CARIES ACTIVITY TESTS

DENTAL CARIES

It is an irreversible
progressive disease of
multifactorial in nature
affecting the calcified
tissues of the teeth
characterized by
demineralization of
inorganic portion &
destruction of organic
portion of the tooth.
CARIES ACTIVITY

• Refers to the increment of active lesion (new and

recurrent lesions) over a stated period of time
• Caries activity is a measure of speed of progression
of a carious lesion.

CARIES SUSCEPTIBILITY

• Refers to the inherent tendency of the host & target

tissue, the tooth to be affected by the carious process
 REQUIREMENTS OF CARIES ACTIVITY
TESTS

• Test should be reproducible & valid

• There should be good correlation between the caries activity
scores & actual caries development
• Should be simple
• Results should be obtained rapidly, within hours or few days
• Should have measurement of mechanisms involved in caries
process
• Should be inexpensive, non-invasive & applicable to any
clinical setting
 CARIES ACTIVITY
TESTS:

1. Lactobacillus colony count test

• Saliva is collected by chewing paraffin

before breakfast
• The specimen is vigorously shaken and
after that 0.1 cc of sample is withdrawn
• Dilute and undiluted samples are then
spread evenly over a rogosa’s SL agar
plate
• The plate is incubated for 4 days & no. of
lactobacillus colonies that developed are
counted.
No of organisms Symbolic Degree of caries
designation activity suggested

1-1000 + Little or none

1000-5000 + Slight

5000-10,000 ++ Moderate

More than 10,000 +++/++++ Marked

SNYDER TEST

• This test measures the ability of salivary

microorganisms to form organic acid from a
carbohydrate medium.
• The classical formula of Snyder’s agar per litre
of purified water is

pancreatic digest/ casein -13.5 gm

yeast extract -6.5 gm
dextrose -20 gm
sodium chloride -5 gm
agar -16 gm
Bromocresol green -0.029 gm
 24 hrs 48 hrs 72hrs

Color : yellow yellow yellow

Caries activity: marked definite limited

Color : green green green

Caries activity: continue test continue test continue test

ALBEN’S TEST

• It is a modified Snyder test

• At the time of test 5 ml, tube of semisolid agar is removed
from refrigerator but is not heated
• The patient is asked to spit unstimulated saliva directly in to
the tube. Tube is incubated for 4 days.

SWAB TEST

• Advantage is no collection of saliva is necessary

• Valuable in evaluating caries activity in very young children
• Principle is same as Snyder test
• The oral flora is sampled by swabbing the buccal surface of
tooth with cotton.
REDUCTASE TEST

• This test measures the activity of reductase enzyme present in

salivary bacteria
• The sample is mixed with fixed amount of diazo-resorcinol
• The change in color after 15 min is taken as a measure of
caries activity
 color Time score Caries activity

Blue 15min 1 Non conductive

Orchid 15 min 2 Slightly conductive

Red 15 min 3 Moderately

conductive
Red Immediately 4 Highly conductive

pink Immediately 5 Extremely conductive

ENAMEL SOLUBILITY
TEST

• It is based on the fact that when glucose

is added to saliva containing powdered
enamel, organic acids are formed
• Organic acid decalcifies the enamel,
resulting in an increase in the amount of
soluble calcium
• The extend of increase of calcium is a
direct measure of caries activity
SALIVA FLOW TEST

• Flow rate is determined by collecting paraffin stimulated

saliva in a test tube over 5 min
• Severely decreased flow is related to caries susceptibility
• As salivary flow rate decreases viscosity increases
PATIENT EDUCATION WITH METHYL RED

• A simple and effective technique that may be of assistance in

educating child patient to the problem of dental caries control
involves the use of aqueous solution of methyl red
• Indicator dye changes colour in the pH range from 6.3(distinct
yellow) – 4.2(red)
• Aqueous methyl red is then applied to the surface of the tooth
with dropper
• Red colour is developed in the area of plaque accumulation
• This is interpreted to patient as evidence of continuous acid
formation