to D4 terminology has formerly been widely used by the WHO. The two most commonly selected thresholds are D3 (dentin caries, comprising D3 and D4 lesions only) and D1 (enamel caries, comprising lesions at D1 + D2 + D3 + D4). Figure 231 shows clearly that examinations in clinical practice will detect more lesions than will examinations using the same methods at a different threshold in a survey. Similarly, the use of diagnostic aids will also result in the detection of more lesions. For example, in contrast to national epidemiologic surveys according to WHO
criteria, surveys in Sweden routinely record approximal caries on the basis of bitewing radiographs, and enamel lesions (D1, D2) as well as noncavitated and cavitated lesions in dentin are detected. Compared to other national surveys, epidemiologic data from Sweden, which include noncavitated approximal lesions in dentin, are therefore overestimated. Figure 232 from the county of Jonkoping, Sweden, illustrates the proportion of approximal enamel (D1, D2) and dentin lesions detected on bitewing radiographs in 3-, 5-, 10-, 15-, and 20-year-old children and
young adults in 1973, 1983, and 1993 (Hugoson et al, 1999). 
There are, moreover, additional problems when caries is measured as a dichotomous variable, because mineral loss from the surface, leading to cavitation, represents a continuum of changes as a result of the carious process. To dichotomize this continuous variable inevitably results in some loss of information (just as it would, for example, if the same were done when the height of a growing child was measured). 
Unfortunately, there are no methods of measuring the lesion as a continuous variable
(like height or weight). There is, however, no a priori reason to classify lesions only
as either one of two categories (present or absent). Alternatives have been proposed,
eg, the Norwegian five-point scores for occlusal, approximal, and secondary caries
(Espelid and Tveit, 1986; Espelid et al, 1994; Tveit et al, 1994; see chapter 5).
With all methods of measuring caries, two additional descriptive dichotomous
categories are always included: filled (presumably because there had, at some time,
been a carious lesion), and missing (for teeth extracted because of caries). An
additional problem arises in epidemiologic studies of dental caries. The unit of attack
of a lesion is usually the surface of a given tooth, eg, occlusal, mesial, buccal, distal,
or lingual. Depending on the purpose of the study, these surfaces may constitute the
unit of diagnosis: The worst lesion present on the surface determines the
classification. It may sometimes be necessary to classify the surfaces differently: for
example, when information on caries affecting different morphologic types (eg, pits,
fissures, and smooth surfaces) is required. The unit of diagnosis is not fixed. For rapid
surveys, it may be appropriate to classify each tooth, rather than the surface, based on
the worst condition on any surface. Epidemiologic studies in children deal almost
exclusively with primary coronal caries. In adults, however, coronal and root caries
are usually considered separately, and from a treatment needs aspect, secondary caries
is also included. Each method has its own strengths and limitations, and some
compromise may have to be made regarding what loss of information is tolerable for
the specific purpose of the study.
Views: 3151 | Comments: 9 Send reply
I bought this bekadmarer these in my guy since i have squashed his duplicate Oakleys. These are fine quality, so if feels like I can’t be breaking these really easy! He adores them, many of them accommodate appropriately!

Lovely to meet you, Judith! Looking at your blog and others you foollw I’ve found a lovely bunch of fellow primal peeps! Huzzah! Glad to find others who love eating healthfully and also know their way around a kitchen. 🙂

What is the cost per tooth for cosmetic deritstny? And did you get a loan to have your teeth done?I read up about the procedure for cosmetic deritstny, and I want to know what it cost you to have cosmetic deritstny done on your teeth, what insurance company covered you, and if you took out a loan to get that done which loan company did you use?still looking for someone who had cosmetic deritstny done. I hear it’s about $100 per tooth, is that what you paid?

No insurance will cover coetsmic procedures. The only time an insurance may pay for it is, if your front teeth have a a major defect. Then the procedure should be pre-approved by the insurance by sending a pre-determination and narrative to the insurance. The dental office would have to do that for you.Tricare Prime is your medical coverage, United Concordia covers the dental portion. If you are active duty, you will not have United Concordia at this time. [url=]ajeygeuc[/url] [link=]wdjqeclkp[/link]

There’s a difference cuz ordnttohoics is to straighten teeth. Sometimes crocked teeth can cause problems like pain in your jaw. Cosmetic dentistry is used when the natural teeth have no problems but you just want them to look a certain way. And some ins do cover ortho but it depends on the type of plan you get.

Doesn’t matter, other than taikng the usual college prep classes and requirements.You’ll first go to college to earn a Bachelor’s degree. Then four years of dental school [VERY competitive] and then do further training for specializing in cosmetic dentistry.I would imagine that the ADA website would have info for prospective dental school students.

Assuming that you are looking for a utrurgdadeane course.There is no utrurgdadeane degree for cosmetic dentistry in India. And you can’t practice without a degree. A possible way forward would be to get a BDS Degree and then get a PG Diploma in Cosmetic Dentistry. [url=]unvpavhfklt[/url] [link=]nhqectw[/link]

First of all, a genearl dnsitet can do cosmetic dnsitetry work too. They can do fillings. Your question is just same like when a person is having gastritis, should he go to a general practitioner, or a gastrologist? Well, it is depends on your condition. If the teeth involve is the front teeth, and your really want a perfect job, and you are willing and afford to pay, you can go to the specialist. If it’s just the back teeth, or you are not willing to pay or not affordable, or you doesn’t need a perfect job, you can go to the general dnsitet. It’s a matter of what you want and what you willing to give.

Is it worth working for a densitt to get a discount on treatment?I need a lot of work done to my teeth. The two reasons I’ve waited as long as I have is because I had very bad experiences with the dental school when I was younger and I haven’t been able to afford it. Can anyone tell me what kind of discount most densitts give to their employees? I’m looking for a job right now and would consider working for a densitt if the discount on my work is worth it. [url=]laugjnnwkc[/url] [link=]ddltpasbmqz[/link]

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Articles for theme “caries”:
Epidemiology of Dental CariesIntroductionAn important function of the World Health Organization (WHO) Oral Health Unit is  the collection and analysis of global epidemiologic data on oral diseases, recorded in national, computer-aided studies. Goals for the level of oral health status are set and revised at certain intervals. Because epidemiologic studies measure dental caries in groups or populations, some care must be taken to ensure that the same diagnostic criteria are applied to each individual examined.
ConclusionsDevelopmentA carious lesion should be regarded as damage resulting from the infectious disease dental caries. The coronal lesion starts as clinically undetectable demineralization of enamel, visible only at the microscopic level, and proceeds gradually to visible, noncavitated demineralization of first the enamel surface and then the dentin, and finally to cavitation of the dentin. Primary carious lesions are most frequently located supragingivally on the crowns and particularly on the occlusal surfaces of the molars and the approximal surfaces of the posterior teeth.
Diagnosis of secondary cariesDefinition and prevalenceSecondary caries has been reported to be eight times more common than primary lesions in adults, particularly in those older than 50 years (Goldberg et al, 1981). However, prevalence may vary markedly in different countries, depending on the total caries prevalence in the population and the level of development of the dental care system. In developing countries with low caries prevalence in the adult population and poor dental care resources, secondary caries may be almost negligible.
Diagnosis of root cariesDefinition and classificationRoot caries usually appears as a shallow area, less than 2 mm deep, a mostly noncavitated, ill-defined, softened, and often discolored lesion, characterized by destruction of cementum and penetration of dentin. Several definitions and classifications have been proposed; Hix and O’Leary (1976) defined root caries as “a cavitation or softened area in the root surface which might or might not involve adjacent enamel or existing restorations (primary and recurrent lesions).
Diagnosis of approximal cariesThe issues to be considered by the clinician with respect to caries of the approximal surfaces are similar to those considered at other sites: Is the surface sound, or is there a lesion? If so, how advanced is the lesion¾involvement of enamel only, enamel and dentinal involvement, or pulpal exposure? Finally, is there cavitation?  Diagnostic methodsMeticulous visual examinationIn the thin anterior teeth, both noncavitated and cavitated approximal lesions are readily detectable by meticulous clinical visual examination.