Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Key QE > Caries Etiology > Flashcards

Caries Etiology Flashcards

1
Q

Biofilms EARLIEST colonizers

A

MOS
S.mitis
S. Salivarius
S. Oralis

Make environment favorable to others or unfavorable to themselves, replacement sp that better suited for environment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Aquired Pellicle

A

Acellular, proteinaceous, forms minutes after cleaning teeth

Made of: Salivary glycoproteins
Phosphoproteins
Lipids
Gingival crevicular fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Mutants streptococci is a grouping
Initial biofilm colonizers?
Once teeth erupt what can be detected?

A

Mutans streptococci include: S mutans and S sobrinus

Initial colonizer: S.sanguine, S.oralis, S. Mitis biovar 1, Actinomyces species

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Cariogenic bacteria

A

Conversion sugars to acids
Maintain metabolism in extreme environment (low ph)
Produce extra cellular polysaccharides: glucans/fructans > contribute to biofilm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Cariogenic bacteria

Cariogenic bacteria in SECC

A

1) Acid producing gram + cocci (non mutans and mutans streptococci)
2) Gram + rods (Actinomyces, lactobaccilli)

Cariogenic bacteria SECC

1) S. Mutans
2) Scardovia wiggsiae
3) S. Cristatus
4) Actinomyces gerencseriae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Bacteria In caries INITIATION

Bacteria in advanced lesions

A

Actinomyces species - CARIES INITIATION

Bifidobacterium species - role in advanced lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Window infectivity

A

1st window Starts : 19-30 months

Closes after all primary teeth erupt

2nd window starts: 6 yo when 6s erupt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

HA

A

In enamel,
-ve inside and + outer layer
Negative macromolecule in saliva attracted to HA absorbed onto enamel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Critical PH for HA and FA and enamel

A

HA - ph 5.5
FA - ph 4.5
Enamel - ph 5.5

Critical PH - ph where saliva and plaque stop being saturated with calcium and phosphate and HA in enamel dissolved

It is the highest ph where there is net loss of enamel from teeth

Critical PH varies depending on total calcium and phosphate in spit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Remin

FAP has 2 advantages that make it better than HA

A

1) fluoride acts as a catalyst (assist remin of enamel with phosphate Ions from saliva)
2) displace hydroxide in HA with fluoride (removes weakness in HA to lactic acid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what’s needed to form FAP?

A

2 Fluoride ions
10 calcium
6 phosphate

If not enough calcium or phosphate limit remin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Ready to feed infant formula PPM

A 
Milk: 0.15 ppm 
Soy: 0.21 ppm 
1 ppm = 1mg/L
1L = 4.16 cups = 0.24 mg/cup 
Baby drinks 2.5 oz/lb/day, 10 lb baby drinks 25 oz 
which is 3 cups per day = .72 mg F-
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Fluorosis - what age are perm max incisors most susceptible to fluorosis?

A

First 3 years - and that’s why pea sized amount after age 3

MAKES sense! Crown finishes at 4 yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

New Level water fluoridation ppm - and what is the goal?

A

0.7 ppm

Goal: maintain anti cavity but reduce risk of fluorosis (old range was .7 to 1.2 ppm higher rate of fluorosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Main effect of fluoride?

A

ENHANCES REMIN of early lesions and DECREASES DEMIN of intact structure
Main effect is topical! low evidence for systemic
water is constant topical application

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q 
Fluoride in 
Juices?
Fluoride toothpaste?
Fluoride mouth rinse?
Professionally applied fluoride GEL?
Professionally applied fluoride VARNISH?
Dietary Fluoride Supplement?
A

Juices: 0.2-0.8 ppm
White grape juice - highest ( fluoridated or non fluoridated
Fluoride toothpaste: 1000 mg/L
Fluoride mouth rinse: 226 mg/L (OTC)
Professionally applied fluoride GEL: 12,300 mg/L (HIGH Dose) 1-2 x per year
Professionally applied fluoride VARNISH: 22,600 mg/L NaFl-
Dietary Fluoride Supplement: .25-1 mg easy if you think of chart .25 to 1 max (MODERATE) designed to take place of FL water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Halo effect?

A

Ppl in non fluoridated areas - eat and drink food processed in fluoridated areas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Acute toxicity Fluoride?

Lethal dose Fluoride?

A

TOXIC: 5MG/KG (5 letters in toxic!)
LETHAL: 15 MG/KG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

MG FL in pea vs smear fluoridated toothpaste?

A

Smear/ r1ce (under 3 yo) : 0.125 mg
Pea (over 3 yo) : 0.25 mg

Recommended DAILY
systemic dose for kids between 6 months and 3 years
Remember : 6 months because 1st tooth till 3 years (when you can start using .25 mg toothpaste pea sized)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Fluorosis is extrinsic of intrinsic stain?

A

Fluorosis is INTRINSIC (excessive fluoride ingestion DURING tooth development )
Severe fluorosis –> Enamel damage
Stain color: usually white, can be dark brown, orange
Can occur in both primary OR permanent teeth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the goal of fluoride therapy?

A

Goal: Caries prevention in infants and young kids while minimizing risk of ingested fluoride, acute toxicity, and fluorosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Dietary Fluoride supplementation chart

A

Age UNDER .3 .3-.6 ppm OVER .6ppm
0-6 mo
6mo - 3 yrs .25 mg (IMP: system. daily for 6m-3y=.25 mg!)
3 yrs - 6 yrs 0.5 mg .25 mg
6yrs PLUS 1.0 mg .50 mg

Note only .25, .5, and 1 in this chart!
Total systemic daily dose for 6 month to 3 year old is .25 mg that’s why you give rice size amount to under 3 yo because its .125 mg and with other halo sources (like water) you dont wanna go over! but with this they dont have those sources

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Fluoride supplements for moderate or high risk?

A

only for VERY HIGH RISK of developing caries with deficient water fluoride. Determine fluoride exposure remember halo effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Infant formula
What is the ppm in ready to feed Milk and Soy based?
What is the ppm in powdered reconstituted with water?

A

Ready to feed milk based formula: 0.15 ppm
Ready to feed soy based formula: 0.21 ppm
1 ppm= 1mg/L
1L=4.166 cups = .24 mg/cup

if baby drinks 2.5 oz/lb/day, 10 lb baby will drink 25 oz or 3 cups per day (.72 mg F-)

25
Q

Topical Fluoride NaF

A

More effective in caries prevention than systemic during tooth development

Main Mechanism fluoride: increase remin, decrease demin, most effective applied many times per day

26
Q

When are maxillary incisors most susceptible to fluorosis?

A

First 3 years of life (think crown finishes by 4 yo)

27
Q

Water fluoridation recommended level?

What is the goal?

A

0.7 ppm only (not a range anymore)
Goal - anti varies but reduce fluorosis
Fluoridated water is considered “topical”

28
Q

Pre-eruptive systemic fluoride effective?

A

Minor effect if anything

29
Q

Risk indicators caries:

modifiable by dentist, associated w/ risk of caries

A

1) Poor OH
2) Low fluoride
3) FREQUENCY between meal carb snack
4) low saliva - xerostomia (meds or medical condition)
5) Recreation drugs
6) Radiation

30
Q

Fluoride in juices

A

.2-.8

highest in white grape juice

31
Q 
Fluoride conc 
Water?
Fluoride toothpaste?
Fluoride mouth rinse?
Professionally applied Fluoride gel?
Professionally applied Fluoride VARNISH?
Dietary fluoride supplements?
A

Water - 0.7 ppm
Juice - 0.2-0.8 ppm
Fluoridated toothpaste - 1000 mg/L
Fluoride mouth rinse - 226 mg/L (moderate dose)
Professionally applied Fluoride gel - 12, 300 mg/L (1-2 per year applied)
Professionally applied Fluoride VARNISH - 22,600 mg/L (high dose)
Dietary fluoride supplements - (0.25-1 mg) SYTEMIC - designed to take place of fluoridated water

32
Q

Snacking between meals, how long does it take to decrease ph? How long does it take for ph to return to normal?

A

ph decreases instantly after eating, and take 20-30 min to return to normal ph (Stephans curve)
At low ph (under 5.5) strep mutans and lactobacilli proliferate –> more acid is produced –> balance shift to demin.

33
Q

NaF (How to convert NaF PERCENT to PPM)

A

Fluoride toothpaste = 0.243% NaF = 0.1215% Fluoride ion = 1,215 ppm

Divide by 2 because there are TWO fluoride ions (.243 /2 is .12.15)

34
Q

Recent ADA guideline

3 Mechanisms of topical fluoride for prevention

A

1) inhibit demin of intact enamel
2) enhance remin of enamel
3) inhibit enzyme activity of cariogenic bacteria (minimal effect)

35
Q

2.26% F varnish how often?

A

3-6 months

36
Q

16-18 yo
What % APF gel?
Fluoride rinse?
Fluoride gel?

A
  1. 23% APF gel for 4 min - 3 to 6 months
  2. 09% fluoride rinse - WEEKLY
  3. 5% fluoride GEL/PASTE - 2X DAILY
37
Q

Risk indicators caries:

modifiable by dentist, associated w/ risk of caries

A

1) Poor OH
2) Low fluoride
3) FREQUENCY between meal carb snack
4) low saliva - xerostomia (meds or medical condition)
5) Recreation drugs
6) Radiation

38
Q

What is MI paste?

What can you not use it in?

A

Casein Phosphopeptide Amorphous Calcium Phosphate

Ppl with milk allergy

39
Q

Visible plaque

A

Indicator for caries risk in young children

- visible plaque was best indicator of caries in study

40
Q

Snacking between meals, how long does it take to decrease ph? How long does it take for ph to return to normal?

A

ph decreases instantly after eating, and take 20-30 min to return to normal ph (Stephans curve)

41
Q

Factors that PREDICT FUTURE caries (2)

A

1) Demin or cavitated lesions of enamel/dentin

2) Stained occlusal pits or fissures.

42
Q

What should you use to arrest noncavitated carious lesions on facial or lingual of primary teeth?

A

1) 5% Sodium fluoride or 2) 1.23% acidulated phosphate fluoride (123 APF)

43
Q

Caries experience in primary teeth predicts future caries experience T or F?

A

T. BEST and MOST consistent predictor of future caries. past caries experience predicts future. 2 carious surface in primary molars = best predictor fo caries in permanent teeth

44
Q

DMFS

A

Doest not account if lesions are active (progressing) or inactive (arrested)

Active vs inactive is better way to determine if pt needs prevention

45
Q

CRA 3 factors

A

1) Biological (cariogenic bacteria, low SES, low education, diet high in carbs, hyposalivation, mother with active caries)
2) Preventive
3) Clinical

46
Q

What is MI paste?

What can you not use it in?

A

Casein Phosphopeptide Amorphous Calcium Phosphate

Ppl with milk allergy

47
Q

CRA: Moderate risk factors for 0-5 yo?

What category of 3 risk factors are these from?

A

MODERATE RISK both in Biologic
SI (Biologic)
SHCN (Biologic)
Immigrant (recent)

48
Q

What is topical fluoride varnish?

A

5% Sodium Fluoride
Sets on contact with saliva
Evidence remin of non cavitated lesions!
Prevent caries in primary and permanent teeth

49
Q

MI paste - more effective or less effective than fluoride?

A

Casein Phosphopeptide Amorphous Calcium Phosphate (CPPACP)
No difference
Does have remin effect but not better than fluoride

50
Q

What should you use to arrest noncavitated carious lesions on facial or lingual of primary teeth?

A

1) 5% Sodium fluoride or 2) 1.23% acidulated phosphate fluoride

51
Q

Xylitol

How much do you need to be effective per day?

A 
Sugar alcohol (5Carbon) NOT metabolized by cariogenic bacteria 
Gum, lozenge, toothpaste, wipes, syrup 
15 gram daily (frequent and high dose) --> inconclusive if reduce caries or MS reduction.
52
Q

SDF CI

A

4 CI to SDF

1) Silver allergy
2) Ulcerative gingivitis/stomatitis
3) Abscessed tooth needing ext
4) Irreversible pulpitis/necrosis

53
Q

Side effects SDF?

A
  • Metallic taste
  • Black stain
  • Transient gingival irritation
  • Stains clothes, skin, floor
  • Eye protection for pt and provider
54
Q

Benefits of SDF?

A

1) Controls pain by arresting caries
2) Affordable
3) Fast
4) Minimal staff/equipment needed
5) non invasive and safe

55
Q

Maternal nutrition - linear enamel hypoplasia in primary incisors is more common in?

A

Malnourished children
Cause: Disruption in appositional state of enamel formation (neonatal first 30 days of life)
- Most common in: middle 1/3 max central and incised third of lateral

56
Q

Enamel hypoplasia is what kind of defect?

A 
QUANTITATIVE  ( hypoPLASIA - Plasia is #) 
Cause: variety stresses during tooth development 
Neonatal line (NNL) - in almost all kids (Can see clinically or subclinically), represents time of birth
57
Q

Enamel hypoplasia in primary teeth is correlated with:

A 
Poor prenatal care in 1st trimester
Premature labor/birth
Heavier pre pregnancy weight of mom 
Post natal measles 
Maternal smoking
58
Q

Vitamin D
Required for what development?
Regulates what synthesis?

A

Vit D required for proper bone and tooth development (works with calcium)
Regulates serotonin synthesis in brain (why it makes you happy)

Key QE (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions