Dental Caries

Question 1

What is the definition of dental caries?

Answer 1

Bacterial disease of the calcified tissue of teeth characterized by progressive-irreversible demineralization of inorganic and destruction of organic substance of the tooth.

Question 2

What are the essential factors required for the etiology of dental caries?

Answer 2

• Dental plaque
• Cariogenic (acidogenic) bacteria
• Susceptible tooth surfaces
• Fermentable bacterial substrate (sugar)
• Time

Question 3

What are the intrinsic factors contributing to dental caries?

Answer 3

• Composition
• Morphology
• Position

Question 4

What are the extrinsic factors related to diet that contribute to dental caries?

Answer 4

• Physical factors: unrefined (natural) food leads to less caries
• Local factors: diet content of carbohydrates, calcium, fluoride, and vitamins

Question 5

How does saliva contribute to caries prevention?

Answer 5

• Increases ammonia decreases caries
• Normal pH (6.2-7.6) or alkaline pH is better
• Quantity: Xerostomia increases caries
• Viscosity increases caries

Question 6

What is dental plaque?

Answer 6

A biofilm of bacteria embedded in an extracellular polysaccharide matrix.

Question 7

What is the role of bacteria in dental caries?

Answer 7

• Utilizes carbohydrates to form acid that decalcifies tooth structure
• Polymerizes monosaccharides to form the dense plaque matrix

Question 8

Which bacteria are most important in the initiation of early enamel caries?

Answer 8

Streptococcus mutans.

Question 9

What are the clinical presentations of pit and fissure caries?

Answer 9

• Early caries: brown and probe sticks
• Undermined enamel: bluish white borders that fracture under stress

Question 10

How does smooth surface caries present clinically?

Answer 10

• Early stages: chalky white spots
• Progression: yellowish pigment

Question 11

What defines nursing bottle caries?

Answer 11

Rampant caries affecting deciduous teeth in babies due to prolonged use of milk.

Question 12

What are the features of arrested caries?

Answer 12

• Shiny hard surface
• May be brown in color
• More resistant to acid attack
• Regarded as scar tissue

Question 13

What is the management for arrested white spots?

Answer 13

• Topical Remineralization Products
• Resin Infiltration (Icon)
• Microabrasion
• Veneers or Bonding
• Bleaching

Question 14

What is eburnated dentine?

Answer 14

Hard brown polished surface of dentine that does not catch the probe.

Question 15

What are the zones of early dentine caries?

Answer 15

• Zone of fatty degeneration of Tomes fibers
• Zone of dentinal sclerosis
• Zone of demineralization
• Zone of bacterial invasion

Question 16

What is the significance of dead tracts in dentine caries?

Answer 16

Empty dentinal tubules resulting from degeneration of odontoblasts and their processes by bacterial acid irritation.

Question 17

What are liquefaction foci in late dentine caries?

Answer 17

Ovoid foci filled with necrotic debris resulting from the local coalescence and breakdown of dentinal tubules.

Question 18

True or False: Lactobacilli bacteria are most active during the initial stages of demineralization.

Answer 18

False

Question 19

Which factors must NOT be present in order for a carious lesion to form?

Answer 19

Saliva protective factors.

Question 20

True or False: Neutral pH minimizes remineralization while acidic pH increases it.

Answer 20

False

Question 21

What is the mechanism of action of fluoride that does NOT apply?

Answer 21

Enhances demineralization.

Question 22

Describe features of late dentin caries.

Answer 22

Formation of liquefaction foci and transverse clefts.

Question 23

Define occult caries.

Answer 23

Hidden or occult caries that may not be visible until advanced.

Question 24

What is rampant caries?

Answer 24

Rapidly progressive caries that involve many or all of the teeth with early pulp involvement.