Caries

Question 1

What is a critical regulator in the caries disease process?

Answer 1

Saliva

Question 2

Keyes contribution to caries theory (1960)

Answer 2

microorgs are the KEY to causing and passing along caries. Also demonstrated these microorgs are transmissible

Question 3

Mutans Step role in caries progression. When is it acquired?

Answer 3

MS is the initiator; necessary but not sufficient to make disease.
- MS ‘windows of infectivity’ 1st-when primary teeth erupt, 2nd when permanent teeth erupt. Some say at birth: Wan (2003) showed 50% infants acquired by 6 mos

Question 4

Lactobacilli: role in caries progression, good indicator of?

Answer 4

an opportunistic bacteria, the # of LB increases after DEJ is invaded.
- good indicator of CHO intake

Question 5

Describe the microflora of children with s-ECC

Answer 5

S-ECC children show less microbial diversity/complexity compared to caries free kids

Question 6

Describe the results of the Vipehold Study (1945)

Answer 6

Vipeholm Vive (5):

1. Sugar at meals = slight INCS in caries
2. Sugar between meals = MARKED incs in caries
3. Sugar that is STICKY= GREATEST caries activity
4. Caries activity DIFFERS among individuals on the SAME diet
5. caries activity DECLINES with sugar withdrawal

Question 7

Glucan: describe its role in caries

Answer 7

A water soluble, extracellular “glue” that enables MS adhesion; inhibits plaque diffusion

Question 8

Fructan: describe its role in relation to MS

Answer 8

Fructan is used intracellularly as energy for MS

Question 9

To what level are fructose, glucose, sucrose, and starch acidogenic?

Answer 9

Fructose = glucose = sucrose = soluble/refined starch in their ability to drop pH (~pH 5.5), raw starch can only drop the pH a small amount

Question 10

Which aspects of food determine cariogenicity?

Answer 10

Retentive/clearance, salivary stimulation, fat content

Question 11

What are the protective aspects of milk? cheese?

Answer 11

Milk: calcium, phosphate, casein, protease peptones prevent enamel demineralization.
Cheese: similar to milk, salivary stimulation, contains CPP-ACP

Question 12

What are the protective aspects of cranberries/apples? Peanuts?

Answer 12

Cran/apples: flavonoids, inhibits bacterial adherence/antibacterial
Peanuts: gustatory salivary flow, mechanical stimulation

Question 13

Host factor related to caries experience?

Answer 13

Saliva: buffering/BICARB, mineral content, pH, flow rate, antimicrobial components, immunologic components (lysozyme, lactoferrin, lactoperoxidase, myeloperoxidase, agglutins, secretory IgA)

Question 14

Modifying factors in caries experience?

Answer 14

Race ethnicy, SES, healthy care delivery, general health, culture stress, and genetic factors (amelogenin, tuftelin)

Question 15

Describe the era of F- and its context in history.

Answer 15

Before “era of F-“ caries PANDEMIC believed inevitable until 1950’s, 50-70’s F- introduced , 1970’s to present decrease in caries (overall, increased in children slightly from 80’s to early 2000s)

Question 16

The caries process is a ________ disease with ___________.

Answer 16

The caries process is a steady state disease with variable expression over time.

Question 17

Caries sequence of primary teeth

Answer 17

Mandibular molars > max molars> max anteriors . Primary 1/2nd molars are more susceptible than 1st perm molars.

Question 18

AAP recommends a visit by age 1 for all children. t/f

Answer 18

False
AAP recs by age 1 IF the child is special needs, mother has high caries, child has disease/plaque/stains, child is a later order offspring, or low family SES.