Tooth Decay (Dental Caries) F007
Current RMA Instruments:
Reasonable Hypothesis SOP | 74 of 2024 |
Balance of Probabilities SOP | 75 of 2024 |
Changes from previous Instruments:
ICD Coding:
- ICD-10-AM Codes: K02.0-K02.3 and K02.8-K02.9
Brief description
Dental caries involves localised destruction of dental hard tissues (enamel, cementum, or dentin) caused by bacteria in dental plaque, leading to demineralisation or cavity formation. Any part of the tooth can develop dental caries, including the crown, neck or root.
Confirming the diagnosis
To establish this diagnosis, a dental report is required.
Additional diagnoses covered by SOP
- Nil
Conditions not covered by SOP
- Dental pulp and periapical disease *
- Periodontitis *
- Loss of teeth/ tooth loss * Loss of teeth
- Tooth wear *
* another SOP applies - the SOP has the same name unless otherwise specified
Clinical onset
Each occurrence of tooth decay/dental caries can be considered as a new clinical onset.
Clinical worsening
The development of new cavities in other locations at later times is a new onset of tooth decay in the affected tooth rather than a case of clinical worsening. Progression of tooth decay to dental pulp disease or loss of a tooth (extraction) is covered under the SOPs for those conditions. The only SoP clinical worsening factor is for inability to obtain appropriate clinical management. Lack of timely treatment of a cavity could lead to worsening of that cavity.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/sops-grouped-icd-body-system/c-d/dental-caries-f007-k020k021k022k02
Rulebase for dental caries
<div><h5><strong>Current RMA Instruments:</strong></h5><table border="1" cellspacing="1" cellpadding="1"><tbody><tr><td><address><h5><a href="http://www.rma.gov.au/assets/SOP/2024/37aa9da20d/074.pdf" target="_blank">Reasonable Hypothesis SOP</a></h5></address></td><td><h5>74 of 2024</h5></td></tr><tr><td><address><h5><a href="http://www.rma.gov.au/assets/SOP/2024/6dd33f3605/075.pdf" target="_blank">Balance of Probabilities SOP</a></h5></address></td><td><h5>75 of 2024</h5></td></tr></tbody></table><h5><strong>Changes from previous Instruments:</strong></h5><drupal-media data-entity-type="media" data-entity-uuid="30a06516-f084-49fa-bd2b-22022683bec1"> </drupal-media><h5> </h5><h5><strong>ICD Coding:</strong></h5><ul><li><span>ICD-10-AM Codes: K02.0-K02.3 and K02.8-K02.9</span></li></ul><h5><strong>Brief description</strong></h5><p>Dental caries involves localised destruction of dental hard tissues (enamel, cementum, or dentin) caused by bacteria in dental plaque, leading to demineralisation or cavity formation. A<span>ny part of the tooth can develop dental caries, including the crown, neck or root.</span></p><h5><span><strong>Confirming the diagnosis</strong></span></h5><p>To establish this diagnosis, a dental report is required. </p><h5><span><strong>Additional diagnoses covered by SOP</strong></span></h5><ul><li>Nil</li></ul><h5><span><strong>Conditions not covered by SOP</strong></span></h5><ul><li>Dental pulp and periapical disease *</li><li>Periodontitis *</li><li>Loss of teeth/ tooth loss * Loss of teeth </li><li>Tooth wear *</li></ul><p>* another SOP applies - the SOP has the same name unless otherwise specified</p><p> </p><h5><strong>Clinical onset</strong></h5><p>Each occurrence of tooth decay/dental caries can be considered as a new clinical onset. </p><h5><strong>Clinical worsening</strong></h5><p>The development of new cavities in other locations at later times is a new onset of tooth decay in the affected tooth rather than a case of clinical worsening. Progression of tooth decay to dental pulp disease or loss of a tooth (extraction) is covered under the SOPs for those conditions. The only SoP clinical worsening factor is for inability to obtain appropriate clinical management. Lack of timely treatment of a cavity could lead to worsening of that cavity. </p></div>
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/c-d/dental-caries-f007-k020k021k022k02/rulebase-dental-caries
An acquired enamel defect
Current RMA Instruments:
Reasonable Hypothesis SOP | 74 of 2024 |
Balance of Probabilities SOP | 75 of 2024 |
Changes from previous Instruments:
ICD Coding:
- ICD-10-AM Codes: K02.0-K02.3 and K02.8-K02.9
Brief description
Dental caries involves localised destruction of dental hard tissues (enamel, cementum, or dentin) caused by bacteria in dental plaque, leading to demineralisation or cavity formation. Any part of the tooth can develop dental caries, including the crown, neck or root.
Confirming the diagnosis
To establish this diagnosis, a dental report is required.
Additional diagnoses covered by SOP
- Nil
Conditions not covered by SOP
- Dental pulp and periapical disease *
- Periodontitis *
- Loss of teeth/ tooth loss * Loss of teeth
- Tooth wear *
* another SOP applies - the SOP has the same name unless otherwise specified
Clinical onset
Each occurrence of tooth decay/dental caries can be considered as a new clinical onset.
Clinical worsening
The development of new cavities in other locations at later times is a new onset of tooth decay in the affected tooth rather than a case of clinical worsening. Progression of tooth decay to dental pulp disease or loss of a tooth (extraction) is covered under the SOPs for those conditions. The only SoP clinical worsening factor is for inability to obtain appropriate clinical management. Lack of timely treatment of a cavity could lead to worsening of that cavity.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/c-d/dental-caries-f007-k020k021k022k02/rulebase-dental-caries/acquired-enamel-defect
Exposure to fermentable dietary carbohydrates
Current RMA Instruments:
Reasonable Hypothesis SOP | 74 of 2024 |
Balance of Probabilities SOP | 75 of 2024 |
Changes from previous Instruments:
ICD Coding:
- ICD-10-AM Codes: K02.0-K02.3 and K02.8-K02.9
Brief description
Dental caries involves localised destruction of dental hard tissues (enamel, cementum, or dentin) caused by bacteria in dental plaque, leading to demineralisation or cavity formation. Any part of the tooth can develop dental caries, including the crown, neck or root.
Confirming the diagnosis
To establish this diagnosis, a dental report is required.
Additional diagnoses covered by SOP
- Nil
Conditions not covered by SOP
- Dental pulp and periapical disease *
- Periodontitis *
- Loss of teeth/ tooth loss * Loss of teeth
- Tooth wear *
* another SOP applies - the SOP has the same name unless otherwise specified
Clinical onset
Each occurrence of tooth decay/dental caries can be considered as a new clinical onset.
Clinical worsening
The development of new cavities in other locations at later times is a new onset of tooth decay in the affected tooth rather than a case of clinical worsening. Progression of tooth decay to dental pulp disease or loss of a tooth (extraction) is covered under the SOPs for those conditions. The only SoP clinical worsening factor is for inability to obtain appropriate clinical management. Lack of timely treatment of a cavity could lead to worsening of that cavity.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/c-d/dental-caries-f007-k020k021k022k02/rulebase-dental-caries/exposure-fermentable-dietary-carbohydrates
Extreme or catastrophic hyposalivation
Current RMA Instruments:
Reasonable Hypothesis SOP | 74 of 2024 |
Balance of Probabilities SOP | 75 of 2024 |
Changes from previous Instruments:
ICD Coding:
- ICD-10-AM Codes: K02.0-K02.3 and K02.8-K02.9
Brief description
Dental caries involves localised destruction of dental hard tissues (enamel, cementum, or dentin) caused by bacteria in dental plaque, leading to demineralisation or cavity formation. Any part of the tooth can develop dental caries, including the crown, neck or root.
Confirming the diagnosis
To establish this diagnosis, a dental report is required.
Additional diagnoses covered by SOP
- Nil
Conditions not covered by SOP
- Dental pulp and periapical disease *
- Periodontitis *
- Loss of teeth/ tooth loss * Loss of teeth
- Tooth wear *
* another SOP applies - the SOP has the same name unless otherwise specified
Clinical onset
Each occurrence of tooth decay/dental caries can be considered as a new clinical onset.
Clinical worsening
The development of new cavities in other locations at later times is a new onset of tooth decay in the affected tooth rather than a case of clinical worsening. Progression of tooth decay to dental pulp disease or loss of a tooth (extraction) is covered under the SOPs for those conditions. The only SoP clinical worsening factor is for inability to obtain appropriate clinical management. Lack of timely treatment of a cavity could lead to worsening of that cavity.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/c-d/dental-caries-f007-k020k021k022k02/rulebase-dental-caries/extreme-or-catastrophic-hyposalivation
Gingival recession
Current RMA Instruments:
Reasonable Hypothesis SOP | 74 of 2024 |
Balance of Probabilities SOP | 75 of 2024 |
Changes from previous Instruments:
ICD Coding:
- ICD-10-AM Codes: K02.0-K02.3 and K02.8-K02.9
Brief description
Dental caries involves localised destruction of dental hard tissues (enamel, cementum, or dentin) caused by bacteria in dental plaque, leading to demineralisation or cavity formation. Any part of the tooth can develop dental caries, including the crown, neck or root.
Confirming the diagnosis
To establish this diagnosis, a dental report is required.
Additional diagnoses covered by SOP
- Nil
Conditions not covered by SOP
- Dental pulp and periapical disease *
- Periodontitis *
- Loss of teeth/ tooth loss * Loss of teeth
- Tooth wear *
* another SOP applies - the SOP has the same name unless otherwise specified
Clinical onset
Each occurrence of tooth decay/dental caries can be considered as a new clinical onset.
Clinical worsening
The development of new cavities in other locations at later times is a new onset of tooth decay in the affected tooth rather than a case of clinical worsening. Progression of tooth decay to dental pulp disease or loss of a tooth (extraction) is covered under the SOPs for those conditions. The only SoP clinical worsening factor is for inability to obtain appropriate clinical management. Lack of timely treatment of a cavity could lead to worsening of that cavity.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/c-d/dental-caries-f007-k020k021k022k02/rulebase-dental-caries/gingival-recession
Having been a prisoner of war
Current RMA Instruments:
Reasonable Hypothesis SOP | 74 of 2024 |
Balance of Probabilities SOP | 75 of 2024 |
Changes from previous Instruments:
ICD Coding:
- ICD-10-AM Codes: K02.0-K02.3 and K02.8-K02.9
Brief description
Dental caries involves localised destruction of dental hard tissues (enamel, cementum, or dentin) caused by bacteria in dental plaque, leading to demineralisation or cavity formation. Any part of the tooth can develop dental caries, including the crown, neck or root.
Confirming the diagnosis
To establish this diagnosis, a dental report is required.
Additional diagnoses covered by SOP
- Nil
Conditions not covered by SOP
- Dental pulp and periapical disease *
- Periodontitis *
- Loss of teeth/ tooth loss * Loss of teeth
- Tooth wear *
* another SOP applies - the SOP has the same name unless otherwise specified
Clinical onset
Each occurrence of tooth decay/dental caries can be considered as a new clinical onset.
Clinical worsening
The development of new cavities in other locations at later times is a new onset of tooth decay in the affected tooth rather than a case of clinical worsening. Progression of tooth decay to dental pulp disease or loss of a tooth (extraction) is covered under the SOPs for those conditions. The only SoP clinical worsening factor is for inability to obtain appropriate clinical management. Lack of timely treatment of a cavity could lead to worsening of that cavity.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/c-d/dental-caries-f007-k020k021k022k02/rulebase-dental-caries/having-been-prisoner-war
Inability to access preventive professional dental care
Current RMA Instruments:
Reasonable Hypothesis SOP | 74 of 2024 |
Balance of Probabilities SOP | 75 of 2024 |
Changes from previous Instruments:
ICD Coding:
- ICD-10-AM Codes: K02.0-K02.3 and K02.8-K02.9
Brief description
Dental caries involves localised destruction of dental hard tissues (enamel, cementum, or dentin) caused by bacteria in dental plaque, leading to demineralisation or cavity formation. Any part of the tooth can develop dental caries, including the crown, neck or root.
Confirming the diagnosis
To establish this diagnosis, a dental report is required.
Additional diagnoses covered by SOP
- Nil
Conditions not covered by SOP
- Dental pulp and periapical disease *
- Periodontitis *
- Loss of teeth/ tooth loss * Loss of teeth
- Tooth wear *
* another SOP applies - the SOP has the same name unless otherwise specified
Clinical onset
Each occurrence of tooth decay/dental caries can be considered as a new clinical onset.
Clinical worsening
The development of new cavities in other locations at later times is a new onset of tooth decay in the affected tooth rather than a case of clinical worsening. Progression of tooth decay to dental pulp disease or loss of a tooth (extraction) is covered under the SOPs for those conditions. The only SoP clinical worsening factor is for inability to obtain appropriate clinical management. Lack of timely treatment of a cavity could lead to worsening of that cavity.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/c-d/dental-caries-f007-k020k021k022k02/rulebase-dental-caries/inability-access-preventive-professional-dental-care
Inability to obtain appropriate clinical management for dental caries
Current RMA Instruments:
Reasonable Hypothesis SOP | 74 of 2024 |
Balance of Probabilities SOP | 75 of 2024 |
Changes from previous Instruments:
ICD Coding:
- ICD-10-AM Codes: K02.0-K02.3 and K02.8-K02.9
Brief description
Dental caries involves localised destruction of dental hard tissues (enamel, cementum, or dentin) caused by bacteria in dental plaque, leading to demineralisation or cavity formation. Any part of the tooth can develop dental caries, including the crown, neck or root.
Confirming the diagnosis
To establish this diagnosis, a dental report is required.
Additional diagnoses covered by SOP
- Nil
Conditions not covered by SOP
- Dental pulp and periapical disease *
- Periodontitis *
- Loss of teeth/ tooth loss * Loss of teeth
- Tooth wear *
* another SOP applies - the SOP has the same name unless otherwise specified
Clinical onset
Each occurrence of tooth decay/dental caries can be considered as a new clinical onset.
Clinical worsening
The development of new cavities in other locations at later times is a new onset of tooth decay in the affected tooth rather than a case of clinical worsening. Progression of tooth decay to dental pulp disease or loss of a tooth (extraction) is covered under the SOPs for those conditions. The only SoP clinical worsening factor is for inability to obtain appropriate clinical management. Lack of timely treatment of a cavity could lead to worsening of that cavity.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/c-d/dental-caries-f007-k020k021k022k02/rulebase-dental-caries/inability-obtain-appropriate-clinical-management-dental-caries
Inability to obtain exposure to fluoride
Current RMA Instruments:
Reasonable Hypothesis SOP | 74 of 2024 |
Balance of Probabilities SOP | 75 of 2024 |
Changes from previous Instruments:
ICD Coding:
- ICD-10-AM Codes: K02.0-K02.3 and K02.8-K02.9
Brief description
Dental caries involves localised destruction of dental hard tissues (enamel, cementum, or dentin) caused by bacteria in dental plaque, leading to demineralisation or cavity formation. Any part of the tooth can develop dental caries, including the crown, neck or root.
Confirming the diagnosis
To establish this diagnosis, a dental report is required.
Additional diagnoses covered by SOP
- Nil
Conditions not covered by SOP
- Dental pulp and periapical disease *
- Periodontitis *
- Loss of teeth/ tooth loss * Loss of teeth
- Tooth wear *
* another SOP applies - the SOP has the same name unless otherwise specified
Clinical onset
Each occurrence of tooth decay/dental caries can be considered as a new clinical onset.
Clinical worsening
The development of new cavities in other locations at later times is a new onset of tooth decay in the affected tooth rather than a case of clinical worsening. Progression of tooth decay to dental pulp disease or loss of a tooth (extraction) is covered under the SOPs for those conditions. The only SoP clinical worsening factor is for inability to obtain appropriate clinical management. Lack of timely treatment of a cavity could lead to worsening of that cavity.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/c-d/dental-caries-f007-k020k021k022k02/rulebase-dental-caries/inability-obtain-exposure-fluoride
Inability to perform effective oral hygiene
Current RMA Instruments:
Reasonable Hypothesis SOP | 74 of 2024 |
Balance of Probabilities SOP | 75 of 2024 |
Changes from previous Instruments:
ICD Coding:
- ICD-10-AM Codes: K02.0-K02.3 and K02.8-K02.9
Brief description
Dental caries involves localised destruction of dental hard tissues (enamel, cementum, or dentin) caused by bacteria in dental plaque, leading to demineralisation or cavity formation. Any part of the tooth can develop dental caries, including the crown, neck or root.
Confirming the diagnosis
To establish this diagnosis, a dental report is required.
Additional diagnoses covered by SOP
- Nil
Conditions not covered by SOP
- Dental pulp and periapical disease *
- Periodontitis *
- Loss of teeth/ tooth loss * Loss of teeth
- Tooth wear *
* another SOP applies - the SOP has the same name unless otherwise specified
Clinical onset
Each occurrence of tooth decay/dental caries can be considered as a new clinical onset.
Clinical worsening
The development of new cavities in other locations at later times is a new onset of tooth decay in the affected tooth rather than a case of clinical worsening. Progression of tooth decay to dental pulp disease or loss of a tooth (extraction) is covered under the SOPs for those conditions. The only SoP clinical worsening factor is for inability to obtain appropriate clinical management. Lack of timely treatment of a cavity could lead to worsening of that cavity.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/c-d/dental-caries-f007-k020k021k022k02/rulebase-dental-caries/inability-perform-effective-oral-hygiene
Xerostomia
Current RMA Instruments:
Reasonable Hypothesis SOP | 74 of 2024 |
Balance of Probabilities SOP | 75 of 2024 |
Changes from previous Instruments:
ICD Coding:
- ICD-10-AM Codes: K02.0-K02.3 and K02.8-K02.9
Brief description
Dental caries involves localised destruction of dental hard tissues (enamel, cementum, or dentin) caused by bacteria in dental plaque, leading to demineralisation or cavity formation. Any part of the tooth can develop dental caries, including the crown, neck or root.
Confirming the diagnosis
To establish this diagnosis, a dental report is required.
Additional diagnoses covered by SOP
- Nil
Conditions not covered by SOP
- Dental pulp and periapical disease *
- Periodontitis *
- Loss of teeth/ tooth loss * Loss of teeth
- Tooth wear *
* another SOP applies - the SOP has the same name unless otherwise specified
Clinical onset
Each occurrence of tooth decay/dental caries can be considered as a new clinical onset.
Clinical worsening
The development of new cavities in other locations at later times is a new onset of tooth decay in the affected tooth rather than a case of clinical worsening. Progression of tooth decay to dental pulp disease or loss of a tooth (extraction) is covered under the SOPs for those conditions. The only SoP clinical worsening factor is for inability to obtain appropriate clinical management. Lack of timely treatment of a cavity could lead to worsening of that cavity.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/c-d/dental-caries-f007-k020k021k022k02/rulebase-dental-caries/xerostomia