Cariology, caries risk assessment and prevention
What this domain tests
Cariology questions test the dynamic caries process, risk assessment, and evidence-based prevention using fluoride, diet and sealants.
Core rules
- Caries is a biofilm-mediated, sugar-driven dynamic process; demineralisation and remineralisation occur continuously.
- Fluoride acts mainly topically: it inhibits demineralisation, enhances remineralisation and reduces bacterial acid production.
- Community water fluoridation is a population-level measure; individual measures include fluoride toothpaste, varnish and, for high-risk patients, higher-fluoride products under guidance.
- Assess risk using caries history, diet frequency, fluoride exposure, saliva, medical factors and social context. ICDAS or similar systems describe lesion activity.
- Fissure sealants are indicated for deep pits and fissures in high-risk teeth; they do not replace caries removal.
- Radiographs are adjuncts, not a diagnosis on their own.
Worked example
A 7-year-old has two new approximal lesions, drinks juice four times daily, and uses no fluoride toothpaste. Risk is high. Plan: fluoride toothpaste with supervision, fluoride varnish according to schedule, reduce sugar frequency, sealant assessment on erupting molars, and review.
Traps
Focusing on sugar amount but ignoring frequency; sealing active cavitated caries; using radiographs alone; assuming fluoride only works systemically.