Chapter 5 J: Caries History And Epidemiology *Should Be In The Other One Flashcards
According to cambridge, caries are defined as?
Decay or rottenness of the teeth
Caries are?
Infectious and transmissible disease because it’s caused by bacteria colonising the tooth surfaces, it’s the result of an imbalance of the indigenous oral biota rather than exogenous pathogens
According to Brown, caries are defined as?
Infectious disease characterised by several complex chemical reactions that produce, in the first place enamel destruction and if not stopped, it continues to destroy all remaining tissues and it starts in the surface of the tooth
White spot lesions are?
First thing we see in caries, it’s when caries remove all minerals
Epidemiology of caries?
- complex bacterial infectious disease
- localised in teeth
- it can only start when the tooth is erupted
- chronic
- progressive
- produces tissue destruction by acids created on chemical reactions
- symptomatic treatment
- prevention is important
- cant reverse or cure, can revert initial stages
Prevalence is?
The proportion of the population affected by a disease at a particular time
Incidence is?
The rate at which disease progresses. Need to compare two periods
The epidemiological indicies are?
DMFT, DMFS, deft, defs
What is the reference age for the epidemiological indicies?
12 years old
Prevalence levels at age 12, very low is?
DMF index < 1.1
Prevalence levels at age 12, low is?
DMF index 1.2-26
Prevalence levels at age 12, moderate is?
DMF index 2.7-4.4
Prevalence levels at age 12, high is?
DMF index 4.5-6.5
Prevalence levels at age 12, very high is?
DMF index > 6.6
The goal is to set the prevalence levels at?
Under 2.5
What is the third health calamity? And the most common chronic disease of modern man affecting 95% of western adults?
Dental caries
In recent years, the prevalence of caries has experienced?
A marked decline in highly developed countries due to the development of preventive measures
The three levels of preventive measures are?
- Tooth: fluoridation of water, topical fluoride treatments, dietary fluoride supplements, fluoride toothpastes, fissure sealants
- Diet: decrease in sucrose consumption
- Microorganisms: greater plaque removal with hygiene, oral antiseptics
The prevalence of caries in Spain has
Decreased since the mid eighties
Sugar consumption increased until the mid-eighties when it reached a peak and started to decline
Which EU country has the lowest consumption of sugar?
Spain
The 3 epidemiological factors are?
Age, sex, race
There are 3 periods in which the incidence for dental caries increases?
- Between the ages of 4 and 8 (mixed dentition)
- Between the ages of 11 and 18
- From 55 years (gingival retraction)
Some studies show higher prevalence in which races?
Caucasian and asian races than in the black population , it closely related socio-cultural and dietary factors
Which teeth are the most affected?
Posteriors (M and PM) especially in pits and fissures in young people and inter-proximal surfaces of all ages
Increasing the incidence of caries in ___ in elderly patients?
Near the CEJ, receding gums and decreased salivary secretion
Rampant caries are?
A pattern of caries in children if they’re subject to continuous contact to refined carbohydrates through the bottle and the decay is focused on the incisors , aggressive caries
Most frequent location in young patients?
Pits and fissures
Common location in free surfaces?
Buccal grooves of first molars and cervical margins of temporary teeth
What indicates high risk patients (Canines and incisors)?
Cervical margins of permanent teeth
How to diagnose caries in interproximal surfaces?
Bitewing
Site frequency in kids and young population:
A. Pits and fissures
B. Interproximal surfaces
C. Free surfaces
A and B: 40-45%
C. 15%
Site frequency in adults
Cervical
Two researchers that revealed that caries were already found as small lesions in the neanderthals?
Mandle (1983) and Thylstrup (1986)
Caries in the neanderthals ?
Where were they mainly localised and what ages?
Rare at young ages
Mostly in CEJ in buccal, mesial, and distal surfaces of PM and M
Small lesions because their diet was low in simple sugars
When did tooth decay start to appear in a significant way ?
When man started to group up in societies and changed their dietary habits
Eskimos and caries?
They conserved their primitive diet of raw meat but their indexes are still the same
Did the rate and pattern of decay change from the iron to the middle age in western man?
No , was very low at that time
In the XVII century in the rich population in London, the rate of caries ?
Increased in occlusal, free and inter-proximal surfaces
In 1850: sugar imports were
Liberalised and its regular consumption increased sending the caries indexes to very high levels
The exogenous theories are?
(8):
1. Vermicular 5000 BC
2. Chemical 1819
3. Parasitic 1834
4. Chemical-parasitic 1890
5. Proteolytic 1940
6. Sulfatase 1950
7. Proteolysis-chelation 1954
8. Complexing and phosphorylating 1967
VCPCPSPC
The endogenous theories are?
(3):
1. Humoral V C. BC
2. Vital 1810
3. Phophatases 1950
HVP
The vermicular theory:
- 5000 BC
- worm theory
- was found in an Assyrian tablet
- creation of the universe and the wom
- worm asked for teeth and gums as food
- cured by a spell and herbs
- was widely accepted and not questioned until the middle age
The chemical theory:
- Parmly
- 1819
- decay started in the enamel surface in places where food is decomposed
- this decomposition created a chemical substance capable of producing the disease
The parasitic theory:
- erdl
- 1834
- studied under a microscope the deposited material on the teeth, describing filamentous parasites
- presence of parasites and the formation of caries was associated
The chemical-parasitic theory
- miller
- 1890
- opposed the vital theory
- suggested that the microorganism in the mouth ferment carbohydrates and produce acids that decalcifies tissues and destroys the enamel
- dentin is softened and dissolved by proteolytic bacteria penetrating inside
- modern assumptions are based on which theory?
Chemical parasitic
The proteolytic theory?
- gottlieb
- 1940
- based on microscopic morphological findings
- first thing altered was the organic matter
- hydrolysis of organic matter then a breakdown of the enamel prisms and dissolution of inorganic salts
The sulfatase theory?
- pincus
- 1950
- variant of the proteolytic theory
- after the initial proteolysis, a hydrolysis of sulfated enamel and dentin components would occur, by the action of the sulfatases of the gram negative bacteria
- sulfuric acid is released demineralising the inorganic tissue
The proteolysis-chelation theory?
- schatz
- 1954
- simultaneous double reaction is carried on the tooth surface (proteolysis of organic components and mineral dissolution by secondary chelation phenomenon
The complexing and phosphorylating theory?
- lura
- 1967
- requirements of phosphate by plaque causes a disturbance in the final balance of phosphates, resulting in a loss of phosphates from the enamel
- bacteria would form complexes with free calcium from the enamel, leading to tooth decay
- no solid base for the theory because saliva is a sufficient source of phosphates for bacterial requirements
The humoral theory?
- hippocrates
- V C BC
- caries occur specifically by accumulation of 4 humours (blood, lymph, bile, and mucous) and the imbalance between them produced the disease
The vital theory?
- jourdain
- 1810
- caries is due to an inflammation of the pulp caused by a metabolic or systemic disorder of unknown nature
- this would cause inflammation or destruction of dentin, affecting the enamel
- the theory had many followers until the mid nineteenth century
The phosphatases theory?
- csernyei
- 1950
- phosphatases are enzymes normally found on the pulp, so when its metabolism is altered by any phenomenon , they start to dissolve the calcified tissues from the pulp chamber towards the exterior
Keyes triad:
- 60s
- following elements are needed in order to develop caries: bacteria, substrate (carbohydrates), guest
