Cariology Flashcards
What are dental caries?
An infectious microbiologic disease of the teeth resulting in localized dissolution and destruction of calcified tissue
What are the elements of caries formation?
- teeth
- streptococcus mutans (bacteria)
- substrate (carbohydrate)
What kind of disease is caries?
multifactorial
What are the different types of bacteria in the mouth?
◦ Steptococcus mutans
◦ Streptococcus sanguis
◦ Streptococcus mitis (normal flora)
◦ Bacteroides melaninogenicus
What bacteria type is associated with periodontal disease?
Bacteroides melaninogenicus
What bacterial type is a normal flora and is meant to slow the growth of strep mutans?
Streptococcus mitis
What is the pH at which enamel begins to demineralize?
5.5
What is the pH that dentin demineralizes at?
6.2
pH remains below 5.5 for _____ minutes after each sugar exposure
20-60 minutes
Enamel is ______ than dentin
stronger (requires higher acidity than dentin)
What is the preferred type of carb for streptococci mutans?
sucrose
What is the epidemology for caries?
-Younger children (2-8yrs) have had minor decrease in caries prevalence
-Caries prevalence has remained constant for older children
-Minority youth still most at risk for caries
-Lower income youth still most at risk for caries
Where are the three sites for caries initiation?
- pit and fissure
- smooth surface (interproximal or near gingiva)
- root surface
What are the clinical features of caries?
- smooth surface cavitated
- occlusal caries
- interproximal caires (use radiographs)
- root surface caries
Are white spot lesions caries or not?
noncavitated
What class is a pit and fissure carie?
class I
Where are pit and fissure caries likely?
- occlusal surfaces of posterior teeth
- buccal surface of posterior molars (buccal pit)
- lingual surface of lateral incisors
What is the most prevalent location for caries?
pit and fissure
What can help prevent pit and fissure caries?
sealants
How do you detect pit and fissure caries?
- use explorer to drag along surface to check for softness (gentle pressure)
- clinical visualize shadowing
- radiographs
What does a “stick” tell you?
Nothing!
Presence of high concentrations of mutans streptococci in pits or fissures is typically followed by a carious lesion in _____ months
6-24
What class are smooth surface caries?
Class V (buccal and lingual)
Class II (interproximal)
What type of caries are associated with high sugar intake?
smooth surface caries
What type of caries are associated with “soda sippers”?
smooth surface caries
What are the characteristics of root surface caries?
- Comparatively rapid succession
- Often asymptomatic
- Closer to the pulp
- More difficult to restore
What are reccurent/secondary caries?
caries that develop at margin of a restoration
How can you diagnosis caries?
visual
- color
- matte vs shiny
tactile
- firm vs soft (leathery)
radiographs
What are factors to consider when managing caries?
- general health
- xerostomia (radiation/chemo, medical conditions, medications)
- fluroid exposure
How can you help prevent caries?
oral hygiene instructions
dietary counseling
sealants
What is a sealant?
◦ Thin resin coating placed on chewing surfaces of teeth
◦ With or without enameloplasty
How can you arrest caries?
- fluroide
- oral hygiene improvement
- dietary changes
- professional cleanings
- address xerostomia
What is an intermediate option between prevention and restoring a tooth?
resin inflitration
What type of resin inflitration do we use in clinic?
Icon is used in our clinic
◦ Clean tooth well (pumice)
◦ Dry working field (rubber dam)
◦ Etch for at least 30 seconds 1-3 times; rinse and DRY well
◦ Infiltrate using Icon resin
What are the four terms for classifying caries?
◦ Sound Tooth Structure
◦ Initial Caries
◦ Moderate Caries
◦ Advanced Caries
