Concept 2 exam 3

Question 1

define dental caries

Answer 1

An infectious disease of the dental calcified structures (enamel, dentin and cementum) that is characterized by demineralization of the mineral components and dissolution of the organic matrix.

Question 2

GV Blacks classification

Answer 2

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Question 3

•Identify the role of the following factors in the caries process:

• diet
• host
• microorganisms
• time/frequency
• saliva

Answer 3

-diet
Cariogenic food source
Sucrose, glucose, fructose 
Carbohydrates (starch) 
-host
less than optimum fluoride exposure
-microorganisms
Streptococcus mutans
Streptococcus sobrinus
Lactobacillus  
-time/ frequency
The longer the pH is lowered the greater the risk for caries to form
The more frequent the exposure the greater the risk for caries to form 
-saliva
stimulated salivary flow: 1.0 ml/min or greater = Normal
0.6 - 0.9 ml/min = Low
0.5 ml/min or less = Dry

Question 4

•Differentiate between essential and contributing factors in caries development.

Answer 4

-essential
things that need to be there in order for dental caries: host, microorganisms, cariogenic food source
-contributing
things that will increase the risk: time, plaque pH, frequency of carbohydrate intake

Question 5

•Identify risk factors for dental caries.

Answer 5

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Question 6

•Define hydroxyapatite.

Answer 6

An inorganic crystallized structure comprised of calcium, phosphorus, and hydroxide

Question 7

•Define fluorapatite.

Answer 7

the crystalline structure that forms when fluoride ions are incorporated during the remineralization process

Question 8

•List the steps in the formation of a cavity:

• phase I incipient lesion
• phase II untreated incipient lesion

Answer 8

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Question 9

•Describe the demineralization / remineralization process.

Answer 9

Demineralization is the breakdown of the tooth structure with a loss of mineral content, primarily calcium, phosphorus, and fluoride.

Remineralization is the process by which minerals are restored to the tooth structure and tooth destruction is arrested

The development of caries is dependent on the relationship between processes that cause demineralization of tooth enamel, and those which cause remineralization
Only when factors favor the high acidity that leads to demineralization does caries occur.

Question 10

•Describe/identify the clinical signs of demineralization.

Answer 10

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Question 11

•Describe the role of systemic calcium and phosphate in the remineralization process.

Answer 11

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Question 12

•Explain the role that topical fluoride plays in the remineralization process.

Answer 12

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Question 13

•Relate the presence of saliva to the role that it plays as a natural buffer and remineralizing agent.

Answer 13

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Question 14

•Identify the normal pH of saliva and discuss the effect that carbohydrate consumption has on the pH of saliva.

Answer 14

Critical pH for enamel 4.5-5.5
Critical pH for root surface 6.0-6.7
The response after exposure of dental plaque to a fermentable carbohydrate is that pH decreases rapidly, reaching a minimum in approximately 5 to 20 minutes.

This is followed by a gradual recovery to its starting value, usually over 30 to 60 minutes

Question 15

•Assess salivary flow rate.

Answer 15

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Question 16

•Identify the pH level (critical pH) at which demineralization occurs.

Answer 16

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Question 17

•Identify the cariogenic bacteria that are responsible for caries.

Answer 17

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Question 18

•Distinguish between the demineralization potential of pits and fissures versus that for smooth surface areas.

Answer 18

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Question 19

•Explain how fluoride acts as a remineralizing agent.

Answer 19

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Question 20

•Identify caries risk factors.

Answer 20

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Question 21

•Employ the CAMBRA (Caries Management by Risk Assessment) protocol.

Answer 21

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Question 22

•Identify the types of fluoride that are commonly used for professional fluoride applications.

Answer 22

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Question 23

•Differentiate between professional fluoride applications on the basis of:

• parts per million (ppm) of fluoride delivered in each product
• composition
• indications for use

Answer 23

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Question 24

•Identify the precautions that must be taken when using an acidulated professional fluoride product.

Answer 24

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Question 25

•Discuss the rationale for four minute versus one minute professional fluoride products.

Answer 25

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Question 26

•Describe the sequence for the application of professional fluoride products.

Answer 26

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Question 27

•Differentiate between the mechanisms of action of systemic versus topical fluoride.

Answer 27

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Question 28

•Identify the fluoride level that is recommended for fluoridation of community water supplies

Answer 28

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Question 29

•Explain why it is critical to determine the fluoride level of non-community based water sources (i.e. well water)

Answer 29

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Question 30

•Relate the level of fluoride found in the water supply to the need for fluoride supplementation.

Answer 30

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Question 31

•Describe how the fluoride supplementation schedule is utilized by members of the dental team and pediatricians.

Answer 31

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Question 32

•Identify reasons for why the current fluoride supplementation schedule may be adjusted.

Answer 32

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Question 33

•Distinguish between the products available for home use fluoride application on the basis of:

• whether the product is a systemic or topical agent
• the parts per million fluoride contained in each product
• brand names that are associated with each product
• how you would integrate these products into your dental hygiene treatment plan

Answer 33

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Question 34

•Evaluate fluoride products and mechanical oral hygiene procedures as to their abilities to prevent caries.

Answer 34

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Question 35

•Assess the “lower dose fluoride more frequently” versus the “higher dose fluoride infrequently” theories as they relate to the management of demineralization.

Answer 35

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Question 36

•Explain the role that pit and fissure sealants play in managing dental caries.

Answer 36

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Question 37

•Identify the tooth surfaces that receive the greatest benefit from topical fluoride applications.

Answer 37

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Question 38

•Assess commercially available toothpastes with regard to their:

• fluoride content
• ingredients
• other therapeutic agents contained in the pastes

Answer 38

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Question 39

•Distinguish between the following chemotherapeutic agents(products) and their ability to prevent periodontal diseases:

• chlorhexidine gluconate (i.e.; Peridex)
• Essential oils (i.e.; Listerine)
• Cetylpyridium Chloride (i.e.; Scope)
• Triclosan
• Fluorides

Answer 39

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Question 40

Early childhood caries

Answer 40

Baby bottle caries
Nursing bottle mouth
Baby bottle syndrome
Baby bottle caries
First effects maxillary anterior teeth followed by molars
Least evident on mandibular anterior teeth

Question 41

smooth surface caries

Answer 41

on the smooth surface of the tooth, like on the buccal surface

Question 42

arrested caries

Answer 42

carious lesion that has become stationary and does not show a tendency to progress further; frequently has a hard surface and takes on a dark brown or reddish-brown color

Question 43

recurrent caries

Answer 43

occurs on a surface adjacent to a restoration; also called secondary caries

Question 44

primary caries

Answer 44

occurs on surfaces not previously effected; also called initial caries; early lesion may be referred to as incipient

Question 45

Rampant caries

Answer 45

widespread formation of chalky white areas and incipient lesions that may increase in size over a short time

Question 46

dental caries incidence

Answer 46

In the United States, dental caries is the most common chronic disease in childhood, with 41% of children between the ages of 2 and 11 having caries in primary teeth
Among dentate adults aged 20 to 64, 92% have caries in permanent teeth