Classification_of_Dental_Caries_AAUP_Lecture.pptx

Dental caries

1. Classification of Dental Caries Faculty of Dentistry – Arab American University, Palestine Instructor: Dr. Naji Ziad Arandi Course: Conservative Dentistry III Duration: 60 minutes

2. Learning Objectives By the end of this lecture, students should be able to: 1. Explain the rationale for classifying dental caries. 2. Describe different classification systems. 3. Identify examples under each category. 4. Relate classification to diagnosis and cavity design.

3. Importance of Classification Classification aids in diagnosis, treatment planning, and communication. It helps determine cavity outline and restorative approach. Supports record keeping and research.

4. Main Bases of Classification Dental caries may be classified by: 1. Location 2. Rate of progression 3. Tissue involvement 4. Occurrence (primary/recurrent) 5. Number of surfaces 6. G.V. Black’s classification.

5. By Location 1. Pit and fissure caries – in deep grooves and pits. 2. Smooth surface caries – on buccal, lingual, and proximal surfaces. 3. Root surface caries – on exposed cementum below CEJ .

6. Pit and Fissure Caries Common in children and adolescents. Progresses rapidly due to narrow entrance and deep morphology. Found on occlusal of molars, premolars, buccal and lingual pits of molars and lingual pits of incisors .

7. Smooth Surface Caries Occurs where plaque stagnates (interproximal, gingival). Slow progression; begins as white-spot lesion. Preventable by effective plaque removal .

8. Root Surface Caries Involves exposed cementum and dentin. Occurs in elderly and xerostomic patients. Progresses slowly and may recur .

9. By Rate of Progression 1. Acute (Rampant): rapid, soft dentin, multiple teeth. 2. Chronic: slow, discolored, firm dentin. 3. Arrested: inactive, smooth, hard, shiny surface.

10. Acute (Rampant) Caries Soft, light-colored lesions with rapid pulpal involvement. Includes nursing bottle and radiation caries. Associated with high sugar intake and reduced salivation .

11. Chronic Caries Slow, discolored, often self-limiting. Firm or leathery dentin with tertiary dentin formation. Less sensitive due to pulpal protection .

12. Arrested Caries Inactive process; lesion becomes smooth, shiny, dark brown. Indicates a balance between demineralization and remineralization . No treatment, only monitoring .

13. By Tissue Involvement 1. Enamel caries – subsurface demineralization. 2. Dentin caries – bacterial invasion and softening. 3. Cementum caries – root involvement. [Insert Histology Image Placeholder]

14. Enamel Caries Chalky white spot when dried. Surface intact, lesion beneath. Reversible with fluoride and plaque control. [Insert Diagram Placeholder]

15. Dentin Caries Begins at DEJ, spreads laterally. Soft, discolored dentin with reparative dentin near pulp. Cone-shaped lesion, wider at DEJ. [Insert Diagram Placeholder]

16. Cementum Caries Occurs on exposed root surfaces. Soft, yellowish, spreads toward pulp. Common in elderly with gingival recession. [Insert Photo Placeholder]

17. By Occurrence 1. Primary caries – on sound surface. 2. Secondary (recurrent) caries – at restoration margins due to leakage. [Insert Diagram Placeholder]

18. By Number of Surfaces 1. Simple – one surface (O, B, L). 2. Compound – two surfaces (MO, DO). 3. Complex – three or more (MOD). [Insert Illustration Placeholder]

19. G.V. Black’s Classification (1896) Class I – pits/fissures (occlusal, buccal, lingual). Class II – proximal of posterior teeth. Class III – proximal of anterior, no incisal edge. Class IV – proximal of anterior with incisal edge. Class V – cervical third facial/lingual. Class VI – incisal edges/cusp tips. [Insert Diagram Placeholder]

20. Clinical Relevance of Black’s Classification Basis for restorative teaching and documentation. Still used in operative dentistry and insurance coding. Modern concept: ‘Prevention of extension’ replaces ‘Extension for prevention.’

21. Modern Integration – ICDAS ICDAS adds lesion activity and severity (0–6). Encourages early detection and preventive care. Complements G.V. Black’s system. [Insert ICDAS Table Placeholder]

22. Summary Table of Classifications | Basis | Types | Example | |--------|--------|----------| | Location | Pit, Smooth, Root | Occlusal, Proximal | | Rate | Acute, Chronic, Arrested | Rampant, Arrested | | Tissue | Enamel, Dentin, Cementum | White spot, Brown lesion | | Occurrence | Primary, Secondary | New, Marginal decay | | Surfaces | Simple, Compound, Complex | MO, MOD |

23. Case 1 – Smooth Surface Lesion White chalky lesion near gingiva. Question: Which type of caries? Answer: Smooth surface caries (incipient enamel lesion). [Insert Case Photo Placeholder]

24. Case 2 – Root Caries Brown, soft lesion near CEJ. Question: Which type? Answer: Root surface caries (cementum/dentin involvement ).

25. Summary Classification simplifies diagnosis and treatment. G.V. Black’s system remains foundational. Modern approaches emphasize prevention and early detection. Integrate classification in clinical judgment.

26. References Textbook of Operative Dentistry (2015) Kidd & Fejerskov, Dental Caries: The Disease and Its Clinical Management Mount & Hume, Preservation and Restoration of Tooth Structure