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Biochem exam 2 > Clinical Correlation: Mechanisms of Caries & Prevention > Flashcards

Clinical Correlation: Mechanisms of Caries & Prevention Flashcards

1
Q

what is caries?

A

infectious disease

multifactorial (not just one thing)
-biofilm, bacteria, time, diet, habits, education, socioeconomic factors

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2
Q

manage caries disease ___

A

holistically

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3
Q

disease of early childhood caries (ECC)

A

the presence of one or more Decayed, Missing, or Filled tooth surfaces in any primary tooth in a child under the age of six

DMFT=decayed, missing, filled teeth

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4
Q

early childhood caries consequences

A

-higher risk of new carious legions
-hospitalizations and emergency room visits
-high treatment costs
-loss of school days, diminished ability to learn
-diminished oral health-related quality of life

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5
Q

ECC is ___ times more common than asthma

A

5

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6
Q

children @ or below the poverty level are ____

A

> 50% more likely to have ECC

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7
Q

how is bacteria transmitted from caregiver to child?

A

transmitted vertically through salivary contact; affected by the frequency and exposure

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8
Q

high levels of ___ is a result of untreated caries

A

Strep mutans

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9
Q

horizontal transmission of bacteria

A

also occurs b/w other members of a family or children in daycare

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10
Q

what happens to infants whose mothers have high levels of Step mutans?

A

they are at greater risk of acquiring the organism earlier than children whose mothers have low levels

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11
Q

AAPD policy statements

A

-limit sugar
-implementing oral hygiene very early
-professionally applied fluoride varnish
-getting a dentist w/in 6 months of first tooth eruption
-work w/ medical providers to make sure there is access to oral healthcare
-educating legislators and policymakers

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12
Q

dental caries

A

“decay and crumbling of tooth”

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13
Q

how do caries form?

A

-bacteria in dental plaque “eat” carbohydrates from our diet
-bacteria secrete acids
-acids lower pH
-enamel demineralizes at pH of 5.5 or below
-results in carious lesion

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14
Q

enamel demineralizes at what pH?

A

5.5

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15
Q

dentin demineralizes at what pH?

A

6.5

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16
Q

pit & fissure caries

A

?

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17
Q

smooth surface caries

A

on the smooth surface of the tooth

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18
Q

new caries lesion

A

attacking a previously INTACT surface

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19
Q

recurrent caries lesion

A

occurs around margins of restoration

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20
Q

residual caries lesion

A

caries left behind before filling is placed

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21
Q

active caries

A

matte & mushy

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22
Q

arrested (inactive) caries

A

shiny & firm

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23
Q

incipient/initial lesion

A

hasn/t broken into dentin layer

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24
Q

caries classification system

A

INITIAL caries
MODERATE caries
ADVANCED caries

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25
Q

initial caries

A

lesion has started but not progressed into the dentin

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26
Q

moderate caries

A

lesion has extended into dentin
*drill and fill

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27
Q

advanced caries

A

deeper lesions- getting close to the pulp
*probably root canal or extraction

28
Q

caries is a(n) ______ disease

A

-infectious
-manageable
-preventable

29
Q

primary microbes in caries

A

-Strep mutans
-Lactobacillus
-Actinomyces

30
Q

requirements for caries

A

-susceptible host
-bacteria
-food source
-time

31
Q

what is better for plaque pH?
-eating 3 meals a day
-snacking all day

A

eating 3 meals a day

32
Q

demineralization and remineralization is ____

A

a constant battle

33
Q

carious lesion form when…

A

demineralization is greater than remineralization over time

34
Q

process of demineralization

A

-bacteria consume carbs from your diet
-acid is the waste product
-acid results in demineralized enamel

35
Q

things that contribute to remineralization

A

-saliva
-good hygeine
-decrease fermentable carb consumption
-fluoride

36
Q

functions of saliva

A

-raises pH to non-demineralizing levels
-flushes away floating microbes
-antibacterial properties
-calcium & phosphate ions that can re-enter the tooth for remineralization

37
Q

good oral hygiene

A

removes bacterial habitat

38
Q

diet

A

“starves” bacteria

39
Q

fluoride

A

hydroxide ion is replaced by fluoride ion –> makes enamel more resistant to acid

40
Q

enamel

A

-outer layer
-most highly mineralized tissue in the body
-96% calcium hydroxyapatite crystals
-4% organic materials and water
-there is no secondary or post-natal production of enamel

41
Q

amelogenesis

A

enamel formation
-ends at tooth eruption

42
Q

dentin

A

-45% hydroxyapatite crytals
-33% organic material
-22% water
-can be produced postnatally (secondary or tertiary dentin)

43
Q

dentin enamel junction (DEJ)

A

-where the dentin and enamel meet
-weak spot
*probably should add more but that’s all she said

44
Q

amelogenesis cycle

A

-cyclical
-dentin forms first

45
Q

steps of amelogenesis

A
  1. pre-secretory stage
  2. secretory stage
  3. transition stage
  4. maturation stage- RA
  5. maturation stage- SA
  6. post-maturation stage
46
Q

pre-secretory stage of amelogenesis

A

growing the enamel out from the dentin

47
Q

secretory stage of amelogenesis

A

enamel matrix proteins (EMPs) constantly secreted near dentin–> create aprismatic enamel near dentin (very hard to bond to)

48
Q

ameloblasts form…

A

individual enamel rods via their Tome’s processes

49
Q

aprismatic enamel is closest to

A

dentin

50
Q

progress of carries

A

-attachment
-colonization
-biofilm development

51
Q

pellicle formation

A

streptococci first
filamentous follow (actinomyces)

52
Q

strep mutans participate in…

A

formation of biofilms on tooth surfaces

53
Q

PEP group translocation

A

distinct method used by bacteria for sugar uptake which uses phosphoenolpyruvate as an energy and phosphate source

54
Q

what process makes lactic acid?

A

glycolysis
*anaerobic

55
Q

how does the carie expand deeper into dentin?

A

region becomes more acidic –> promotes greater colonization

56
Q

factors determining dental caries sensitivity

A

-differences in the gram-positive composition of supragingival microbial biofilms
-dietary carbohydrate ingestion (sucrose content & freq. of ingestion)
-saliva access to teeth surfaces & its flow rate
-fluoride in the drinking water & toothpastes
-antibodies to Strep mucans in blood & oral cavity

57
Q

how does saliva resist caries?

A

rinses & neutralizes w/ bicarbonate ion

58
Q

what stimulates saliva secretion?

A

primarily parasympathetics but some sympathetics

59
Q

sympathetic stimulation of saliva

A

more viscous saliva, slower secretion rate

60
Q

production of bicarbonate ion from CO2 is catalyzed by…

A

carbonic anhydrase enzyme
*present in saliva and salivary glands

61
Q

what is the most abundant enzyme in human saliva?

A

amylase

62
Q

how does amylase PROMOTE caries formation?

A

aids in breakdown of carbohydrates

63
Q

how does amylase PROTECT AGAINST caries formation?

A

aids in clearing carbohydrates from tooth surfaces –> bacteria has less time to digest maltose

64
Q

fluoride can rarely cause…

A

fluorosis (mottled teeth)

65
Q

fluoride may become ineffective below a pH of what?

A

4.5

66
Q

3 mechanisms used by fluoride to protect against caries

A
  1. inhibition of demineralization
  2. enhancement of remineralization
  3. inhibition of bacterial enolase activity inhibiting lactase production from ingested carbohydrates
67
Q

biofilms are resistant to…

A

destruction

Biochem exam 2 (9 decks)

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