CLASSIFICATION OF DENTAL CARIES

Presented by:

Haris Mehmood.BDS-III

CRITERIA OF CLASSIFICATION

Location

Rate Of Progression

According to whether lesion is new one or is occuring around restoration

G.V. Black’s classification

Site and Size Classification

LOCATION:

• Pit or Fissure Caries

• Smooth surface caries

Pit and Fissure Caries:

• Occlusal surface of molars and premolars• Buccal and lingual surface of molars• Lingual surface of maxillary incisors

Why they are more prone to caries?

• High steep walls & narrow bases• Enamel in extreme depth is often very thin

or even absent• Resulting in “Exposure of Dentine”• Deep narrow pits and fissures favour

retention of food debris and microorganisms

Clinical Appearance

• Early carious lesion may appear brown or black

Progression

• Caries extend laterally at DEJ without fracturing away overhanging enamel.

SMOOTH SURFACE CARIES

• Proximal surfaces of teeth

• Gingival third of buccal and

lingual surfaces.

Why caries usually do not occur on other smooth surfaces than these?

• SELF CLEANSING PROPERTIES

Cervical Caries

Buccal, Labial or Lingual surfaces

Crescent shaped

– Always an open cavity– No narrow area of penetration– Of all dental caries:

• LEAST EXCUSE FOR CERVICAL CARIES

It can be prevented at any instance by proper hygiene.

ACCORDING TO RATE OF PROGRESSION

• Acute Dental Caries

• Chronic Dental Caries

ACUTE DENTAL CARIES

• Runs a rapid clinical course• Result in early pulp involvement• Occur most frequently in children and

young adults====}

»WHY???

– Dentinal tubules are large and open.– No sclerosis.

NURSING BOTTLE CARIES

• Nursing caries• Baby bottle syndrome• Bottle mouth syndromeEtiology:Prolonged use of Nursing bottle containing milk or formula

Breast feeding

Sugar or honey sweetened pacifiers

• Habitual use of one of above after 1 year of age as an AID for sleeping at night or at naptime.

CLINICAL PICTURE

widespread caries destruction of deciduous teeth

Occur most commonly in four maxillary incisors…

followed by

First molars…. And then the cuspids if the habit prolonged.

BUT

How we distinguish it from ordinary Rampant caries???

• ABSENCE OF CARIES IN MANDIBULAR INCISORS

RADIATION CARIES

• result of receiving radiation treatment to the head and neck region for cancer

• Caries develop as a result of “Xerostomia”

CHRONIC DENTAL CARIES

• Progress slowly• Involve the pulp much later• Most common in adults• Stained deep brown• Entrance of lesion is invariably larger than

acute caries

• Slow progression allows sufficient time for:

• Sclerosis of dentinal tubules• Deposition of secondary dentine

PAIN IS NOT A COMMON FEATURE.

WHY???

• PRIMARY (virgin) CARIES

• SECONDARY (recurrent) CARIES

PRIMARY CARIES

• Any new carious lesion on tooth surface

RECURRENT DENTAL CARIES

• Occurs in immediate vicinity of the original restoration

• Poor adaptation of the filling material to cavity resulting in “LEAKY MARGINS”

• Favors retention of debris • Bacteria and substrate enter through leaky

margins easily

INFORMATION

• Within Dentinal tubules:::::}}}

– Lactobacilli ~ DIES– Streptococci ~ PERSIST

ARRESTED CARIES

Static or stationary

Does not show any tendency towards further progression

large open cavity

lack of food retention

Formation of a self cleansing area.

G.V. BLACK’S CLASSIFICATION• Class I

– Occlusal Pit and fissure of molars and pre molars– Buccal and lingual grooves of molars– Lingual pits of anteriors

• Class II– Proximal surface of posteriors

• Class III– Proximal surface of anteriors

• Class IV– Proximal surface of anteriors including incisal edge

• Class V– Gingival third of facial and lingual surfaces of all teeth

• Class VI– Cusp tips

SITE AND SIZE CLASSIFICATION

• Proposed by Dr. Graham J. Mount and Dr. W. Rory Hume in May 1997.

• Three sites and four sizes description.

G.I. MOUNT’S CLASSIFICATION

SITE

1Fissure

2Proximal

3Cervical

SIZE

1

Minimal

2

Moderate

3

Enlarged

4

Extensive

1.1 1.2 1.3 1.4

2.1 2.2 2.3 2.4

2.1 3.2 3.3 3.4