Caries symposium 1

Question 1

what are the factors that are required for caries to be present?

3

Answer 1

tooth
substrate
flora - strep mutans

Question 2

what is a caried risk assessment used as?

Answer 2

a prognastic indicator to help determine what care that individual needs

Question 3

what are the four categories of caried risk factors?

Answer 3

biological
environmental
behavioural
protective

Question 4

what are the biological risk factors of caries?

4

Answer 4

previous caries history
diet
salivary function
bacterial load

Question 5

what are the environmental risk factors of caries?

2

Answer 5

fluoride exposure
socioeconomic status

Question 6

what are the behavioural risk factors of caries?

2

Answer 6

oral hygiene
dental visits

Question 7

what are the protective risk factors of caries?

4

Answer 7

sealants
diet
salivary function
bacterial load

Question 8

what are the 7 elements of caries risk?

Answer 8

clinical evidence
dietary habits
social history
fluoride use
plaque control
saliva
medical history

Question 9

what is the role of clincal evidence in caries risk?

3(3,1,1)

Answer 9

caries experience
* dmft>=5, DMFT>=5
* caries in 6 before 6yrs
* 3 year caries increment >=3 teeth
orthodontics
* fixed appliance therapy
prosthetics
* fixed or removable

Question 10

what is the role of diet in caries risk?

4

Answer 10

> =3 sugar intakes per day
high frequency worse than volume of sugar
highly processed carbs more cariogenic than natural sugars
natural sugars still cause harm

Question 11

what are some social history factors to consider?

8

Answer 11

SIMD category
education
unemployment
work stressors
single parent families
violence
inequalitites and access to healthcare
dependents

Question 12

what is the role of fluoride in caries development?

2

Answer 12

infrequent use of F- toothpaste
no F- in water supply

Question 13

what are the actions of fluoride on bacteria

2

Answer 13

inhibits bacterial growth by interrupting bacteria metabolism so less acids produced
interferes with the adhesion of bacteria so less able to stick to teeth, disrupting the formation of the biofilm

Question 14

what are the actions of fluoride on enamel?

2

Answer 14

remineralisation is promoted
fluorapatite is created which is stronger and more acid resistant

Question 15

what is the role of plaque control and oral hygiene in caries development?

5

Answer 15

poor technique
irregular brushing
unassisted brushing
access to toothbrush/toothpaste
difficulty due to changes (mixed dentition/orthodontics/gaps/recession)

Question 16

what is the role of saliva in caries development?

5

Answer 16

amount
flow
buffering capacity
pH
viscosity

Question 17

what is the role of medication in caries development?

7

Answer 17

• xerostomia
• other side effects making OH hard e.g. mucositis
• free sugars added to make more palatable
• lactulose - very sugary
• frequency of taking sugar containing medicine
• recreational drug use/rehabilitation (methadone)
• social convention - giving sick people sweets

Question 18

describe the typical high caries risk child

4(2,2,4,1)

Answer 18

social
* poor dental attender
* family unit situation (single mother)
health
* poor health
* sugar-based medications
caries experience
* dmft>=5, DMFT>=5
* >=10 initial lesions in primary dentition at first attendence
* caries in 6s at 6yrs
* 3 year caries increment >=3 teeth
orthodontics
* fixed appliance therapy

Question 19

what are social/behavioural considerations of caries risk for toddles/infants?

6

Answer 19

mother’s caries risk
prolonged nursing habits
bottle/pacifier at bedtime
cariogenic snacking
no tooth cleaning
little fluoride exposure

Question 20

what are some factors to consider with typical high risk adults?

7

Answer 20

level of education
attends only when they identify a problem
social difficulties
“sweet tooth” with poor OH
sugar containing meds/that affect saliva
root caries
secondary caries

Question 21

what are the 8 elements of the preventative programme?

Answer 21

radiographs
toothbrushing
strength of F- in toothpaste
F- varnish
F- supplementation
diet advice
fissure sealants
sugar free medicine