Clinical Correlation Lecture: caries (guest lecture) Flashcards
what is the definition of early childhood caries
the presence of one or more decayed. missing, or filled tooth surface in any primary tooth in a child under the age of 6
what are the consequences of ECC
-a higher risk of new carious lesions
-hospitalizations and ER visist
- high treatment costs
-loss of school days
-diminished oral health related quality of life
how common is ECC
-5 times more common than asthma
- 30-50% of low income children have ECC
-
how can a child get ECC
-microbes
- transmitted from caregiver to child through salivary contact
- childrens’ mothers with high stre mutans
what is AAPD statement #1
avoid frequent consumption of liquids or solid foods containing sugar such as
-sugar beverages
- breast feeding
- fruit juice
what is AAPD statement #2
implement oral hygiene no later than first eruption
- fluoridated toothpaste
what is AAPD statement #3
apply fluoride varnish
what is AAPD statement #4
establish a dental home within 6 months of eruption of the first tooh
what is AAPD statement #5
work with medical providers to ensure infants and toddlers have access to dental screenings and preventative measures
what is AAPD statement #6
educating legislators, policy makers and third party payers of strategies for ECC
what pH does enamel demineralize
5.5
what is a recurrent lesion
occurs around margins of restoration
what are residual caries
caries left behind before filling is placed
what are initial caries
earliest clinically detectable lesion with mild demineralization. limited to enamel or shallow demineralization of dentin
what are moderate caries
visible signs of enamel breakdown or signs the dentin is moderately demineralized
what re advanced caries
enamel is fully cavitated and dentin is exposed, dentin lesion is deeply and severely demineralized
what are the primary microbes in caries
strep mutans, lactoabcillus, actinomyces
what are the requirements for caries
susceptible host, bacteria, food source, time
what does saliva do in remineralization
raises pH to non-demineralizing levels, flushes away floating microbes, antibacterial properties, calcium and phosphate ions to enter tooth
what are the common concerns of fluoride
lowers IQ, poison added to water supply, fluorosis
what is the enamel made of
96% calcium hydroxyapatite crystals and 4% organic materials and water
what is amelogenesis
enamel formation
what is dentin made of
45% hydroxyapatite crystals, 33% organic material, 22% water
can enamel be produced postnatally? dentin?
dentin can, enamel cant
how does the dissolution of dentin occur
requires collagenase and proteases to breakdown collagenous matrix and acid to dissolve the mineral crystals present
what happens in amelogenesis
reciprocal induction of ameloblasts and odontoblasts form enamel in layers
what do tomes processes do
form enamel rods
what is PTS or PEP group translocation
method used by bacteria for sugar uptake which uses phosphoenolpyruvate as an energy and phophate source
-involves enzymes of the plasma membrane and cytoplasm
what are the sources of bacterial lactic acid
-fructose (from sucrose)
-salivary amylase
-and other bacteria
how does saliva effect caries susceptibility
saliva flow over the teeth and its bicarbonate content rinse and neutralize ions that cause caries
what nervous system portion stimulates saliva secretion
parasympathetic
what catalyzes the production of bicarbonate from CO2
carbonic anhydrase enzyme
what is the most abundant enzyme in human saliva
amylase
how does amylase promote and prevent caries?
promote: aids in breakdown of carbohydrates -> acid
prevent: aids in clearing carbohydrates from tooth surfaces
what does fluoride do for the teeth
replaces hydroxide ions in hydroxyapatite of enamel
what pH does hydroxyapatite in enamel demineralize
5.5
what pH does fluroide demineralize
4.5
what pH does dentil demineralize
6.5
what are the 3 mechanisms flouride uses to protect against caries
-inhibit demineralization
-enhance remineralization
-inhibit bacterial enolase activity inhibiting lactase production from carbohydrates
