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Patient Care > Caries > Flashcards

Caries Flashcards

1
Q

definition of caries

A

decay and crumbling of tooth structure

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2
Q

caries is a —

A

disease

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3
Q

most common chronic disease of childhood

A

caries

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4
Q

cavity

A

empty space or hole

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5
Q

caries is a — disease

A

multifactorial

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6
Q

requirements for caries (4)

A

host
food source
bacteria
time

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7
Q

oral environment factors affecting caries (8)

A 
fluoride
dental sealants
antibacterial agents
saliva
sugars
calcium and phosphate ions
plaque pH and species of microbes 
chewing gum
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8
Q

personal factors affecting caries (8)

A 
patient education
patient bevaiors
oral health literacy
socioeconomic status
income 
dental insurance
knowledge
attitude
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9
Q

is it possible to impact personal factors?

A

very challenging or impossible

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10
Q

main component of enamel

A

fluoride

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11
Q

fluoride ions replace hydroxyl groups, creating

A

fluorapetite

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12
Q

Fluorapatite is — resistant to demineralization than hydroxyapatite

A

more

more resistant to acid

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13
Q

where is fluoride effective at reducing caries? (2)

A 
crown (enamel)
root surfaces (cementum)
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14
Q

systemic fluoride

A

found in water supply

used for drinking, cooking

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15
Q

topical fluoride (2)

A

toothpastes (OTC and prescription)

fluoride treatments in dental office (foam, varnish, silver diamine fluoride)

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16
Q

dental sealants

A

thin coating of resin painted on the chewing surfaces of molars (occasionally premolars)

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17
Q

high concentration of — in pits and fissures

A

strep mutants

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18
Q

dental sealants help to prevent

A

occlusal caries

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19
Q

saliva properties (3)

A

physical
chemical
antibacterial

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20
Q

physical saliva properties (3)

A

• Cleanses oral cavity
• Humans produce ~0.5-1 liter saliva per day
• Chewing gum increases saliva production
(• Xylitol ingredient also cariostatic)

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21
Q

chemical saliva properties (3)

A
  • Sodium bicarbonate and phosphate ions neutralize environment
  • Calcium and phosphate ions help remineralize
  • Proteins raise salivary pH, help remineralize enanel
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22
Q

antibacterial saliva properties (6)
• — clear bacteria
• — break down food particles that stick to teeth
• — lyse cell walls of bacteria
• — deprive bacteria of iron
• — forms free radical compounds in bacterial cells, leading to self destruction
• — block bacteria from adhering to tooth surface

A 
Mucins
Amylases
Lysozomes
Lactoferrin
Peroxidase
Immunoglobulins
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23
Q

bacterias favorite food

A

fermentable carbohydrates

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24
Q

preferred sugar

A

sucrose

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25
Q

— is more important than — when determining caries risk

A

frequency

quantity

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26
Q

lower pH= more — environment

A

acidic

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27
Q

enamel demineralizes at

A

5.5

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28
Q

dentin and cementum are softer than enamel so they each demineralize at

A

6.5

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29
Q 
Streptococcus
◦ especially --- (but not exclusively)
◦ Gram --- cocci
◦ Prefer pH ~---
◦ Most prevalent in (2)
A

Strep mutans
positive
5.5
pits and fissures

30
Q

Lactobacillus
◦ Gram — rods
◦ Prefer very — pH

A

positive

low

31
Q

biofilm

A

an aggregation of microorganisms adhering to each other in a matrix

32
Q

dental biofilm is

A

dental plaque stuck to tooth

33
Q

biofilm alone is not

A

cariogenic

34
Q

biofilm must contain

A

caries causing microbes

  • streptococcus and lactobacillus
  • specific plaque hypothesis theory
35
Q

Caries occurs when Demineralization — Remineralization over time

A

>

36
Q

Enamel demineralizes at pH

A

5.5

37
Q

Normal oral cavity pH ~

A

6.7-7.3

38
Q

Enamel components (3)

A

◦ 90% hydroxyapatite
◦ 8% water
◦ 2% organic material

39
Q

Dentin components (3)

A

◦ 50% hydroxyapatite
◦ 30% organic material
◦ 20% water

40
Q

Fermentable carbohydrates

A

• Food source for caries-causing (cariogenic) bacteria

41
Q

Acidic food, drink

A

• Baseline environment lowers pH

42
Q

Dry mouth (2)

A
  • Lack buffers, rinse

* Age, medications contribute

43
Q

Poor oral hygiene

A

• Bacteria able to thrive

44
Q

MORE FREQUENT SUGAR = — CARIES LIKELIHOOD

A

INCREASED

45
Q

Saliva (3)

A
  • Neutralizes pH
  • Rinses oral cavity
  • Ions to remineralize
46
Q

Good oral hygiene

A

• Destroys bacteria’s habitat, they can’t stick to tooth

47
Q

Lack of cariogenic —

A

microbes

48
Q

Reduced sugar consumption

A

• Bacteria starve

49
Q

Why are sugary or acidic drinks so bad?

A

NO CHEWING.

Chewing increases saliva production. Sipping on a latte does not.

50
Q

Drink your sugary drinks with

A

a meal

51
Q

Certainly avoid Gatorade/powerade during workouts if possible
◦ Why?

A

◦ Salivary flow already decreased during strenuous activity.

52
Q

What’s fluoride’s role in all of this? (3)

A
  • When oral cavity pH drops below 5.5, hydroxyapatite dissolves
  • Fluoride ions enter to form fluorapatite
  • Enamel is now resistant to demineralization pH ~4.5
53
Q

Pellicle

A

◦ Thin membrane on surface

54
Q

Biofilm (2)

A

◦ Community of microorganisms held together by extracellular matrix
◦ Complex structure

55
Q

Dental plaque forms itself into a Biofilm
◦ Can be comprised of (2)
◦ NOT — debris
◦ Food debris can be removed by —, dental plaque can not

A

microorganisms or pathogenic organisms
food
rinsing

56
Q

What is the primary tool used to diagnose caries?

A

eyes

57
Q

how to diagnose interproximal caries

A

Radiographs

58
Q

Sharp — > sharp explorer

◦ “a stick” is not helpful

A

eyes

59
Q

Explorer is helpful for (2) senses

A

tactile and acoustic

60
Q

Soft, leathery feel when explorer is gently dragged across tooth=

A

carious

61
Q

Firm, chalkboard feel and nails on chalkboard=

A

sound enamel

62
Q

Caries progression

◦Be familiar with progression to aid with diagnosis (2)

A

◦Slow to progress through enamel

◦Faster once it reaches dentin

63
Q

Caries is a disease
◦Must be managed —
◦Treat the person (4)

A

comprehensively

◦Oral hygiene instruction
◦Dietary counselling
◦Fluoride therapy
◦Surgical treatment

64
Q

Oral hygiene instruction (3)

A

◦Plaque free surfaces do not decay
◦Home care
◦Regular dental visits

65
Q

Dietary counselling
◦This is part of our job
◦Stress on — — and frequency
◦Start with small — changes

A

fermentable carbohydrates

habit

66
Q

Fluoride therapy (4)

A 
In office
◦ Fluoride Varnish
◦ Silver diamine fluoride
At home
◦ Fluoride toothpaste
◦ May prescribe Prevident 5000 or similar
Fluoride trays
Education
◦ Can’t force this on patients, but you can educate them
67
Q

— must also be managed

A

Xerostomia

68
Q

evaluate the patients medications, some may cause

A

dry mouth

69
Q

recommend aids to assist such as (3)

A

fluoride
xylitol chewing gum
biotine (patient comfort)

70
Q

recommend habit changes to assist

A

recommend water instead of sugary drinks

71
Q

surgical caries management once the caries has progressed pas the ability to

A

remineralized

drill and fill

72
Q

surgical caries management is a very important part of management but

A

not the whole picture

Patient Care (15 decks)

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