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Cariology Flashcards

1
Q

What are the 4 things necessary to create dental caries?

A

1.TIME 2.Micro-Organisms 3.Substrate 4.Host & Teeth

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2
Q

What are three things that TODAY’s view of what causes caries incorporates?

A

1.Education 2.Income 3.Social Class

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3
Q

Dental caries is a _______ disease process.

A

multi-factorial

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4
Q

What are the two types of lesions that can occur with enamel exposure to acid?

A

1.Carious lesion 2.erosion

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5
Q

In remineralization: Partially demineralized apatite crystals can grow to their _______. Especially in the presence of ______!

A

ORIGINAL SIZE!….Fluoride

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6
Q

Caries: A ______ disease that progresses very ______ in most individuals.

A

chronic….SLOWLY

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7
Q

In erupting teeth, the outermost surface layer is _____ and ____ in fluoride

A

porous…low

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8
Q

If fluoride is present in the oral fluids, the gradual increase in the surface enamel is called “_______ maturation”

A

Secondary Maturation

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9
Q

Is there a VISUAL sign of caries after 1 week of undisturbed plaque? Is there a HISTOLOGICAL sign?

A

NO…Histo: yes, increase in enamel porosity

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10
Q

How long does it take for White Spot Lesions to appear with Undisturbed Plaque?

A

2 weeks

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11
Q

What is the technique that needs to be used when checking for White Spot Lesions?

A

Air-drying

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12
Q

Histologically, how long does it take for a surface lesion to form with undisturbed plaque?

A

2 weeks

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13
Q

How long does it take to see a White Spot lesion with a chalky surface (no air drying necessary!)? (w/o undisturbed plaque)

A

4 weeks

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14
Q

After 4 weeks of undisturbed plaque, what do you see Histologically?

A

Enlarged inter-crystalline spaces

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15
Q

What are the 4 indications of HIGH risk caries in CAMBRA?

A

1.Visible Cavites Present 2. Restorations in the last 3 Years 3. Interproximal caries lesions/radiolucencies 4.White Spots on enamel surfaces

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16
Q

What is CAMBRA short for?

A

CArries Management By Risk Assessment

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17
Q

If you have a have a W.S.L. that you have been letting plaque grow on for a while, THEN you take the plaque off… how long does it take for the chalky appearance to diminish?

A

1 week

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18
Q

If you have a have a W.S.L. that you have been letting plaque grow on for a while, THEN you take the plaque off… How long does it take to see a normal shiny appearance of normal enamel?

A

2 weeks

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19
Q

When thinking about our Caries Classification Pyramid (D1-D4)… Where on the pyramid will I find “Sub-clinical lesions in a dynamic state of progression/regression”??

A

The Base of the Pyramid

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20
Q

When thinking about our Caries Classification Pyramid (D1-D4)…Where on the pyramid will I find “lesions detectable only with additional diagnostic aids”?

A

The second rung from the bottom

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21
Q

When thinking about our Caries Classification Pyramid (D1-D4)…Which classification level is this, “Clinically detectable enamel lesion with intact surfaces”?

A

D1

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22
Q

When thinking about our Caries Classification Pyramid (D1-D4)… Which classification level is this, “Clinically detectable cavitation limited to enamel”?

A

D2

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23
Q

When thinking about our Caries Classification Pyramid (D1-D4)…Which class am I: “Clinically detectable lesions in dentin”?

A

D3

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24
Q

When thinking about our Caries Classification Pyramid (D1-D4)… Which classification am I: “Lesions into pulp”?

A

D4…yikes.

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25
Q

When thinking about our Caries Classification Pyramid (D1-D4)… WHERE IS THE LINE DRAWN between CAVITATED and NON-CAVITATED lesions????

A

In D3

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26
Q

When thinking about our Caries Classification Pyramid (D1-D4)… When do we switch treatment form chemo-theraputics to drill and fill?

A

When the lesion becomes caveated in D3 (some schools teach drill and fill all cavities to the dentin/all D3)

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27
Q

What are 2 positives of having resident flora?

A

1.Assist wil nutrient absorption 2. Barrier to colonization by transient bugs

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28
Q

Can you “catch” decay?

A

YES! you can give your strep mutans to people!

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29
Q

WHEN is the “WINDOW of INFECTIVITY”? (when most children become inoculated with S.Mutans)…

A

18-36 months

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30
Q

When is the earliest a child can become inoculated with S.Mutans (like before the Window of Infectivity)?

A

3 months (or earlier!)

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31
Q

About ___% of children get MS from MOM, significantly associated with her ______ levels of bacteria referred to as “_______ transmission”

A

70%…mom…salivary…“vertical transmission”

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32
Q

What was the main point of the Sweedish and Japanese studies of transmission of S.Mutans?

A

that 45-58% of transmission can be HORIZONTAL transmission

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33
Q

______ the acquisition of S.Mutans reduces caries experience in both the primary and permanent dentition!!!

A

DELAYING

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34
Q

How do we DELAY transmission of S. Mutans?

A

Reducing Maternal Bacterial Load!!

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35
Q

When looking at the impact of Delayed Transmission: if a child has S.Mutans at age 2 (window of infetivity) WHAT is the % of CARIES in that child at age 4????

A

89%!!!! BOOM

36
Q

When looking at the impact of Delayed Transmission: If a child has NO S. Mutans at age 2, what % of them have caries at age 4??

37
Q

When looking at the impact of Delayed Transmission: how much of an increase in Decay & Fill Services at age 4 do we see for a child who did not have S.Mutans at age 2 compared to a child WITH S.Mutans at age 2???

A

5 fold increase in fillings!!!

38
Q

What are the 4 risk factors for Early Transmission?

A
  1. high MATERNAL levels of S.Mutans 2.Sweetend fluids in bed 3.Sugar/Snacks 4.Sharing food with adults
39
Q

HOLY CRAP! In the Common Childhood Diseases graph CARIES was NUMERO UNO….What % of Children have Caries?????

A

44 FREGGIN %!!!

40
Q

Is the Caries rate in Permanent Teeth of 6-17 year olds increase or decrease from 1971 to 1994?

A

Decreased!

41
Q

From 1994 to 2002, which age groups saw an INCREASE in caries free teeth?

A

ALL age groups! (but as you get older, you have less and less caries free teeth)

42
Q

WHY has there been a DECLINE in Caries?? (2 main reasons)

A

1.Increased Fluoride Exposure (toothpastes and water) 2.improved preventative behaviors/services (better O.Hygiene and Sealants)

43
Q

(Aside) Does brushing decrease the decay rate?

A

NO! No correlation between brushing and decay!

44
Q

HUGE CONCEPT: What is the most common surface for Caries??? WHAT % of caries occur here?

A

1.OCCLUSAL surface- 55%

45
Q

HUGE CONCEPT: What is the second most common surface for Caries? What % of caries occur here??

A

2.Buccal and Lingual Caries!- 34%

46
Q

HUGE CONCEPT: What is the 3 most common surface for caries? What % of caries occur here?

A

3.Smooth Surfaces (interproximals!)- 11% (CRAZY, interproximal decay is the LEAST common location!!)

47
Q

What are the 3 groups of people/children with the HIGHEST Caries rates???? ___% of underserved children experience 80% of the decay!!!

A

1.Low Income Children 2.Racial & Ethnic Minorities 3. Children with Special health care needs….20%

48
Q

In general what % of children have HIGH caries?

49
Q

In general what % of children have low caries?

50
Q

In general what % of children have caries (add low and high)?

51
Q

In general what % of children do not have Caries?

52
Q

In the Children (age 3-5) of the American Indian community, what happened to the prevalence and severity of dmfs between 1991 and 1999??

A

It increased!

53
Q

What has happened to the prevalence of Edentualism in adults 65 years and older from 1957 to 2004??

A

Decreased (about 3 fold!!)

54
Q

Who is the NEW “AT-RISK” population? Why? (1)

A

Older individuals, edentualism is decreasing!

55
Q

What are 2 caries factors for the new “at-risk” older population?

A

1.Xerostomia 2.Previous Restorative Work

56
Q

Interesting….Caries, not _________, is the PRIMARY cause of tooth loss in adults!

A

periodontal disease

57
Q

What type of Caries is MOST COMMON in older adults? (he asked this again in class!!!)

A

ROOT caries

58
Q

_______ is increasing prevalence corresponding with decline in caries.

A

Dental Fluorosis

59
Q

What age group is most affected by dental fluorosis?

A

12-15 years old

60
Q

What are the 4 factors for dental fluorosis?

A

1.[F-] 2.Duration/Time of exposure 3.age 4.weight

61
Q

What are the current fluoridation levels in the water? (in ppm, please)…

62
Q

2011 USA commission looking to _____ levels of water fluoridation. (INTERESTING!)

63
Q

Progression of caries: Permanent Teeth: Progression is a ____ process in most individuals (there are exceptions), It takes an average of about ___ years for a lesion to progress through the enamel of permanent teeth

A

slow..4 years

64
Q

Is caries progression FASTER or SLOWER in primary teeth compared to permanent teeth?

A

FASTER in primary teeth

65
Q

WHAT are the 5 guiding principles for Caries Mgmt?? NEW SCHOOL DENTISTRY YO!

A

1.Asses Risk Status 2.Diagnose EARLY 3.Treat (remineralize/control the infection) 4.avoid operative 5.restore Active disease only

66
Q

Guiding Principle #1: Asses Caries Risk- Race/ethnicity, Socioeconomic status, Previous history of caries, Inherited risks, Salivary composition…these are all factors I _____ change.

A

can’t… i hate that word but ok

67
Q

Guiding Principle #1: Asses Caries Risk- Levels of cariogenic bacteria Fluoride exposure, Diet, Oral hygiene, Salivary flow. These are all factors I ___ change.

A

CAN! Wooo!

68
Q

Guiding Principle #1: Asses Caries Risk- Impact of Race. What ethnic group has the highest caries rate in 2-4 year olds?

A

American Indians..by far

69
Q

Guiding Principle #1: Asses Caries Risk- Impact of SocioEconomic Status–is there a relationship between income and caries?

70
Q

Guiding Principle #1: Asses Caries Risk- Impact of Previous history of Caries…..Children with caries in primary teeth are ___ times more likely to have caries in their permanent teeth!!!!

71
Q

Guiding Principle #1: Asses Caries Risk- Impact of Inherited risks….________ (______) twins have similar caries patterns but _______ twins don’t.

A

Monozygotic (identical)….dizygotic

72
Q

Guiding Principle #1: Asses Caries Risk- Impact of Inherited risks….What are 4 genetic differences between us humans?

A

1.Sructure of our Enamel 2. Immune response to S. Mutans 3.Salivary Gland activity/Composition of Saliva 4.Sugar Metabolism

73
Q

Guiding Principle #1: Asses Caries Risk- Si Se Puede! Levels of Cariogenic bacteria…[S. Mutans] is DIRECTLY related to ______.

A

Caries Risk

74
Q

Guiding Principle #1: Asses Caries Risk- Si Se Puede! Fluoride Exposure…Regular exposure to ______ fluorides significantly reduces caries risk. (water, toothpaste, varnish)

75
Q

Guiding Principle #1: Asses Caries Risk- Si Se Puede! Diet..Eat less ______ carbs, eat more _____.

A

Less FERMENTABLE carbs, more Calcium

76
Q

Guiding Principle #1: Asses Caries Risk- Si Se Puede! Diet…. Sugar intake drops oral ____, which leads to: ________ and altered plaque ecology–>Which Favors _____ bacteria such as streptococci, and lastly their impact is dependent on presence of ______!

A

pH….Demineralization…aciduric.. flouride

77
Q

Guiding Principle #1: Asses Caries Risk- Si Se Puede! Diet…. What is the double whammy of Acid in the mouth?

A

1.Demineralization of enamel 2.Promotino of S.Mutans growth

78
Q

Guiding Principle #1: Asses Caries Risk- Si Se Puede! Diet…. What costs more? Milk or soda?

A

milk, by a lot.

79
Q

Guiding Principle #1: Asses Caries Risk- Si Se Puede! Diet…. When eating Sugar, what are the two main issues to consider?

A
  1. the Form of sugar and 2. Frequency of consumption
80
Q

Guiding Principle #1: Asses Caries Risk- Si Se Puede! Diet…. They SAY stickiness of the sugar is the only thing but matters, BUT you know that ______ is even more important…

A

FREQUENCY of sugar ingested

81
Q

Guiding Principle #1: Asses Caries Risk- Si Se Puede! Diet….It’s not how much sugar you eat, its ______ you eat it that is important.

82
Q

Guiding Principle #1: Asses Caries Risk- Si Se Puede! Diet..BIG BOY recommendation time!!! Limit the total amount of ADDED sugars to ___ g/day in NON-Fluoridated areas.

A

40 g/day (54g in a green monster)

83
Q

Guiding Principle #1: Asses Caries Risk- Si Se Puede! Diet..BIG BOY recommendation time!!! Limit the total amount of ADDED sugars to ___ g/day in NON-Fluoridated areas.

A

55 g/day (54g in a green monster)

84
Q

Guiding Principle #1: Asses Caries Risk- Si Se Puede! Diet..BIG BOY recommendation time!!! The total amount of added sugars should be __-__% of your energy intake.

85
Q

Guiding Principle #1: Asses Caries Risk- Si Se Puede! Diet..BIG BOY recommendation time!!! Limit SUGAR intake to __x/day. Preferably at _____.

A

4x/day..meals

86
Q

Guiding Principle #1: Asses Caries Risk- Si Se Puede! Diet….Sugar and Babies-> Encourages colonization by ______ bacteria like 1. _______ 2. ________.. Also it discourages ________ by noncariogenic bacteria :(

A

aciduric…1.Strep Mutans 2.LactoBacilli…colonization

87
Q

Guiding Principle #1: Asses Caries Risk- Si Se Puede! Diet….Infants & toddlers with high sugar intake have _____ colonization by S. Mutans and _____ caries rates

A

Earlier…..higher

Operative Dentistry (25 decks)

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