2/3 What happens to the tooth structure

Question 1

What are the contributing factors to caries?

Answer 1

tooth
diet
dental plaque

Question 2

What does caries on enamel look like

Answer 2

White spot

Question 3

What do you NOT do to a white legion, why?

Answer 3

probe it

- fragile?

Question 4

What is the structure of an enamel legion like?

Answer 4

subsurface loss
enlarged gaps between rods
rod length preserved

Question 5

What does remineralised white spot look like?

Answer 5

chalky, tends to get brighter as remineralises

Question 6

where is white spot especially common

Answer 6

around the gingival margins as that’s where plaque builds up

Question 7

what happens to the microscopic appearance of an active white spot at reminerlization

Answer 7

the surface becomes smoother

when it is rough there is a larger surface for plaque to build upon

Question 8

how can we tell that caries doesn’t come from nothing?

Answer 8

lots of people will have small legions which are too small to restore on their teeth

Question 9

What would we start to assume about the activeness of a white spot which is near the gingival margin?

Answer 9

that it is active

Question 10

how can you have gingivitis and white spot near the gingival margin but no plaque?

Answer 10

a patient who has brushed their teeth just cause they are coming to the dentist - no compliance (knows what to do but doesn’t do it), need to talk about the problem and see more frequently

Question 11

what can we tell about a patient who has white spot, no cavitation and the white spot has moved away from the gingival margin

Answer 11

didn’t have compliance but does now

we can see this because the white spot has moved away from the gingival margin

Question 12

Describe the differences in stephen curve between sound, inactive and active carious legions

Answer 12

sound and inactive not that different- probably to do with diet

active is often below pH5.5

Question 13

Describe how caries occurs

Answer 13

it is a breakdown of the balance between remineralisation and demineralisation

Question 14

What is the ecological shift which occurs in caries development

Answer 14

S. sangunis and S. gordonii are present for remineralization (their energy is not from sugar)

MS lactobacili take over in time
S. mutans

Question 15

Why are carious legions from pits and fissures a triangular shape

Answer 15

plaque is present on surface and in pits and fissures
plaque receives sugar, produces acid
Saliva can buffer but that will be mostly at the surface
Rods are perpendicular to the surface
Acid gives demineralisation at the core central regions
so ends up triangular - to do with the shape of the rods

Question 16

What does the triangular shape mean for the difference between what a carious legion looks like from the surface and what it actually is

Answer 16

the legion might be small on the surface but large on the base

Question 17

Describe the progression of dentine caries

Answer 17

• Scleorotic dentine
• Demineraliasation
• tertiary dentine
• invasion of bacteria into structure

Question 18

A key change to carious dentine?

Answer 18

different hardness

outer carious dentine

• infected
• unreminerlizable
• dead
• senseless

inner carious dentine

• uninfected
• reminerlizable
• alive
• sensitive

Question 19

what is the worst kind of root caries to restore

Answer 19

when it looks wet, this means you have a soft carious legion

if it’s dark and hard it’s been there for decades

restoring teeth is based on having a hard enough area

Question 20

How has dentistry transformed the Oral health status of high, middle and low-income countries?

Answer 20

Read:

Ole Fejerskov and Edwina Kidd (Ed)
Second edition
Baelum et al
Chapter 32
Page 576-605