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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
What 2 main constituents of mixed saliva affect aetiology of caries?
1. Antimicrobial factors | 2. Minerals
26
Name 3 microorganisms responsible for caries
1. Streptococcus mutans (enamel) 2. Streptococcus sobrinus 3. Lactobacillus acidophilus (dentinal caries)
27
What are the 3 important features of microorganisms with regards to the aetiology of caries?
1. Bacteria must adhere 2. Bacterial preference for different oral surfaces 3. Bacteria implicated in caries
28
Name a microorganism with a preference for the tongue
Streptococcus salivarius
29
What are adhesion mechanisms?
Involve specific carbohydrate receptors on the pellicle coated tooth surface interacting with proteins receptors on bacterial cell walls
30
How may actinomyces species be associated with caries?
Associated with root surface and dentinal caries in middle aged / elderly people
31
How may veillonella species affect caries?
May have protective effect by converting lactic acid produced by plaque bacteria into weaker acids
32
What are 2 adhesion mechanisms of bacteria?
1. Specific co-aggregation | 2. Glycosyltransferase
33
What is glycosyltransferase?
An enzyme produced by S. mutans absorbs to tooth surfaces where it produces insoluble ridged glucans from sucrose
34
What 2 features of S. mutans and Lactobacillus species allows them to cause caries?
1. Aciduric | 2. Acidogenic
35
What is the difference between aciduric and acidogenic?
Aciduric means having affinity for acidic conditions while acidogenic means strong acid producing
36
How may sucrose affect the aetiology of caries?
- 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
Why may xylitol be preferential to sucrose, apart from sucrose not being present?
It disrupts the energy production of S. mutans by forming toxic intermediate during glycolysis
38
What 5 factors may allow for prediction of caries?
1. Microbiology of plaque 2. Structure and chemistry of enamel 3. Diet 4. Salivary factors 5. Epidemiology
39
What 5 factors may allow for prevention of caries?
1. Good oral hygiene 2. Fissure sealants 3. Fluoride 4. Antimicrobial agents 5. Reduction in sucrose intake
40
Why can fluoride prevent caries forming?
Alters resistance of teeth to demineralisation as well as speed with which enamel surface remineralises following a plaque acid challenge
41
Name 3 ways in which fluoride can prevent cwries?
1. Inhibits bacterial metabolism of sugar 2. Inhibits demineralisation of enamel 3. Speeds up remineralisation process by enhancing crystal growth
42
How does fluoride inhibit demineralisation?
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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