caries symposium 2 + 3 Flashcards
what are the 3 main things needed for caries to form
- tooth
- dental plaque
- diet
what is a 4th factor that affects caries formation
time - how often is sugar consumed
what kind of patient can’t get any caries
edentulous patients as have no teeth for caries to from on
can baby’s get caries
yes
- if fed with milk with lots of sugar
- if mother has high caries diet then effects baby’s risk of caries too
how is the enamel structure adapted to receive the first coat of proteins
- first coating is coating that appears after brushing
- is a protective lubricant to stop tooth from harming other soft tissues
- when coating attaches to enamel it changes conformation (however bacteria have adapted to detect this change)
what are the secondary elements fro caries
- perhaps more important than primary
- saliva, capacity of buffering, presence of fluoride, diet etc
- these elements drive caries
secondary elements are also driven by external factors = social class, income, knowledge and education, attitudes and behaviour
what is the definition of caries
- demineralisation of tooth surface caused by acid produced by bacteria - acidogenic bacteria
- breakdown of the balance between demineralisation and remineralisation
does caries happen immediately
no, develops over a long time
how deep does caries go
as deep as it progresses
- has nothing to do with a hole, the hole is a consequence of caries
can demineralised tissue be repaired
- if repaired before cavity is there
- prevention is preferred = avoiding restorative procedures gives better quality of life for patient
how is a bigger lesion exposing the inside of the tooth better than a small lesion
- small lesion may have caries growing underneath along the ADJ
- an exposed lesion can still be brushed at least
- can be restored without exposing the pulp
what can affect how long a lesion will last
the environment in the mouth
what are the 4 parts of a white spot lesion
- surface = 1% mineral loss (still intact)
- body = 5% mineral loss
- dark = 10% mineral loss
- translucent = 20% mineral loss
what promotes a white spot lesion
- a succession of demineralisation and remineralisation
- surface is remineralised first which is why it is less demineralised at the surface compared to the deeper enamel even though the plaque is on the surface
- acid works better in subsurface of enamel than surface due to change in pKa
why should you never probe a white spot lesion
it will likely create a cavity
what is the structure of a white spot lesion
- subsurface is lost
- enlarged gaps between rods = rods become thinner and rounder
- rod length is preserved = crystallites running perpendicular to rod instead of parallel are less likely to demineralise
does a white spot lesion from immediately
no
- there is large time scale before cavitation
- doesn’t happen immediately
what is a good way to allow patients to see how to clean their plaque off
- use a staining chemical to allow them to see where the plaque is and then have them clean it
- will give them a better understanding of how to clean properly
what is inter proximal caries
- a lesion underneath the contact point
- plaque forms here so demineralisation occurs
should you be worried about dark spots
- no, should care about ‘active’ white spots
- the more active/demineralised the white spots are, the brighter more chalky white they become
how do you know the white spot is active
- if the white spot lesion is not at the gingival margin then it is not active as plaque is at gingival margin
- need mature plaque to produce acid - plaque that has been present for a long time
what does an active white spot lesion look like under microscope
- is quite rough
- has larger surface area for plaque to build up