Radiology Chapter 32

Tooth decay. The localized destruction of teeth by microorganisms. It causes decalcification of enamel, destruction of enamel and dentin, and cavitation of teeth. Appears radiolucent.

A carious lesion or an area of tooth decay.

Hole in a tooth that is the result of the caries process. Appears radiolucent.

Both careful clinical examination and a radiographic examination are necessary.

Some can be detected by looking in the mouth. Checked with a mirror and explorer for catches or tug back. Occlusal surfaces may show dark staining in the fissures, pits, and grooves. Smooth surfaces may exhibit a chalky white spot or opacity. Interproximal areas are hard to detect but can be detected on radiograhs.

Useful in detection because of the nature of this disease process. Carious lesions appear radiolucent. Bite wing radiograph is usually used but can also use a periapical radiograph using the paralleling technique.

All films must be properly mounted and viewed on a viewbox. A pocket sized magnifying glass is also helpful. View in the presence of the patient. Radiographs must be of diagnostic quality with proper contrast and density and without overlap.

Location (interproximal, occlusal, buccal, lingual, and root surfaces), recurrent and rampant

Caries found between two teeth. Typically seen at or just below (apical to) the contact point. They can be classified according to the depth of penetration of the lesion through the enamel and dentin. Can be classified as incipient, moderate, advanced, and severe.

Beginning to exist or appear. Extends less than halfway through the thickness of enamel. Class I seen in enamel only.

Extends more than halfway through the thickness of enamel but does not involve the DEJ Class II seen in enamel only.

Extends to or through the DEJ and into dentin but does not extend through the dentin more than half the distance toward the pulp. Class III affects both enamel and dentin.

Extends through enamel, through the dentin, and more than half the distance toward the pulp. Class IV involves both enamel and dentin and may appear clinically as a cavitation in the tooth.

Caries that involve the chewing surface of the posterior teeth. Usually detected with thorough clinical exam. Difficult to see on radiographs because of the superimposition of the dense buccal and lingual enamel cusps. Can be classified as incipient, moderate, or severe.

Cannot be seen on a dental radiograph and must be detected clinically with an explorer.