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Cariology > Caries Formation > Flashcards

Caries Formation Flashcards

1
Q

What are the primary factors of caries? (4)

A

Host
Microbial flora
Substrate
Time

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2
Q

According to the modified keyes diagram what are the factors?

A

Primary modifying - oral environment

Secondary modifying - environmental factors

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3
Q

This is a layer that contains microorgranisms

A

Biofilm

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4
Q

What is an acquired pellicle?

A

if the plaque has no microorgranisms within them.

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5
Q

Biofilm is composed of? (4)

A

Bacteria
By-products
Extracellular matrix
Water

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6
Q

The microorganisms found in plaque are foreign. T or F

A

False, they are found in the normal oral flora

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7
Q

Streptococcus mutans are usually very adherent to the tooth structures especially in the _______ and __________

A

pits and fissure

mesial surface of the molars

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8
Q

Streptococcus mutans causes the biofilm to increase in _______, __________, _________, and _________

A

Carbon dioxide
Lactate
Acetate
Peroxide

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9
Q

The presence of streptococcus mutans causes the environment of the biofilm to become__________?

A

Anaerobic

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10
Q

Rapid _________ metabolism in the presence of ______________ forms acids

A

Anaerobic

suitable substrates

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11
Q

What is an important factor in mature biofilm?

A

Time

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12
Q

______________ byproducts causes the pH to drop

A

Metabolic

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13
Q

What are the critical pH of enamel and dentin respectively?

A

5.5 and 6.2

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14
Q

Low pH = _______

A

Demineralization

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15
Q

What are the indispensable factors of caries? (4)

A

Tooth
Substrate
Time
Biofilm

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16
Q

Which would dissolve faster in the presence of acids, Enamel or Dentin? Why?

A

Dentin, they only have 60-64% of HA crystals

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17
Q

What areas of the teeth are considered Caries Suceptible?

A

Pits and fissure
Proximal surfaces
CEJ
Lingual pits of lateral incisors

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18
Q

What areas of the teeth are considered Caries resistant?

A

Facial surfaces of the anterior teeth
Incisal edges of the anterior teeth
Cuspal tips of posterior teeth

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19
Q

Which are more susceptible to caries, Anteriors or Proximals? why?

A

Proximals because they are more exposed when we chew our food

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20
Q

These are shelters of the microorgranisms

A

Faults such as Pits and fissures

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21
Q

What is the composition of saliva?

A

Calcium and Phosphate ions

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22
Q

It is important to have a lot of saliva because?

A

Saliva aids in the mechanical washing of the tooth surfaces

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23
Q

The saliva should have what kind of viscosity?

A

Watery

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24
Q

This is when the calcium and phosphate ions leaves the tooth

A

Demineralization

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25
Q

This is when calcium and phosphate ions diffuses into the tooth

A

Remineralization

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26
Q

what does IAP stand for?

A

Ion activity product

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27
Q

KSP stands for?

A

Solubility Product Constant

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28
Q

SI stands for?

A

Saturation index

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29
Q

if SI is negative it means _________

A

there is demineralization occurring

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30
Q

ISP < KSP = SI is __________-

A

Negative

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31
Q

ISP > KSP = SI is ___________

what does the above mean?

A

SI is positive meaning there is no demineralization

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32
Q

What is the pH level of stimulated saliva?

A

7.4-7.8 pH

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33
Q

50% of stimulated saliva comes from __________ gland?

A

Parotid

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34
Q

There are _______ ions and ______ bicarbonates in stimulated saliva

A

More

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35
Q

What are the ions found in saliva?

A

Sodium
Chloride
Bicarbonate ions

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36
Q

Stimulated saliva is less ________ than unstimulated saliva

A

Hypotonic

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37
Q

What is the main buffer system?

A

Bicarbonates

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38
Q

what is the pH level of unstimulated saliva?

A

6.8-7.2 pH

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39
Q

The minor salivary glands produces _____ of the total saliva in the mouth?

A

10%

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40
Q

what is another gland that aids produces the unstimulated saliva other than the minor salivary glands?

A

Submandibular glands

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41
Q

Unstimulated saliva is more _________ than plasma

A

Hypotonic

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42
Q

A decrease in ions and an increase in potassium and phosphate indicates a _______ flow rate

A

low

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43
Q

There is an increase in ____,____, & ____ and a decrease in ____ and _____ in high flow rates of saliva

A

Na, Cl, HCO3

K and PO4

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44
Q

Which is more efficient in mechanical cleansing of the tooth surfaces, low flow rate or high flow rate?

A

High flow rate

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45
Q

Organic composition of saliva (6)

A

Digestive enzyme
Proteins with lubricating function
Ca binding proteins

Carbon dioxide hydration
Antimicrobial proteins
Growth factors

DPC CAG

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46
Q

The thicker the saliva the more prone the tooth is to _______________

A

Caries formation

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47
Q

Increase in buffer capacity, ________ caries formation

A

Less

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48
Q

This is the rate at which a substance is removed or cleared from the mouth or reduced to a very low concentration

A

Oral clearance rate

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49
Q

Oral clearance rate is dependent on?

A

Saliva flow rate

Volume of saliva before and after swallowing

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50
Q

What is the normal threshold of swallowing?

A

1.1 mL

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51
Q

What is the normal pH of the buffer capacity of saliva?

A

6 - 7.5 pH

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52
Q

Buffer capacity is determined by the lab through ___________

A

titration of saliva

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53
Q

Stimulated flow is the most _________

A

alkaline

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54
Q

What are the antimicrobial enzymes of saliva?

A

Lysozyme
Lactoperoxidase
Lactoferrin

Salivary peroxidase and thiocyanate
Immunoglobulins
Amylase

LLL SIA

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55
Q

These are also found in our tears

56
Q

These increases availability of oligosaccharides and substrates

57
Q

This suppresses biofilm formation on tooth surfaces

A

Lactoperoxidase

58
Q

This inhibits the growth of some iron dependent microorganisms

A

Lactoferrin

59
Q

This is the most common caries when it comes to anatomical sites

A

Pit and fissure caries

60
Q

Pit and fissure caries usually occur in? (5)

A

Occlusal surfaces of the molars and pre molars
Lingual pit of maxillary incisors specifically lateral incisors
Buccal pit of molars
Buccal / lingual grooves of molars
Facial surfaces of teeth with pits or fissures

61
Q

Which premolar is more prone to caries formation and why?

A

Maxillary 2nd premolar because it has a lot of grooves and has a wrinkled appearance.

62
Q

What is the distinguishing characteristic of the maxillary 1st molar?

A

Cusp of carabelli

63
Q

You don’t usually find caries in the facial surfaces due to? (2)

A

Mechanical washing by the lips

Anatomy of the teeth

64
Q

What is the appearance of pit and fissure caries?

A

Triangular configuration with the apex on the external surface and the base towards the pulp

65
Q

Once the caries reaches the DEJ what happens?

A

There will be rapid lateral progression due to the lateral dichotomous branching of the dentinal tubules. The apex is now at the pulp and the base is at the DEJ

66
Q

What is the enamel rod configuration in pit and fissure caries?

67
Q

What is the most caries resistant?

A

Lower lingual surfaces of the anteriors

68
Q

What is the appearance of smooth surface caries?

A

Apex is on the pulp side

Base is on the eternal tooth surface

69
Q

What does relatively caries resistant mean?

A

it means they can still be affected by caries

70
Q

Proximal caries begins where?

A

Just below the contact points

71
Q

What is the first sign of caries formation?

72
Q

what is an opacity?

A

areas of decalcification

73
Q

if it is smooth it is caries. t or f

A

false, it has to be rough

74
Q

During the early stage of caries, what does the caries look like?

A

Faint white opacity of the enamel without apparent loss of continuity of the enamel surface

75
Q

What are the other names of greatest convexity?

A

Crest of curvature

Greatest bulge of the tooth

76
Q

Describe acute dental caries (6)

A 
Has pain
Lighter in color
Soft
Yellowish
Cheesy 
Leathery
77
Q

These are caries that occur in areas that are usually caries resistant

A

Rampant caries

78
Q

Why are children more prone to caries?

A

Greater permeability of the enamel
More organic content
Wider dentinal tubules

79
Q

Where do nursing milk caries occur?

A

Upper anterior teeth

80
Q

Is meth mouth an example of rampant caries?

81
Q

Describe chronic dental caries?

A

Asymptomatic
darker in color
hard surface
brown or black

82
Q

Which is more common in adults, chronic or acute caries?

83
Q

This is caries that has become static and does not show any tendency for further progression

A

Arrested caries

84
Q

Describe the appearance of arrested caries

A 
Large open cavity
Lack of food retention
Superficially softened and decalcified dentin
Brown stained
Polished appearance
Hard
85
Q

What does eburnation of dentin mean?

A

Dentin is smooth and looks polished

86
Q

another name of primary caries

A

virgin caries

87
Q

Another name for secondary caries (3)

A

Recurrent caries
Marginal caries
center caries

88
Q

Secondary caries is caries along the __________ or even in the perimeters of __________.

A

Restorations

Crown

89
Q

What is the definition of recurrent caries?

A

Caries that occurs on a tooth with existing restoration or condition

90
Q

Earliest sign of caries formation in the enamel

A

Opacities which are usually whiter than the rest of the enamel

91
Q

Earliest sign of caries in the dentin

A

Caries on the DEJ

92
Q

Rapid lateral progression of caries occurs due to the?

A

Dichotomous branching of the dentinal tubules

93
Q

Explain incipient caries

A

Caries that is less than halfway through the enamel, not reaching the DEJ

94
Q

Explain moderate caries

A

Caries is more than halfway through the enamel but does not reach the DEJ

95
Q

Explain advanced caries

A

Caries that reach half of the dentin

96
Q

Explain severe caries

A

Caries that involves the enamel and more than half of the dentin and more than half the distance toward the pulp

97
Q

G.V. black class 1

A

Occlusal areas or Buccal areas or Lingual pits on the tooth surfaces

98
Q

G.V. Black classification class 2

A

Proximal areas of the posteriors

99
Q

G.V. Black classification class 3

A

Caries on the proximal areas of the anterior teeth not including the incisal angle

100
Q

G.V. black classification class 4

A

Caries on the proximal areas of anterior teeth including the incisal angles

101
Q

G.V. black classification Class 5

A

Caries on the gingival third of the crown on facial or lingual surfaces of the tooth

102
Q

G.V. black classification class 6

A

Caries on the cuspal tips or any smooth surface areas except the lateral incisors

103
Q

ICDAS stands for?

A

International caries detection and assessment system

104
Q

before classifying in ICDAS, you should do the following: (3)

A

Clean and dry the tooth
Remove plaque
use a ball ended explorer

105
Q

Code 0 in ICDAS

A

Sound tooth surface after 5 seconds of drying

106
Q

Code 1 in ICDAS

A

There is visual change in enamel after prolonged drying.

107
Q

Code 2 in ICDAS

A

Distinct visual change in enamel even without prolonged air drying

108
Q

Code 3 in ICDAS

A

Localized enamel breakdown is seen but no dentinal involvement

109
Q

Code 4 in ICDAS

A

Underlying dark shadow from the dentin

110
Q

Code 5 in ICDAS

A

Distinct cavity with visible dentin. Less than half of the tooth surface is involved

111
Q

Code 6 in ICDAS

A

Extensive distinct cavity with visible dentin. More than half of the tooth surface is involved

112
Q

What are developmental defects that are considered sound: (6)

A 
Enamel hypoplasia
Fluorosis
Tooth wear - Attrition
Tooth wear - Abrasion
Tooth wear - Erosion
Stains
113
Q

What is Attrition?

A

Physiologic wearing of the tooth structure. usually seen in the lower anteriors

114
Q

What is abrasion?

A

Wearing of the cervical portion of the teeth due to incorrect brushing

115
Q

What is erosion?

A

Chemical wearing of the tooth structure due to acids

116
Q

What is the ICDAS 2 digit coding method?

A

Restoration and the caries code

117
Q

What is the restoration code 1?

A

Partial sealant

118
Q

What is the restoration code 2?

A

Full sealant

119
Q

What is the restoration code 3?

A

Tooth colored restoration / composite

120
Q

What is the restoration code 4?

A

Amalgam restoration

121
Q

What is the restoration code 5?

A

Stainless steel crown

122
Q

What is the restoration code 6?

A

PFM crown, veneer or gold crown

123
Q

What is the restoration code 7?

A

Lost or broken restoration

124
Q

What is the restoration code 8?

A

Temporary restoration

125
Q

What is the restoration code 96?

A

Tooth surface cannot be examined

126
Q

What is the restoration code 97?

A

Tooth is missing due to caries

127
Q

What is the restoration code 98?

A

Tooth is missing due reasons other than caries

128
Q

What is the restoration code 99?

129
Q

What does the code 46 mean?

A

Amalgam restoration, Extensive cavity with visible dentin, more than half of the tooth surface is involved.

130
Q

What does code E mean in ICDAS?

A

Root surface cannot be visualized due to calculus thus it cannot be classified.

131
Q

Difference of code 1 and 2 in ICDAS root caries codes

A

Code 1 - loss of anatomical contour is less than 0.5 mm

Code 2 - loss of anatomical contour is 0.5 mm or more than 0.5 mm

132
Q

ICDAS code 1 and 2 is ICCMS classification?

133
Q

Moderate classification in ICCMS is codes ______ and _____ in ICDAS

134
Q

Severe classification in ICCMS is codes ___ and _____ in ICDAS

135
Q

What are the classifications according to ADA

A

Sound
Initial
Moderate
AAdvanced

136
Q

What are the classifications according to ICCMS

A

Sound
Initial
Moderate
Extensive

Cariology (5 decks)

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