Caries Flashcards
What risk factors impact a persons risk of caries?
- Clinical evidence
- Medical history
- Salivary flow
- Dietary habits
- Fluouride use
- Plaque control
- Social history
What are the three key elements which dictate the development of caries/
Tooth (Location, morphology)
Substrate (Clearance, OH)
Flora (S. mutans, OH)
How might poor OH lead to an increased caries risk?
Poor technique
Irregular brushing
Unable to effectively disrupt biofilm
How might salivary flow rate lead to an increased caries risk?
Saliva acts as a buffer
Mechanical/chemical removal of bacteria
Why might previous caries indicate a higher risk of future caries?
Underlying issue not resolved
Caries rarely develops in an isolated situation
How might diet impact the risk of someone developing caries?
High sugar intakes which allow bacteria to grow.
High acid intake could demineralise tooth tissue, making it more susceptable to caries.
What medical conditions might indicate a higher risk of caries?
Acid refulx
Diabetes
Obesity
Congenital defects
Development issues
What aspects of social history may indicate a higher risk of caires?
SIMD catagory
Education
Work stressors
Familial approaches to OH/dentist
How is fluoride directly linked to caries risk?
Forms fluorapatite on the outermost layers of enamel, which is more resistant to demineralisation than hydroxyapetite.
It is also bactericidal, and interferes with bacterial adhesion to tooth surfaces.
How can you identify enamel caries?
White spot lesions
Brown lesions
Areas of chalky enamel due to demineralisation
What happens to the enamel rods as they become demineralised?
Gap between the rods widens, however the rod legnth is preserved. The gap allows for further leakage of bacteria into the tooth.
Why is caries more effective at breaking down dentine than enamel?
Dentine has a lower mineral content.
Dentine is formed of tubules, which bacteria can leak into.
Fluoride/saliva often struggles to reach the full extent of the lesion topically.
What are the two most common areas where caries are likely to be found?
Interproximal surfaces, as they are difficult to clean.
Pits and fissures, as they are difficult to clean and have thinner areas of enamel.
What is the threshold for tooth demineralisation?
pH 5.5
What does the Stephan curve show?
The pH of a certain area of the mouth over a period of time.
Which microoganism is the primary driver of dental caries?
S. mutans
What is the importance of creating a seal when restoring a tooth?
To prevent leakage of bacteria into the susceptable tooth tissue.
What is needed for optimal detection of caries?
Good light
Dry the tooth
Probing with BPE probe
Radiographs
How do you classify caries?
Primary/secondary
Active/inactive
Cavitate/non-cavitated
Location
How can you detect when you have removed all the caries?
Sound dentine can be felt with probe.
Visible staining removed, but not always.
Describe the mechanism by which bacteria in caries break down teeth.
A bacterial biofilm absorbs fermentable carbohydrates, and produces weak acids. This then demineralises tooth tissue over time, leading to breakdown of the tooth structure.
What is the progression by which caries happens?
Adhesion
Survival and Growth
Biofilm formation
Complex plaque
Acid production
Caries
What is the key pathogen thought to be involved in caries?
S. mutans, but there can be a large mixed population of bacteria contributing to caries.
What is important about understanding the caries microbiome?
It may help to predict risk.
