Cariology 4

Question 1

What is risk

Answer 1

the probability that an event will occur, an event occurring within a specific period of time, usually connotes the event will lead to a negative implication. Jeez

Question 2

Why is it important to estimate caries risk

Answer 2

caries is almost universal, not everyone will get a cavity, diagnostic ability to locate small cavities is rather poor

Question 3

Most important activity we engage in

Answer 3

determining patient risk of current oral environment in causing formation of cavities requiring restoration-dictate aggressiveness of our therapies

Question 4

what dictates aggressiveness of our therapies

Answer 4

caries risk

Question 5

There is not one set of conditions that can be determined highest risk in a single patient-just know this

Answer 5

–

Question 6

Factors contributing to disease are dependent on

Answer 6

Dose-how much
Frequency-how often
Duration-how long

Question 7

Factors to be immediately involved in caries process

Answer 7

Attack and defense mechanisms

Question 8

Factors related to occurrence of cavities

Answer 8

educational factors
Socioeconomic factors
Past Caries experience

Question 9

Attack mechanisms

Answer 9

Bacteria and fermentable carbs

Strep Mutans-initiators

Question 10

Initiator of caries and why

Answer 10

Strep mutans

• acidogenic
• aciduric
• produce glycans and fructans to adhere to tooth
• some produce substance which will kill neighboring bacteria and produce dominence in the flora

Question 11

Bacteria dose and predictor

Answer 11

high levels of S mutans increases risk-not a good predictor alone

Question 12

low levels of s mutans

Answer 12

is a good predictor for future cavities avoidance

Question 13

Older plaque….

Answer 13

can transport materials/nutrients better

Question 14

Amount of glucose to drop pH from 7 to below 4.8

Answer 14

15ml

Question 15

15ml of glucose pH if brush and floss after

Answer 15

above 5.5 so okay (above critical level)

Question 16

Progressor of cavities

Answer 16

Lactobacillus

Question 17

larger sugar consumption means what

Answer 17

more lactobacillus –> more acid

Question 18

Sucrose

Answer 18

complex carb with glucose and fructose

Question 19

prime sugar contributing to glucans and fructans

Answer 19

sucrose

Question 20

Starch and caries

Answer 20

repeating glucose, can form glucans to help adhere

Question 21

Fructose and caries

Answer 21

moderate cariogenecity, can form fructans

Question 22

lactose and caries

Answer 22

low cariogenecity

Question 23

Dose of fermentable carbs

Answer 23

sucrose drops pH fast, more sugar will not drop pH more just will take longer for saliva to remove sugar from teeth (low cariogenic plaque returns pH to normal from acidic faster )

Question 24

10% sucrose in 5 min does what

Answer 24

pH from 7 to 4.5

Question 25

Saliva defense (how?)

Answer 25

buffers, water in saliva will dilute acids, Ca and P stabalize enamel equilibrium

Question 26

Stimulated vs non stimulated saliva

Answer 26

stimulated is better, from smell, taste, chewing

Question 27

contains bicarb?

Answer 27

saliva

Question 28

what will bicarb do

Answer 28

buffer and reduces solubility of the enamel crystal

Question 29

proportion of salivary proteins in saliva on cavity rates

Answer 29

it has an effect

Question 30

A large part of the reason why we ask what medications someone is on

Answer 30

they reduce salivary flow

Question 31

Sleeping reduces what

Answer 31

salivary flow, thus sugar stays in the mouth longer

Question 32

Chewing gum vs caries

Answer 32

increases saliva, this is good

Question 33

Fluoride present will preferentially form what apatite

Answer 33

Flourohydroxyapatite

Question 34

poison to ameloblast

Answer 34

Fluoride is, will produce poor enamel formation

Question 35

fluoride does what to solution

Answer 35

super-saturates it

Question 36

small doses of Fluoride often or large doses less often?

Answer 36

small doses often-hence water

Question 37

is SES status a cause or correlation of cavities?

Answer 37

no-just a relationship

Question 38

is gingivitis a direct indicator of cavities?

Answer 38

no, but likely do not brush a lot so this is bad news bears

Question 39

non-surgical caries measures

Answer 39

antibacterial mouthwash xylitol flouride amorphous calcium phosphate

Question 40

more than 1 million cfu's S. mutans?

Answer 40

prescribe chlorhexidine gluconate .12% QD or BID x14 days-reculture and repeat if necessary

Question 41

When Rx of antibacterial mouthwash can be stopped

Answer 41

once 2 consecutive cultures with low (<100,000cfu)

Question 42

How do you keep the patient below 1 million without the mouthwash

Answer 42

xylitol

Question 43

appropriate dose of xylitol

Answer 43

5-10grams/day in 3-5 divided doses

Question 44

A problem with xylitol

Answer 44

not absorbed well, water goes to it, cause diarhhea

Question 45

high dose fluoride recommended for who? Why?

Answer 45

children over 10 (because enamel is finished on most teeth crowns)

Question 46

How do we know how much fluoride is in a product? 1 ppm = ?

Answer 46

1mg Fl/liter water

Question 47

Children swallow about how much fluoride from toothpaste

Answer 47

about 1/2

Question 48

a 1% solution has _____ppm

Answer 48

10,000ppm

Question 49

colgate total has .14% w/v fluoride, how much fluoride in ppm?

Answer 49

14,000ppm

Question 50

fluoride varnishes have ______ppm

Answer 50

22,500ppm but use little

Question 51

Fluoride varnish releases for how long

Answer 51

4-6 hours

Question 52

% reduction when fluoride varnish is used 2-3x year

Answer 52

14% reduction of caries

Question 53

Silver diamine fluoride % reduction

Answer 53

70-80%, arrests decay for up to 6 months

Question 54

Licorice root

Answer 54

kills a shit ton of S. mutans,

Question 55

Smart bombs

Answer 55

kills stuff

Question 56

acts as a yardstick for sugar consumption

Answer 56

lactobacillus

Question 57

F in mouth when teeth first erupt

Answer 57

very little

Question 58

KSP of FHAP ___ KSP of HAP; thus which will form in solution super saturated with F

Answer 58

FHAP < HAP; so FHAP is formed in preference

Question 59

Silver diamine F turns demineralized tooth ______ (color)

Answer 59

black-and arrests decay for ~6 months