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Finals- caries > caries aetiology > Flashcards

caries aetiology Flashcards

1
Q

what is aetiology?

A

study of the cause of a disease

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2
Q

what is needed for caries development?

A
  • tooth surface
  • plaque biofilm
  • time
  • sugar
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3
Q

what causes demineralisation?

A

when plaque uses dietary sugar to produce acids

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4
Q

where are the most common surfaces affected by caries?

A
  • pits and fissures
  • approximal surfaces (at or below contact points)
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5
Q

what would smooth surface caries indicate?

A

high caries rate

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6
Q

what does the plaque need to be before producing acids?

A

dysbiotic plaque

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7
Q

what sugars are needed to cause caries?

A

fermentable carbohydrates
- frequent
- amount

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8
Q

what bacterial acid is produced by plaque?

A

lactic acid

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9
Q

how can caries progression be modified?

A
  • biofilm disruption- fluoride and tb
  • environment of biofilm- diet
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10
Q

what is the specific plaque hypothesis?

A

small number of specific organisms cause disease
- if absent- no disease
- specific tx targets- vaccine, antibacterials.

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11
Q

what is a key species associated with caries (is it specific plaque hypothesis??) ? likely??

A

streptococcus mutans
- however, people with caries sometimes don’t have s.mutans
- and can be found in biofilm of caries free patients

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12
Q

what is the non-specific plaque hypothesis ? likely???

A

all microorganisms in the biofilm contribute to disease- not specific

  • not likely as all bacteria would need to be removed and most people would have caries as its hard to remove all plaque
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13
Q

what is marsh’s ecological plaque hypothesis ?

A

cariogenic bacteria are ubiquitous (always there) in plaque- but at too low concentrations to cause disease. Requires a shift in the balance driven by local environmental change (so there is more)

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14
Q

what is the local environmental changes highlighted in marsh’s ecological plaque hypothesis?

A

availability of sugars

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15
Q

what is the ecological shift of plaque bacteria?

A

shift in bacteria to withstand acids (adaptation) and produce acids (selects)- dysbiosis

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16
Q

what is the Stephan curve?

A

it shows what happens to the pH with sugar consumption- and how it favours demineralisation when the pH drops below the critical level.

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17
Q

what is the critical pH level?

A

5.5

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18
Q

what does falling above or below the critical pH mean?

A

above- potential remineralisation

below- demineralisation

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19
Q

name each part of enamel caries

A
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20
Q

what zone of enamel caries is the most demineralised?

A

body of the lesion zone

21
Q

what are early signs of demineralisation?

A

WSL’s

22
Q

what is needed for detection of caries?

A
  • dry teeth
  • remove plaque (clean)
  • well illuminated
23
Q

do enamel white spots always mean caries?

A

NO

  • developmental issues
24
Q

how does dentine respond to early enamel lesions?

A
  • fill tubules with more mineral- prevent acid from passing through
  • produce secondary/tertiary dentine to protect the pulp
25
Q

when dentine is infected why does it keep its structure?

A

because of the matrix- the dentine is demineralised so it loses its strength but it holds its shape due to the Matrix. Necrotic dentine has lost its matrix- but zone of bacterial invasion still has the matrix and is not yet broken down.

26
Q

name each part of dentine caries

A
27
Q

what is the advancing front zone of the dentine?

A

the demineralised zone (matrix remains and shape is maintained but loses its strength)

28
Q

what part of the dentine caries is contaminated?

A
  • necrotic zone (matrix broken down)
  • contaminated zone (matrix remains but bacteria present)
29
Q

what is the translucent zone?

A

the hard/sound dentine

30
Q

where does caries spread rapidly?

A

along the ADJ

31
Q

what is the purpose of saliva with caries?

A
  • it is alkaline- so acts as a neutraliser
  • acts as buffer- returns pH to neutral before it can go below the critical pH
  • antibacterial components
32
Q

why is saliva good for remineralisation?

A

because it contains calcium and phosphate and fluoride- needed for remineralisation

33
Q

what does fluoride do to enamel?

A
  • changes OH ions of hydroxappetite with fluoride ions- to form flourappetite-
34
Q

what happens to the critical pH when forming fluorappetitie ?

A

critical pH is lowered
- demin needs lower pH
- resin can happen at lower pH

-reduces demin and increases remin and increases speed of remin

35
Q

what is the most important etiological factor when it comes to controlling caries?

A

diet and availability of sugars

36
Q

what drives dysbiosis of plaque biofilm?

A

diet and oral sugar availability

37
Q

what are methods for detecting caries?

A
  • radiographs
  • direct vision
  • transillumination
  • orthodontic separators
38
Q

at what age can bitewings be used?

A

age 4 and above as part of examination unless dentition is spaced/low caries risk

39
Q

when should bitewings be taken for high risk children?

A

6-12 months

40
Q

when should bitewings be taken for low risk children?

A

12-18 months for primary teeth and 2 years for permanent teeth

41
Q

what do arrest enamel WS lesions look like?

A

smooth/shiny

42
Q

what do active enamel WS lesions look like?

A

rough and frosty

43
Q

what eventually happens to carious dentine which keeps its shape due to collagen matrix?

A

-proteolytic bacteria eventually breaks down to matrix- overlying enamel loses its support and fractures= cavitation

44
Q

how can dentine caries become arrested?

A
  • if cavitated, the dentine will be exposed to oral environment and if diet modifications work/ability to Clean well with tb- plaque biofilm will not have substrate to progress
45
Q

in a child, what considerations should be taken when considering wether to restore caries?

A

assess risk of lesion causing pain:

  • exfoliation time
  • ability to cleanse cavity with tb
  • activity of lesion
  • proximity to pulp
  • cooperation of parent/child
46
Q

describe the international caries detection and assessment system

A
47
Q

what is the difference between sensitivity and specificity of diagnostic tests?

A

sensitivity- ability of a test to detect disease

specificity- ability of a test to not falsely detect disease

48
Q

what factors show increased risk of dental caries in children?

A
  • previous caries
  • socioeconomic status
  • s.mutans levels
  • lactobacilli levels
  • siblings/parents caries levels
  • salivary flow rates
  • DMFT
  • DMFS
49
Q
A

Finals- caries (1 decks)

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