Caries

Question 1

What is MI dentistry?

Answer 1

Holistic approach to individualised patient care, disease management involves all members of the oral healthcare team and the patient, suing developments in caries detection.

Question 2

What are the 4 parts to a care plan?

Answer 2

1. Identify (history, examination)
2. Prevent and control: develop care plan
3. MI restore
4. Recall: check up

Question 3

What is dental caries?

Answer 3

The reversible disease process of dental hard tissues, instigated by action of bacteria upon fermentable carbohydrates in the plaque biofilm at tooth surfaces, leading to formation of the carious lesion.

It results in softening and ultimate destruction of tooth substance - the carious lesion.

Question 4

What is the difference between the caries process and the carious lesion?

Answer 4

Caries process: the metabolic interactions occurring in the plaque biofilm causing disease

Carious lesion: the signs of the disease on dental hard tissues

Question 5

What 4 factors are needed to cause caries?

Answer 5

1. Need the relevant bacteria
2. Need a susceptible tooth surface to biofilm
3. Need carbohydrate to feed biofilm
4. Needs time to occur

(other environmental factors too such as socio-economics)

Question 6

Explain how sound enamel can become carious enamel

vice versa

Answer 6

Plaque biofilm becomes cariotic. Lactic acid production causes acid demineralisation of the enamel.
The carious enamel forms when there is plaque, carbohydrate and time which lowers the pH of the biofilm.

On the other hand, carious enamel can become sounds enamel with saliva, oral hygiene and the diet. This increases the pH.

Question 7

Explain the Stephan curve

Answer 7

Shows pH change in the biofilm on the tooth surface.
When we eat, the pH drops from normal (7)to critical which is 5.5. it stays here until the green factors above come into play and shifts the pH back up.
Dentine has a critical pH of 6.2 so dentine will be more susceptible to the acid attack.

Question 8

How do we diagnose caries?

Answer 8

• Caries history / susceptibility assessment
• Signs - detection
• Symptoms - pain history
• Investigations e.g. temperature tests and radiographs

Question 9

What can happen without a good biofilm?

Answer 9

cariogenic dysbiosis (imbalance of carious bacteria)

Question 10

What can lead to increased susceptibility of caries?

Answer 10

• Drug therapy
• Social aka stress
• Diet
• Host resistance
• Saliva (low secretion)
• Microbiology

Question 11

How do we control inactive and active caries?

Answer 11

Inactive:
- Add hydroxide and fluoride, dietary modification

Active:
- Dental treatment