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D1 Spring - Operative Dentistry I > 3/21: Cariology > Flashcards

3/21: Cariology Flashcards

1
Q

What is cariology?

A

The study of dental caries and cariogenesis

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2
Q

What are dental caries?

A

An infectious microbiologic disease of the teeth resulting in localized dissolution and destruction of calcified tissues

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3
Q

What are the three elements of caries formation?

A

Teeth
- without teeth, bacteria have no habitat
Bacteria
- streptococcus mutans
Substrate
- any type of carbohydrate will support some strain of bacteria

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4
Q

What is the Tldr; recipe for caries?

A

Tooth
Biofilm (plaque)
Food source

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5
Q

Caries is ____________

A

Multifactorial

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6
Q

What are the types of bacteria that can cause caries?

A

Streptococcus mutans
Streptococcus sangius
Streptococcus mitis
Bacteroides melaningenicus

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7
Q

What is Considered normal oral flora- presence can actually slow the growth of Strep mutans colonies?

A

Streptococcus mitis

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8
Q

What is bacteroids melaninogenicus?

A

◦ Obligate anaerobe
◦ Associated with periodontal disease

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9
Q

What is dental plaque?

A

Gelatinous mass of bacteria adhering to tooth surface
Biofilm

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10
Q

What is cariogenic bacteria metabolism?

A

Bacteria consume sugars, the waste product is acid

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11
Q

What do acids lower pH in mouth to?

A

below 5.5

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12
Q

What occurs at 5.5 pH?

A

Deminerlization of enamel begins to take place

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13
Q

Since enamel is stronger, what does it require?

A

Higher acidity than dentin

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14
Q

What pH does dentin demineralize at?

A

6.2

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15
Q

What pH does dentin remain at after each sugar exposure?

A

Below 5.5 for 20-60 min

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16
Q

What is the food source for caries?

A

Fermentable carbohydrates
- bacteria eats what we eat

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17
Q

What is the preferred type of source for mutans streptococci?

A

Carbs - sucrose

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18
Q

What are examples of simple carbohydrates and starches?

A

◦ Chips
◦ Soda
◦ Candy
◦ Cookies
◦ Chewing gum
◦ Fruit drinks
◦ Rice
◦ Trail mix
◦ Granola bars

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19
Q

What is the epidemiology of caries in the past 30 years?

A

-Younger children (2-8yrs) have had minor decrease in caries prevalence
-Caries prevalence has remained constant for older children
-Minority youth still most at risk for caries
-Lower income youth still most at risk for caries

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20
Q

What are some examples of things that have been introduced to DECREASE caries rates?

A

Fluoride toothpaste
Water
Water Pik
Electrical toothbrush

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21
Q

Why do you think caries rates have not decreased significantly in the last 30 years?

A

Because things like soda, candy, cookies, baby bottles, sippers, drug users and poor brushing habits are still around

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22
Q

What are sites for caries initiation?

A

Pits and fissures
Smooth surfaces
- interproximal contacts (Cl II and III)
- near gingiva (Cl V)
Root surfaces

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23
Q

Is a white spot lesion a clinical feature of caries?

A

NONcavitated

24
Q

Are smooth surface caries a clinical feature of caries?

A

Cavitated

25
Q

How can you see interproximal caries?

A
  • clinically, but more often radiographs
26
Q

What are clinical features of caries?

A

Smooth surface caries
Occlusal caries
Interproximal caries
Root surface caries

27
Q

Describe pit and fissure caries

A

Class I caries
Occlusal surfaces of posterior teeth
Buccal surface of posterior molars
◦ Buccal pit
Lingual surface of lateral incisors

28
Q

What is the most prevalent location for caries?

A

Pit and fissure caries

29
Q

How can pit and fissure caries be prevented?

A

By sealants

30
Q

How do you detect pit and fissure caries?

A

◦ NOT A STICK- use explorer to drag along surface to check for softness. Use
gentle pressure.
◦ Clinical visualization- shadowing
◦ Radiographs
◦ Only when large enough

31
Q

What bacteria is present in pit and fissure caries?

A

Presence of high concentrations of mutans streptococci in pits or fissures is typically followed by a carious lesion in 6-24 months

32
Q

When is it important to place sealants?

A

Shortly after eruption of teeth

33
Q

What are types of smooth surface caries?

A

Buccal and lingual caries
Interproximal

34
Q

Describe buccal and lingual caries

A

Class V
Diagnose visually

35
Q

Describe interproximal caries

A

Class II
Difficult to diagnose visually
Diagnose with radiographs (bitewings, PA angulation = inaccurate)

36
Q

How to take care of interproximal caries?

A

Begin gingival to contact and extend toward pulp
Progress more rapidly once reach dentin

37
Q

What are smooth surface caries associated with?

A

High sugar intake

38
Q

What are smooth surface caries prevalent in?

A

“soda sippers”
- easily restored (still a serious lesion)

39
Q

Describe root surface caries

A

Comparatively rapid succession
Often asymptomatic
Closer to the pulp
More difficult to restore

40
Q

What are recurrent/secondary caries?

A

Caries developed at margin of a restoration

41
Q

What are ways of diagnosing caries?

A

Visual
Tactile
Radiographs

42
Q

What are visual diagnoses of caries?

A

Color
Matte vs shiny

43
Q

What are tactile features of caries?

A

Firm
Soft
- leathery

44
Q

Within caries management, what are we moving away from?

A

“Caries prevention” and “caries treatment”

45
Q

What are management ways of caries?

A

Surgical
Non-surgical options

46
Q

Waht are factors to consider regarding caries?

A

General health
Xerostomia
Fluoride exposure

47
Q

What are causes of xerostomia?

A
  • radiation and chemotherapy
  • medical conditions
  • medications
48
Q

What are ways to prevent caries?

A

Oral Hygiene Instructions
◦ Plaque-free surfaces do not decay!
Dietary Counseling
◦ Identify sources
◦ Reduce frequency and ingestion
Sealants

49
Q

What are sealants?

A

◦ Thin resin coating placed on chewing surfaces of teeth
◦ With or without enameloplasty

50
Q

What are things that “arrest” (stop) caries?

A

Fluoride
◦ Enamel resists acids more effectively
Oral hygiene improvement
◦ Reduces biofilms
Dietary changes
◦ Reduces bacteria’s food source
Professional cleanings
◦ May change recall intervals, more frequent assessment
Address xerostomia

51
Q

What is an intermediate option to managing caries?

A

Resin infiltration

52
Q

What do we use in our clinic to infiltrate resin to manage caries?

A

Icon is used in our clinic
◦ Clean tooth well (pumice)
◦ Dry working field (rubber dam)
◦ Etch for at least 30 seconds 1-3 times; rinse and DRY well
◦ Icon Etch is 15% hydrochloric acid gel
◦ Acts as a “chemical” drill
◦ Infiltrate using Icon resin

53
Q

What are some ways to manage caries?

A
  • silver diamine fluoride
  • surgical management
54
Q

Describe using surgical management for caries

A

◦ STILL A GREAT OPTION
◦ Cavitated carious lesions
◦ Remove carious lesion
◦ Establish resistance form in preparation
◦ Avoid fracture of tooth or restoration in the future
◦ Establish retention form in preparation
◦ Avoid restoration being dislocated or lost
◦ Restore

55
Q

What classification system does UMKC SOD use?

A

ADA caries classification system

56
Q

What is terminology of classifying caries?

A

◦ Sound Tooth Structure
◦ Initial Caries
◦ Moderate Caries
◦ Advanced Caries

D1 Spring - Operative Dentistry I (12 decks)

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