Cariology - Lecture 2 Flashcards
1
Q
What are the factors the contribute to Caries?
A
Bacteria, Carbohydrates & tooth structure
2
Q
Primary modifying factors of caries:
A
- Tooth Anatomy
- Saliva
- Biofilm pH
- Use of flouride
- Diet specifics
- Oral hygiene
- Immune system
- Genetic factors
3
Q
Secondary modifying factors:
A
- Socioeconomic status
- Education
- Life-style
- Environment
- Age
- Ethnic group
- Occupation
4
Q
Four factors that lead to caries:
A
- Host
- Cariogenic biofilm
- Time
- Fermentable carbohydrates
5
Q
What does smooth surface decay mean?
A
There is going to be a lot more decay in that mouth
6
Q
Localized demineralization and loss of tooth structure
A
Characterization of caries activity
7
Q
Refine carbohydrates for energy and produce organic acid by-products
A
Cariogenic bacteria
8
Q
Critical pH for enamel
A
5.5
9
Q
Critical pH for dentin
A
6.2
10
Q
When the pH in the biofilm returns to neutral and the concentration of soluble calcium and phosphate is supersaturated relative to that in the tooth, mineral can then be added back to partially demineralized enamel
A
Remineralization
11
Q
pH of baking soda rinse
A
8
12
Q
- Acid-producing bacteria
- Sub-normal saliva flow and/or function
- Frequent eating/drinking of fermentable carbohydrates
- Poor oral hygeine
A
Pathological factors of caries
Demineralization
13
Q
- Saliva flow and components
- Remineralization ( fluoride, calcium, phosphate)
- Antibacterials (fluoride, chlorhexidine, xylitol)
- Good oral hygeine
A
Protective factors of caries
Remineralization
14
Q
What happens if you use too much chlorhexidine?
A
You become resistant to lacto bailli
15
Q
Keeps bacteria from attaching to your teeth
A
Xylitol
16
Q
pH of hydroxyapitite
A
5.5
17
Q
pH of dentin
A
6.2
18
Q
pH of hydroxyflurapitite
A
4.5
19
Q
What causes Ca & F to come out
A
pH
20
Q
Tooth demineralzation as a result of the caries process
A
Caries lesion
21
Q
A caries lesion on a smooth tooth surface
A
Smooth-surface caries
22
Q
A caries lesion on a pit and fissure area
A
Pit and fissure caries
23
Q
A caries lesion in any surface of the anatomic tooth crown
A
Coronal caries
24
Q
A caries lesion not adjacent to an existing restoration or crown
A
Primary caries
25
A caries lesion adjacent to an existing restoration, crown, sealant.
Secondary caries
26
Refers to carious tissue that was not completely excavated prior to placing a restoration.
Residual caries
27
Less than half way through enamel
E1
28
Between DEJ and midway point of enamel
E2
29
Only 10% are cavitated
| 1mm
D1
30
2mm in root canal
D2
31
3mm in root canal
D3
32
A caries lesion that results in the breaking of integrity of the tooth, or a cavitation
Cavitated caries lesion
33
A caries lesion that has not been cavitated.
Non-cavitated caries lesion
34
Referred to as white spots in enamel
Non-cavitated caries lesion
35
A caries lesion that is considered to be biologically active, that is, lesion in which tooth demineralzation is in frank activity at the time of examination
Active caries lesion
36
Term used to describe the presense of extensive and multiple cavitated and active caries lesions in the same person
Rampant caries
37
Soft, tenacious film accumulating on the surface of teeth
Dental plaque
| or biofilm
38
Composed of bacteria, their by-products, extracellular matrix and water
Biofilm
39
- Acquired pellicle
- Forms in 30 min - 1 hr
- Made of salivary proteins, cell free
- Protects (IgA, IgG, lysozymes)
- Reduce friction remineralzation
Non-pathogenic bacterial plaque
40
Protective layer that develops on the tooth immediately after they are cleaned
Non-pathogenic bacterial plaque
41
- Plaque biofilm
- Enamel rods
- Striae of Retzius
- Acquired pellicle
- Perikymata ridges
Smooth-surface noncavitated lesion
42
What keeps acid closer to the tooth?
Biofilm
43
Main bacteria on coronal plaque
Gram-positive filaments
44
Main bacteria on Gingival crevice
Gram- positive filaments
45
Main bacteria on Tongue dorsum
Other species
| 20% each are S. salivarius & Gram- positive filaments
46
Main bacteria on buccal mucosa
S. mitis
47
Predominant species on mucosa
S. mitis
S.Sanguis
S.salivarious
48
Predominant species on tongue
S.Salivarius
S.mutans
S.sanguis
49
Predominant species on teeth (non-carious)
S. Saguis
50
Predominant species on gingival crevice
Fusobacterium
Spirochaeta
Actnomyces
Veillonella
51
Aerobic
pH of about 7
Oxidation-reduction potential positive
Mucosa & tongue
52
Aerobic
pH 5.5
Oxidation-reduction negative
Teeth
53
Anaerobic
pH variable
Oxidation-reduction very negative
Gingival crevice
54
Predominant species in Enamel caries
S. Mutans
55
Predominant species in dental caries
S. Mutans
| Lactobacillus
56
Predominant species in root caries
Actinomyces
57
Anaerobic
pH < 5.5
Oxidation- reduction negative
Enamel caries
Dentin Caries
Root caries
58
Tooth habitats favorable for harboring pathogenic biofilm
- Pits & fissures
- Smooth enamel surface immediately gingival to the proximal contacts in the gingival third of the facial and lingual surfaces of the clinical crown
- Root surfaces, near cervical line
- Subgingival areas
59
What do composites bind best to?
Enamel
60
What binds best to dentin?
Glass ionomer
61
What does saliva do?
Buffers acid in mouth to raise the pH
62
Important substance for the proper digestion of foods, and it plays a key role as a natural caries agent
Saliva
63
After radiation, salivary glands become fibrotic and produce little or no saliva, leaving the patient with an extremely dry mouth
Xerostomia
64
- Cleaves- 1,4 glucoside bonds
| - Increases availability of oligosaccharides
Amylase
65
- Catalyzes hydrogen peroxide-mediated oxidation; absorbs to hydroxyapatite in active form
- Lethal to many organisms: suppresses plaque formation on tooth surfaces
Lactoperoxidase
66
- Lyses cells by degradation of cell walls, releasing peptidoglycans; binds to hydroxyapatite in active conformation
- Lethal to many organisms; peptidoglycans activate complement; suppresses plaque formation on tooth surfaces
Lysozyme
67
- Hydrolysis of triglycerides to free fatty acids and partial glycerides
- Free fatty acids inhibit attachment and growth of some organisms
Lipases
68
Non-enzyme protein
- Ties up free ion
- Inhibits growth of some ion-dependent microbes
Lactoferrin
69
Non-enzyme protein
- Aggluination of bacteria inhibits bacterial enzymes
- Reduces numbers in saliva by precipitation, slows bacteria growth
Secretory immunoglobin
70
Non-Enzyme protein
- Agglutination of bacteria
- Reduces numbers in saliva by precipitation
Glycoproteins (mucins)
71
How much saliva do adults produce a day?
1-1.5 L a day, very little of which occurs during sleep
72
Lysozyme, lactoperoxidase, lactoferrin, and agglutinins
Possess antibacterial activity
73
Resting pH is lower than..
Stimulated salvia pH & chewing pH
74
What determines the buffering capacity of saliva
Bicarbonate ion
75
Molecules that increase biofilm pH in saliva
Urea & Sialin
76
What are saliva and biofilm supersaturated with?
Calcium & phosphate
77
Proline-rich peptide that stabilizes calcium and phosphate ions and prevents excessive deposition of these ions on teeth
Statherin
78
Most important factor in producing cariogenic biofilm
fermentable carbohydrates
