Aetiology & Risk for Caries

Question 1

is the pulp mineralsied or unmineralised?

Answer 1

unmineralised

Question 2

what 2 cell types does the pulp contain?

Answer 2

fibroblasts and undifferentiated mesenchymal cells (macrophages, lymphocytes)

Question 3

what collagen fibres does the fibrous matrix of pulp consist of?

Answer 3

collagen fibres type 1 & 2

Question 4

what does the ground substance of the pulp contain?

Answer 4

proteoglycans and water

Question 5

what is the key bacterial species w/ caries?

Answer 5

S. mutans

Question 6

can caries occur if S. mutans absent?

Answer 6

yes - its absence can allow for colonisation of acidogenic and acidoduric bacteria including Scardovia wiggsiae

Question 7

what are the 2 main bacteria involved in caries?

Answer 7

S. mutans and lactobacilli

Question 8

what is Marsh’s ecological plaque hypothesis?

Answer 8

cariogenic bacteria are ubiquitous in plaque but at levels too low to cause problems - unless there is a shift in the balance driven by local environmental change

Question 9

why does demineralised enamel look chalky white? in what 2 situations does enamel become demineralised?

Answer 9

disorganised HA crystals when hypoplastic enamel or deep enamel caries

Question 10

how does dentine change when demineralised?

Answer 10

looks the same but texture changes - active caries soft and arrested caries hard and scratchy

Question 11

list 3 evidence based factors to clearly predict future caries

Answer 11

clinician intuition
previous of current disease - including fam history
socioeconomic status