Caries risk: aetiology and risk

Question 1

4 factors that contribute to dental caries?

Answer 1

susceptible tooth surface
bacterial biofilm
time
sugar substrate

Question 2

what does bacteria do to the dental biofilm that makes it more susceptible to caries?

Answer 2

decreases pH to 4.5-5.5
dissolution of hard dental tissues

Question 3

what initiates dentinogenesis?

Answer 3

odontoblasts in the pulp

Question 4

what does dental pulp consist of?

Answer 4

soft connective tissue
vasculature
lymphatics
nervous tissue

Question 5

what lines the periphery of pulp chamber?

Answer 5

odontoblasts

Question 6

name 2 bacteria associated with dental caries

Answer 6

strep mutans
lactobacilli

Question 7

what is Koch’s postulate?

Answer 7

disease cannot happen without specific bacteria
this is not true!

Question 8

what is Marsh’s ecological plaque hypothesis?

Answer 8

every person has a plaque biofilm which is capable of causing caries however it needs a niche environment to feed off

Question 9

common cause of white spot lesion?

Answer 9

failure of brushing
plaque buildup

Question 10

hall technique success at 2 years and 5 years

Answer 10

2 years - 98%
5 years - 92%

Question 11

composite restoration success rate at 2 and 5 years

Answer 11

2 years - 71%
5 years - <50%

Question 12

GI success rate at 2 years?

Answer 12

0%

Question 13

what is the most important clinical event in the progression of dental caries? and why?

Answer 13

cavitation - difficult to remove the biofilm out of the cavity

Question 14

what direction do lesions tend to spread in?

Answer 14

laterally

Question 15

why do you not take a sharp probe to a fissure cavity?

Answer 15

it will open fissures and break unsupported enamel

Question 16

what colour change is seen when enamel is disrupted by abrasion? and why?

Answer 16

clear - white/ opaque
light hitting the roughened surface gets refracted many times

Question 17

why does etch make enamel appear frosty?

Answer 17

it demineralises the enamel

Question 18

where does 99% of decay occur?

Answer 18

fissures
contact points

Question 19

pathophysiology of dental caries?

Answer 19

frequent access to fermentable dietary carbohydrates leads to an established dysbiotic microbiological population of high cariogenicity which is capable of increased production of organic acids promoting dental hard tissue mineral loss

Question 20

SIMD stands for?

Answer 20

scottish index of multiple deprivation