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Endemic Oral Health > Caries Aetiology > Flashcards

Caries Aetiology Flashcards

1
Q

what is epidemiology

A

powerful research tool, populations, diseases and patterns

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2
Q

what is the main acid produced by bacteria

A

lactic acid from glucose

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3
Q

what is the critical pH

A

5.5

below which HA dissolves

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4
Q

how is plaque pH studied

A

metal probes
glass pH electrodes
radio telemetry
removal of plaque samples

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5
Q

what are the metal probes used

A

antimony

iridium

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6
Q

what si the sequence if events in measuring plaque pH

A 
plaque on ant teeth 
antimony electrode in plaque 
record pH 
2 min rinse - 25ml 10% glucose
record every 10 mins
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7
Q

what is a stephan curve characteristic

A

rapid pH drop
slow pH rise
variable time course (15-20mins)

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8
Q

why is there a rapid drop in stephan curve

A

speed microbe metab carb
- glucose and sucrose are rapid
large carbs - starch - slower

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9
Q

how does plaque bac interact with glucose and sucrose

A

rapid diffusion
lots acid - lactic acid
low pH

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10
Q

how does plaque bac interact with starch

A

amylase - glucose to maltose

less acid an mixed types acid not so low pH

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11
Q

what does lowest pH dept on

A

microbial composition of plaque
nature of carb source
rate diffusion ira nd out of plaque

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12
Q

why is there a rise in the stephan curve

A

acid diffusing out

salivary buffering

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13
Q

what does CF subjects show

A

started higher and finished higher

stayed above critical pH

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14
Q

what does a caries active subject show pH

A

started lower and finished lower

reined below critical pH for long periods

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15
Q

what can starchy foods =

A

produce stephan like response

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16
Q

what is the acidogenic potential

A

ability of food to produce acid

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17
Q

what does the acidogneic potential dept on

A

nature of food
properties of host
bac in dental plaque

18
Q

what are some types of nutritive sweeteners

A

sorbitol
mannitol
xylitol

19
Q

what are nutritive sweetness

A

sugar alcohols
bulk sweetners
slowly fermented by bacteria
only slight pH drop

20
Q

what are nutritive sweetners used in

A

chewing gum - mannitol

confectionary and toothpastes - xylitol

21
Q

what is a problem of nutritive sweetners

A

potential laxative effects

22
Q

what are some alternative sweetners

A

Intense

non nutritiive

23
Q

when are intense sweetners used

A

in small quantiiees

24
Q

what are some intense sweetner examples

A

saccharin

  • 300X > sucrose
  • bitter aftertaste

aspartame
- candarel and nutrasweet

acmsulfame-K

  • 300X sucrose
  • soft drinks and sugar free gum
25
Q

what is a tooth friendly sweeter

A

if plaque pH doesnt go below 5.7 within 30 mins of ingestion
in switzerland

26
Q

what are the ways theatre of the food has an affect

A 
amount and type of ferment carb in food
physical form 
buffering capacity
sialogues
sequence foods in meal
27
Q

what is the way the physical form changes

A

sticky and retained vs liquid and swallowed

28
Q

what is sialogues

A

saliva flow promoters

29
Q

how does the host factors affect the plaque pH

A 
food eating habits - sequence
frequency food intake
buffer capacity 
CaPHos conc in saliva
fluoride content enamel
30
Q

why si the summary of pattern eating

A

best to end a meal with non acidgmenic food - cheese

snacking - more low pH episodes, less time for pH to recover

31
Q

what does saliva typically contian

A

bicarb - buffer

Ca and Phos

32
Q

when does saliva inc

A

masticatory nd salivary reflexes

gustatory stimulus

33
Q

when does saliva flow decrease

A

at night

xerostomia - gland damage - radiotherapy cases this

34
Q

are the inter proximal spaces pH greater in mandible or maxilla

A

maxilla less saliva less buffer as more saliva at mandible so greater buffer efect

35
Q

why is it bad to have 1/2 apple at bedtime

A

longer pH drop and takes longer to climb as while asleep less saliva reduced less saliva buffer

36
Q

what does eating a sweet do to saliva flow and plaque pH

A

increased saliva flow

plaque pH may rise before drop

37
Q

what does eating a non fermentable substance do to saliva flow and plaque pH

A

increase saliva flow

pH inc to resting levels

38
Q

what is imp when considering saliva flow and plaque pH

A

sequence of food consumption
sugar contiangi food shouldn’t be last
sugar free gum good

39
Q

what are some factors affecting acid production

A 
No. acidogenic bac
types of acid prod 
No. acid consuming bac
No. base prod bac 
metab state bac when food is ingested
40
Q

what is acid erosion usually from

A

dietary acid

gastric acid

41
Q

what is the erosion histologically

A

generalised loss of enamel
no zone estruture
no surface layer

42
Q

what do polysaccharides and other gel like components do to dental plaque

A

reduce diffusion of dissolved enamel mineral away form tooth surface

Endemic Oral Health (7 decks)

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