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2 Cariology > Caries Aetiology & Risk > Flashcards

Caries Aetiology & Risk Flashcards

1
Q

What is aetiology?

A

Study of the cause of disease

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2
Q

The development of caries requires what 4 things?

A

Time
Tooth - susceptible surface
Plaque (biofilm) - dysbiotic
Sugars

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3
Q

3 steps of the development of a carious lesion (overview)

A

Active caries process in biofilm (sugar dependant)
Bacterial acid (lactic) production
Demineralisation of tooth structure
Carious lesion

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4
Q

4 facts about caries

A
  • Biochemical process within biofilm
  • Sugar converted to acids by bacteria
  • Dependant upon available sugars
  • Can be modified with changes to biofilm and environment of biofilm
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5
Q

What is a carious lesion?
2things

A

Clinically detectable demineralisation

The effect of bacterial acids from caries process

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6
Q

Carious lesion can be halted if

A

Caries process is controlled

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7
Q

What can happen to the mineral in a carious lesion? 2things

A

Loose further mineral
Regain limited mineral

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8
Q

A carious lesion results in what kind of problems? 2things

A

Functional

Aesthetic

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9
Q

What is the specific plaque hypothesis?

A

Small number of specific organisms are responsible for all of the disease

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10
Q

What is the non-specific plaque hypothesis?

A

All organisms in the micro flora contribute to disease, the specific bacteria don’t matter, disease can be present in all biofilms

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11
Q

What is marsh’s ecological plaque hypothesis?

A

CARIOGENIC BACTERIA are UBIQUITOUS in plaque, but usually in CONCENTRATIONS TOO LOW to cause problems, UNLESS THERE IS A SHIFT IN THE BALANCE driven by LOCAL ENVIRONMENTAL CHANGE

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12
Q

What is the ecological caries hypothesis?

A

Environmental acidification is the driving force which makes bacteria adapt to the acidic environment and selects bacteria more likely to tolerate it and produce acids themselves - dysbiosis

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13
Q

What is dysbiosis? 4 things

A

Increased cariogenicity of the biofilm
Acid production increases
Biofilm more acidogenic/aciduric
Favours species that produce more acid

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14
Q

How does an increased cariogenic diet and low salivary flow cause disease? 4 (include bacteria)

A

Increased stress in system
Increased acid production
Environmental shift -> low pH
Ecological shift within plaque -> S. mutants, lactobacilli and bifidobacteria

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15
Q

What is this graph?

A

The ‘Stephan’ curve with snacking

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16
Q

What happens to the tooth if pH is below 5.5?

A

Favours demineralisations of hydroxyapatite crystals (mineral component of enamel and dentine)

17
Q

What happens to the tooth if pH is above 5.5?

A

potential for remineralisation of the enamel

18
Q

What is enamel caries?

A

Effect of plaque acids on the enamel

19
Q

Enamel structure 4 things

A

Prismatic
85% apatite
12% water
3% protein

20
Q

What does this picture show?

A

White spot lesion

21
Q

Why does the enamel need to be clean and dry to detect and diagnose enamel carious lesions? 2

A

Carious lesions found under plaque

Increased contrast between healthy and unhealthy enamel

22
Q

How does the dentine and pulp respond to an enamel lesion?

A

Filling tubules with mineral

Add tertiary dentine to wall the area of the lesion off

23
Q

This image shows tertiary dentine added to wall off the area of the lesion

A
24
Q

Dentine structure 3

A

Tubular
33% protein - 20% collagen
70% mineral

25
Q

What is happening in the necrotic zone?

A

Everything is contaminated and is being broken down by bacteria

26
Q

What is happening in the contaminated zone?

A

Bacteria in the area but it has not yet broken down the tubular structure of the collagen matrix

27
Q

What is happening at the translucent zone?

A

Dentine tried to wall off the infection

28
Q

What happens to the collagen matrix if not protected by mineral content? 3

A

Can be abraded away, infected and degraded by proteolytic bacteria

29
Q

2 non restorative ways to control caries

A

Improving access to biofilm - less protected

Stainless steel crowns - separates bacteria from sugar and oral environment

30
Q

Why do dentists do fillings? 3

A

Facilitate biofilm modification (biofilm now on outside of tooth)

Seal in soft demineralised dentine

Restore function and aesthetic

31
Q

3 functions of saliva

A

Buffers acids

Reservoir of Ca2+ and PO4 (fluoride) for remineralisation of surface lesion

Antibacterial components

32
Q

3 functions of fluoride

A

Increase resistance/stability of enamel

Enhances speed of remineralisation

Impacts biofilm metabolism

33
Q

Caries is higher in which sociodemograohic status?

A

Deprived areas

34
Q

What is the most important way to control caries?

A

Diet/oral availability of sugars

35
Q

What is methodone?

A

Used to overcome a heroin addiction

36
Q

Why do methodone users have a higher risk of caries?

A

Sugar in preparation

Makes u hungry

Induces xerostomia - lack of saliva

2 Cariology (1 decks)

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