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CARIES ACTIVITY TESTS

INTRODUCTION
Caries activity: increment of active lesions over a period of time Caries susceptibility: inherent tendency of the host and target tissue, the tooth,to be afflicted by caries Caries activity tests: refers to the degree to which the local environment challenge favours the probability of caries

IDEAL REQUISITES
Reliability and validity Simplicity Should be rapid enough to obtain results in a few hours or few days Inexpensive, non invasive, applicable to any clinical setting

Lactobacillus colony count test


Hadlee 1933 Principle: estimate the no of acidogenic and aciduric bacteria in patients saliva by counting the no of colonies on a suitable medium after inoculation with pts saliva

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Procedure after arising ask patient to chew small piece of paraffin and then saliva that accumulates is collected in a small sterile container 1:10 dilution by pipetting 1ml of saliva in 9ml tube of sterile saline solution 1:100 dilution by pipetting 1ml of tis solution into 9ml solution of sterile saline Mixed thoroughly and spread on agar plate containing 20ml of cooled liquified agar

5. colonies counted using magnifying glass Inference 0 1000 : little or none 1000-5000 : slight 5000-10,000:moderate more than 10,000:marked

CALORIMETRIC SNYDER TEST


Snyder,1951 Measures ability of salivary microorganisms to form organic acids from a carbohydrate medium Procedure : 1. Pt asked to chew paraffin before breakfast 2. 0.2ml Stimulated saliva collected

Collected saliva mixed with 10 ml melted agar in a test tube Medium contains bromocresol green which changes colour from green to yellow in a pH range of 5.4 to 3.8 Amount of acid produced is detected using pH indicator Compared using uninoculated control after 24, 48 and 72 hours Rate of colour change from green to yellow indicates degree of caries activity

SWAB TEST
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Grainger et al 1965 Procedure: Swab the buccal surfaces of the teeth with a cotton applicator, incubated for 48 hrs in the medium Change in pH is read using pH indicator Inference pH 4.1 & <4.1 : marked caries activity pH 4.2 4.4 : active pH 4.5 - 4.6 : slightly active pH 4.6 & above:caries active

STREPTOCOCCUS MUTANS LEVEL IN SALIVA


Measures the no of s.mutans colony forming units/unit vol of saliva Medium : MSA mitis salivarius agar + high concentration of 20%sucrose&0.2 U bacterium/ml This medium effectively suppresses non s.mutans colonies in the sample

Procedure 1. Sample collected using tongue blades 2. Pressed against the medium and incubated at 37^c for 48 hrs at 5% co2 mixture Inference > 105/ml : unacceptable 4.5 * 10^4/ml:colonization of new surface occurs readily

dip slide method Salivary buffer capacity test Enamel solubility test Alban test Salivary reductase test Streptococcus mutans screening test Fosdick calcium dissolution test

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