1. DENTAL CARIES (Classification And Theories)
DNT 353
DENTAL CARIES (Classification And Theories)
Dr. Shahzadi Tayyaba Hashmi

2. CLASSIFICATION CLASSIFICATION BY THE RATE OF ATTACK: Acute caries
Chronic caries
Arrested caries
CLASSIFICATION BY THE SITE OF ATTACK:
Pits and fissure caries
Smooth surface caries
Root caries (cemental caries)
Recurrent caries

3. CLASSIFICATION BLACK'S CLASSIFICATION: Class I Class II Class III
Class IV
Class V
Class VI
CLASSIFICATION BASED ON VIRGINITY OF LESIONS:
Primary caries (initial)
Secondary caries (recurrent )

4. CLASSIFICATION
CLASSIFICATION BASED ON NUMBER OF TOOTH SURFACE INVOLVED:
Simple
Compound
Complex
EARLY CHILDHOOD CARIES :
Rampant caries (nursing bottle caries)

5. CLASSIFICATION BY THE RATE OF ATTACK
Acute caries:
Most common in young patients because they have teeth with large pulp chambers and short dentinal tubules with no or little sclerosis
Caused by diet rich in refined carbohydrates and less than adequate oral hygiene
Multiple advanced carious lesion develops simultaneously that reaches the pulp and cause severe pain

6. CLASSIFICATION BY THE RATE OF ATTACK
Chronic caries:
Most common in older patients whose teeth have small pulp chambers with additional deposits of dense tubular dentin on the pulpal walls known as tertiary dentin
They have significant degrees of sclerosis which provides resistance to the progression of dental caries
Less pain occurs
Arrested caries:
Enamel, dentine or root caries that become static and slower
No tendency for further progress

7. Acute caries in a child
Chronic caries
Arrested caries

8. CLASSIFICATION BY THE SITE OF ATTACK
Pits and fissure caries:
Most common type of caries
Appears at an early age on the occlusal and buccal surfaces of molars of the primary and secondary dentition
This form of caries is most destructive because it goes deeply into dentin and clinically appears as a large cavity which is painful

9. CLASSIFICATION BY THE SITE OF ATTACK
Smooth surface caries:
Less common
Occurs on the interproximal contact areas of teeth that are not self cleansing
Cervical regions of the
buccal and lingual
surfaces of teeth are
involved

10. CLASSIFICATION BY THE SITE OF ATTACK
Root caries (cemental caries):
Always found in old people who have roots exposed to oral environment as a result of gingival recession
This form of caries initiates differently than enamel and dentin caries, because root surfaces are soft and thin and can be traumatized by abrasive action during tooth brushing
Cementum is readily decalcified and presents little barrier to infection
Saucer shaped shallow cavity is formed with ill defined boundaries

11. ROOT CARIES IN LOWER PREMOLARS ROOT CARIES
ROOT CARIES DIFFICULT TO DETECT CLINICALLY,
BECAUSE THEY ARE FREQUENTLY
HIDDEN BY GINGIVA
ROOT CARIES AS A RESULT OF AGING

12. CLASSIFICATION BY THE SITE OF ATTACK
Recurrent Caries:
Caries that arises around an existing restoration
Lesions arises as a result of alteration in the integrity of a restoration results in marginal leakage
It causes accumulation of food and bacteria around the tooth where oral hygiene restricts the removal of those bacteria and food
Carious lesions progress
according to patients diet and
oral hygiene habits

13. BLACK’S CLASSIFICATION
Class I cavity is that in which Caries affect pits and fissures on occlusal surfaces of posterior teeth (molars and premolars) , lingual or buccal pits of posterior teeth and Lingual pit of incisors
CLASS II:
Class II cavity is one in which carious process affects approximal (mesial or distal ) surfaces of posterior teeth
CLASS III:
Class III cavity is one which is present in the approximal surface of the anterior teeth but does not involve the incisal edge

14. BLACK’S CLASSIFICATION
CLASS IV:
Class IV Caries affecting proximal surfaces including incisal edges of anterior teeth
CLASS V:
Class V Caries is one in which carious process creates defects in the cervical third of any tooth
CLASS VI:
Class VI Cavity is one in which the cusp tips or the incisal edges are involved in carious process

15. CLASS II
CLASS I
CLASS III

16. CLASS IV
CLASS V
CLASS VI

17. BLACK’S CLASSIFICATION
CASS III
CLASS V
CLASS II
CLASS I

18. EARLY CHILHOOD CARIES Rampant caries (nursing bottle caries):
Present on the labial surfaces of the primary teeth of infants
Caused by a habit of leaving the feeding bottle
containing milk or juice in the infants mouth when sleeping

19. THEORIES OF DENTAL CARIES
There are different theories about the progress of dental caries,
Acidogenic theory (miller’s theory)
Proteolytic theory
Proteolytic chelation theory

20. Acidogenic theory Proposed by W.D Miller in 1882
Miller proved after certain experiments that certain bacteria present in mouth, produce acids from carbohydrates which causes demineralization of the dental tissues
Consumption of more refined carbohydrates was associated with more caries
Frequency of carbohydrate foods
(snacks and drinks) also contribute
to incidence of dental caries
Widely accepted theory

21. Proteolytic theory Proposed by Gottlieb
According to this theory, the organic or protein elements of tooth are the initial pathways of invasion by microorganisms And, caries is essentially a Proteolytic process , in which the microorganisms invade the organic pathways and destroy them while advancing through them by forming acids
Hence certain structures of enamel having high organic material composition, like enamel lamellae and enamel rod sheaths, could serve as a pathway for microorganism invasion through the enamel

22. Proteolytic chelation theory
It was postulated that certain chelate compounds are present in the carious lesion
These types of compounds have a secondary role in the carious process

23. Thank you