Dental Caries: the Disease and Its Clinical Management

640 Pages·2012·17.932 MB·English

by  Fejerskov, Ole;Kidd, Edwina

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Dental Caries
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Dental Caries
The Disease and its Clinical Management
Second Edition
Edited by
Ole Fejerskov and Edwina Kidd
with
Bente Nyvad and Vibeke Baelum
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© 2003,2008 by Blackwell Munksgaard Ltd
Chapter 23 © 2008 J.Frencken
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First published 2003 by Blackwell Munksgaard Ltd
Second edition published 2008
ISBN:9781405138895
Library ofCongress Cataloging-in-Publication Data
Dental caries:the disease and its clinical management/edited by Ole Fejerskov and Edwina A.M.Kidd,with Bente Nyvad and
Vibeke Baelum.-- 2nd ed.
p.XX;cm.
Includes bibliographical references and index.
ISBN-13:978-1-4051-3889-5 (hardback :alk.paper)
ISBN-10:1-4051-3889-0 (hardback :alk.paper)
1.Dental caries--Diagnosis.2.Dental caries--Treatment.I.Fejerskov,Ole.II.Kidd,Edwina A.M.
[DNLM:1.Dental Caries--diagnosis.2.Dental Caries--therapy.3.Dental Restoration,Permanent.WU 270 D4145 2008]
RK331.D465 2008
617.6’7--dc22
2007021650
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Contents
Preface: an Editors’guide to reading the book xiii
Contributors xix
Part I The disease and its diagnosis 1
Chapter 1 Defining the disease:an introduction 3
O.Fejerskov,E.A.M.Kidd,B.Nyvad and V.Baelum
Introduction 4
Terminology 5
Background literature 6
References 6
Chapter 2 Clinical appearances ofcaries lesions 7
O.Fejerskov,B.Nyvad and E.A.M.Kidd
What do caries lesions look like clinically? 8
Deciduous dentition 8
Permanent dentition 10
References 18
Chapter 3 Pathology ofdental caries 19
O.Fejerskov,B.Nyvad and E.A.M.Kidd
Introduction 20
Enamel reactions during eruption 21
Enamel changes during early caries lesion development 23
The approximal white-spot lesion 27
Progression ofthe enamel lesion 32
Arrest ofthe caries lesion 32
Occlusal caries 35
Dentin reactions to caries progression 39
Pulpo-dentinal reactions 42
Root-surface caries 44
Background literature 47
References 48
Chapter 4 Visual–tactile caries diagnosis 49
B.Nyvad,O.Fejerskov and V.Baelum
Introduction 50
The diagnostic process 50
Why do we diagnose caries? 51
Diagnosis in a dental caries perspective 51
How early should caries lesions be detected? 53
What are the best visual–tactile caries diagnostic criteria? 53
Commonly used visual–tactile criteria 55
Differential diagnosis 60
Visual–tactile caries examination: a systematic clinical approach 62
Additional aids in visual–tactile caries diagnosis 64
Benefits and limitations ofvisual–tactile caries diagnosis 66
References 67
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vi Contents
Chapter 5 Radiography for caries diagnosis 69
I.Mejàre and E.A.M.Kidd
Introduction 70
Technical and quality aspects 70
Prescription and timing ofbitewing radiography 79
References 87
Chapter 6 Additional diagnostic measures 89
A.Lussi and B.Angmar-Månsson
Introduction 90
Methods based on X-ray 90
Methods based on light 92
Methods based on electrical current 97
Are the methods suitable for use in clinical practice or only useful for research? 98
Can the methods stand alone or are they only adjuncts to a clinical–visual examination? 99
References 99
Chapter 7 The foundations ofgood diagnostic practice 103
V.Baelum,B.Nyvad,H.-G.Gröndahl and O.Fejerskov
Introduction 104
The making ofa dentist 104
The dental examination: in the best interest ofpatients 105
What are we looking for – what is caries? 106
The wealth ofcaries diagnostic methods 108
The evolution in caries diagnostic methods 108
Evaluating caries diagnostic methods 109
Diagnostic test assessment in the essentialistic gold-standard paradigm 109
Leaps in the essentialistic gold-standard reasoning 111
Diagnostic test evaluation in the nominalistic caries paradigm 113
Interexaminer and intraexaminer errors in caries diagnosis 114
How do we deal with the unavoidable diagnostic uncertainty? 115
The additional diagnostic yield argument 116
Concluding remarks 117
References 118
Part II Clinical caries epidemiology 121
Chapter 8 The epidemiology ofdental caries 123
B.A.Burt,V.Baelum and O.Fejerskov
Introduction 124
Measuring dental caries 125
Distribution ofcaries 129
Summary 141
References 141
Chapter 9 The impact ofdiagnostic criteria on estimates ofprevalence, 147
extent and severity ofdental caries
N.Pitts
Introduction 148
Diagnostic criteria for dental caries: an epidemiological perspective 148
Caries diagnostic thresholds and specific epidemiological considerations 151
Impact ofdiagnostic criteria on estimates ofcaries prevalence 154
Impact ofdiagnostic criteria on estimates ofcaries extent 155
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Contents vii
Impact ofdiagnostic criteria on estimates ofthe severity ofdental caries 157
A framework for considering the choice ofappropriate diagnostic criteria for 158
epidemiological studies
Summary 158
References 158
Part III Dental caries in a biological context 161
Chapter 10 The oral microflora and biofilms on teeth 163
P.D.Marsh and B.Nyvad
Introduction 164
The resident microflora 164
Dental biofilms: development,structure,composition and properties 166
Caries microbiology: a briefhistorical perspective 178
Methodological problems in microbiological studies ofdental caries 178
Microbiology ofcaries 179
Cariogenic features ofdental biofilm bacteria 182
Concluding remarks 185
Background literature 185
References 185
Chapter 11 The role ofsaliva 189
A.Bardow,F.Lagerlöf,B.Nauntofte and J.Tenovuo
Introduction 190
Formation ofsaliva 190
Hypofunction ofsalivary glands 194
Oral clearance 195
Inorganic saliva composition 196
Saliva buffer capacity and pH regulation 198
Saliva proteins 200
Role ofthe pellicle 202
Other caries-related components in saliva 203
Saliva and the risk ofdeveloping caries lesions 204
Management ofsalivary gland hypofunction 206
Concluding remarks 206
Background literature 207
References 207
Chapter 12 Chemical interactions between the tooth and oral fluids 209
J.M.ten Cate,M.J.Larsen,E.I.F.Pearce and O.Fejerskov
Introduction 210
The importance ofthe mineral phase in enamel 210
Enamel mineral and oral fluids 213
Demineralization and remineralization ofthe dental hard tissues 217
Remineralization 220
Dentin caries 221
Fluoride reactions in the oral environment 225
Dental calculus 229
Background literature 230
References 230
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viii Contents
Chapter 13 Erosion ofthe teeth 233
M.J.Larsen
Introduction 234
Clinical manifestations and diagnosis 234
Histological and chemical features 236
Classification by depth ofthe lesion 237
Classification by etiology 237
Erosion caused by food and drinks 238
Erosion caused by stomach contents 243
Erosion caused by airborne acids 243
Idiopathic erosion 244
Prophylaxis and treatment oferosion 244
Conclusion 246
Background literature 246
References 246
Part IV Non-operative therapy 249
Chapter 14 The control ofdisease progression:non-operative treatment 251
E.A.M.Kidd and O.Fejerskov
Introduction 252
Can the caries process be prevented? 252
Controlling disease progression 252
Should disease control be considered as ‘treatment’ofthe caries lesion? 253
Why use the term ‘non-operative treatment’? 254
Does the approach work? Is it cost-effective? 254
References 254
Chapter 15 Role oforal hygiene 257
B.Nyvad
Introduction 258
Some theoretical considerations 258
The biological effect oftooth cleaning 258
The clinical effect oftooth cleaning 259
The effect ofprofessional tooth cleaning 262
The effect ofdental flossing 263
Concluding remarks 263
References 263
Chapter 16 Antimicrobials in caries control 265
A.A.Scheie and F.C.Petersen
Dental plaque: the biofilm lifestyle and the rationale for antimicrobial intervention 266
Biological activity and mode ofaction 267
Modification ofdental biofilm biochemistry and ecology 269
Vehicles for administration ofcaries-prophylactic agents 269
Specific agents 270
Other agents proposed for caries prophylaxis,but without documented anticaries effect 273
Concluding remarks and future approaches 275
Background literature 276
References 276
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Contents ix
Chapter 17 Might caries control involve immunization and gene therapy? 279
R.R.B.Russell
Introduction 280
Dental caries vaccine 280
Alternative approaches to targeting cariogenic bacteria 284
Natural defense mechanisms ofthe tooth 284
Conclusion 285
References 285
Chapter 18 Fluorides in caries control 287
R.Ellwood,O.Fejerskov,J.A.Cury and B.Clarkson
Introduction 288
How fluoride came into dentistry 288
Physiological and toxicological aspects offluoride delivery 293
Current methods offluoride delivery 304
Appropriate use offluoride in caries control 319
Summary ofrecommendations for fluoride-delivery methods 322
Background literature 323
References 323
Chapter 19 The role ofdietary control 329
D.T.Zero,P.Moynihan,P.Lingström and D.Birkhed
Introduction 330
Diet and dental caries in humans 330
Influence ofdifferent intake patterns 333
Influence offluoride on the relationship between sugars and caries 334
Groups at increased risk ofdental caries in relation to diet 336
Relative cariogenicity ofdifferent carbohydrates 338
Novel carbohydrates and dental health 338
Protective factors in foods 344
Diet and dental erosion 346
Promoting good dietary habits for dental health 346
References 349
Part V Operative intervention 353
Chapter 20 The role ofoperative treatment in caries control 355
E.A.M.Kidd,J.P.van Amerongen and W.E.van Amerongen
Introduction 356
What is happening in your dental school? 356
The outcome ofnon-operative treatment 356
Does this approach always work? 358
Occlusal surfaces 358
Approximal surfaces 359
Recurrent caries 359
Deciduous teeth 361
Summary 363
References 364
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x Contents
Chapter 21 Caries removal and the pulpo-dentinal complex 367
E.A.M.Kidd,L.Bjørndal,D.Beighton and O.Fejerskov
Introduction 368
Summary ofcaries lesion progression in dentin 368
The pulpo-dentinal complex and caries 371
The relevance ofpulpo-dentinal reactions to operative management 373
The current operative tradition 374
The infected dentin concept and its clinical consequence 374
Studies placing fissure sealants over carious dentin 376
Stepwise excavation studies 376
Why re-enter? 377
Randomized controlled clinical trials 380
Conclusions 382
References 382
Chapter 22 Restoring the tooth:‘the seal is the deal’ 385
J.P.van Amerongen,W.E.van Amerongen,T.F.Watson,N.J.M.Opdam,F.J.M.Roeters,
D.Bittermann and E.A.M.Kidd
Introduction 386
Materials 387
Treatment ofpit and fissure caries 396
Treatment ofapproximal caries 402
Treatment ofcaries in anterior teeth and the cervical area 410
Restorative procedures in the primary dentition 416
Failure and repair ofrestorations 420
References 423
Chapter 23 The atraumatic restorative treatment approach 427
J.E.Frencken and W.E.van Amerongen
History ofART 428
A treatment approach offissure sealing and minimal operative intervention 429
Atraumatic aspects 431
The ART approach step-by-step,for use with glass-ionomer restorative material 432
Survival ofART sealants and ART restorations 434
Comparison ofART with conventional treatment approaches 438
Causes offailure ofART restorations 439
Integration ofART into oral health services 439
References 440
Chapter 24 Longevity ofrestorations:the ‘death spiral’ 443
V.Qvist
Introduction 444
Clinical assessment ofrestorations 444
Assessment ofrestoration longevity 444
The amalgam debate and its consequences for restoration longevity 447
Longevity ofrestorations in the primary dentition 448
Longevity ofrestorations in the permanent dentition 449
Factors influencing restoration longevity 451
Consequences ofrestoration longevity for dental health and cost 453
Concluding remarks 454
References 454