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DEN 2027 - Disease Mechanisms > Caries > Flashcards

Caries Flashcards

1
Q

What 3 changes in the oral cavity may occur which causes caries to form from stable plaque community?

A
  1. Frequent sugar intake
  2. Low pH
  3. Low saliva flow
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2
Q

What is caries?

A

Localised destruction of the tissues of the tooth by bacterial fermentation of dietary carbohydrates

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3
Q

Describe the mechanism of caries

A
  • Fermentable carbohydrates in diet will be utilised by bacteria
  • Acid produced which causes drop in plaque pH
  • Drop in pH causes demineralisation
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4
Q

Name 4 factors inside the mouth affecting development of caries

A
  1. Bacterial composition of biofilm
  2. Plaque pH
  3. Salivary flow rate
  4. Food retention in mouth
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5
Q

Name 4 factors of a person’s general health affecting the development of caries

A
  1. Medical history / treatment
  2. Hormones
  3. Age
  4. Genetics
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6
Q

Name 4 environmental factors affecting the development of caries

A
  1. Diet
  2. Frequency of eating
  3. Oral hygiene
  4. Fluoride
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7
Q

What 4 factors are involved in the aetiology of caries?

A
  1. Host and teeth
  2. Plaque microorganisms
  3. Substrate
  4. Time
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8
Q

What are 4 types of dental caries?

A
  1. Pit and fissure
  2. Smooth surface
  3. Root surface
  4. Recurrent caries
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9
Q

In what 3 areas of the mouth does pit and fissure caries occur?

A
  1. Molars
  2. Premolars
  3. Lingual surface of maxillary incisors
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10
Q

In what area of the mouth does smooth surface caries occur?

A

Approximal tooth surfaces below the contact point

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11
Q

In what 2 areas of the mouth does root surface caries occur?

A

Cementum or dentine when root is exposed to oral environment

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12
Q

In what area of the mouth does recurrent caries occur?

A

Areas associated with an existing restoration

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13
Q

Name 4 host factors which affect the aetiology of caries

A
  1. Surface
  2. Salivary clearance rate
  3. Saliva buffering capacity
  4. Composition of saliva
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14
Q

How may the surface of the tooth affect the aetiology of caries?

A

Some areas of the same tooth are more susceptible to carious attack i.e. challenge on more mineralised area may fail to initiate disease

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15
Q

Describe clearance of saliva from the oral cavity

A
  • Washing action of saliva removes food debris
  • After swallowing residual volume of saliva is left in mouth
  • Saliva enters mouth and volume increases
  • Maximum volume is reached and swallowing is triggered
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16
Q

What 3 factors influence salivary clearance rates?

A
  1. Residual and maximum volume
  2. Extent to which substance binds to oral surfaces
  3. Unstimulated and stimulate flow rates
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17
Q

Why does residual volume affect salivary clearance rate?

A
  • Indicates more effective swallowing

- Effective swallowing clears substance from mouth quicker

18
Q

Why does maximal volume affect salivary clearance rate?

A

Individuals with lower maximal volume clear substances more rapidly

19
Q

How does salivary flow rates influence salivary clearance rate?

A

The lower the salivary flow the less the swallowing frequency

20
Q

What is the importance of saliva buffering capacity in the aetiology of caries?

A

Maintains neutral pH in plaque and oral cavity

21
Q

What 4 factors influence saliva buffering capacity?

A
  1. Bicarbonate
  2. pH
  3. Calcium and phosphate
  4. Proteins and peptides
22
Q

How does bicarbonate affect saliva buffering capacity?

A
  • Most important buffering system in stimulated saliva against acid
23
Q

How does xerostomia affect saliva buffering capacity?

A

Low salivary flow means low buffering capacity

24
Q

What protein or peptide is important in saliva buffering capacity?

A

Sialin causes increased clearance of carbohydrate which is followed by base production which elevates pH

25
Q

What 2 main constituents of mixed saliva affect aetiology of caries?

A
  1. Antimicrobial factors

2. Minerals

26
Q

Name 3 microorganisms responsible for caries

A
  1. Streptococcus mutans (enamel)
  2. Streptococcus sobrinus
  3. Lactobacillus acidophilus (dentinal caries)
27
Q

What are the 3 important features of microorganisms with regards to the aetiology of caries?

A
  1. Bacteria must adhere
  2. Bacterial preference for different oral surfaces
  3. Bacteria implicated in caries
28
Q

Name a microorganism with a preference for the tongue

A

Streptococcus salivarius

29
Q

What are adhesion mechanisms?

A

Involve specific carbohydrate receptors on the pellicle coated tooth surface interacting with proteins receptors on bacterial cell walls

30
Q

How may actinomyces species be associated with caries?

A

Associated with root surface and dentinal caries in middle aged / elderly people

31
Q

How may veillonella species affect caries?

A

May have protective effect by converting lactic acid produced by plaque bacteria into weaker acids

32
Q

What are 2 adhesion mechanisms of bacteria?

A
  1. Specific co-aggregation

2. Glycosyltransferase

33
Q

What is glycosyltransferase?

A

An enzyme produced by S. mutans absorbs to tooth surfaces where it produces insoluble ridged glucans from sucrose

34
Q

What 2 features of S. mutans and Lactobacillus species allows them to cause caries?

A
  1. Aciduric

2. Acidogenic

35
Q

What is the difference between aciduric and acidogenic?

A

Aciduric means having affinity for acidic conditions while acidogenic means strong acid producing

36
Q

How may sucrose affect the aetiology of caries?

A
  • Sucrose is most cariogenic sugar
  • Sucrose is highly soluble and diffuses easily into plaque acting as substrate for production of extracellular polysaccharides and acids
37
Q

Why may xylitol be preferential to sucrose, apart from sucrose not being present?

A

It disrupts the energy production of S. mutans by forming toxic intermediate during glycolysis

38
Q

What 5 factors may allow for prediction of caries?

A
  1. Microbiology of plaque
  2. Structure and chemistry of enamel
  3. Diet
  4. Salivary factors
  5. Epidemiology
39
Q

What 5 factors may allow for prevention of caries?

A
  1. Good oral hygiene
  2. Fissure sealants
  3. Fluoride
  4. Antimicrobial agents
  5. Reduction in sucrose intake
40
Q

Why can fluoride prevent caries forming?

A

Alters resistance of teeth to demineralisation as well as speed with which enamel surface remineralises following a plaque acid challenge

41
Q

Name 3 ways in which fluoride can prevent cwries?

A
  1. Inhibits bacterial metabolism of sugar
  2. Inhibits demineralisation of enamel
  3. Speeds up remineralisation process by enhancing crystal growth
42
Q

How does fluoride inhibit demineralisation?

A

It becomes incorporated into enamel lattice and replaces hydroxyl groups in hydroxyapatite into fluorapatite which is more stable

DEN 2027 - Disease Mechanisms (20 decks)

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