Dental Caries Flashcards
Enamel is
The microporous solid that is no longer alive - ions diffuse in and out of.
Hardest structure in the body
Acellular layer, avascular, and made up of hydroxide appetite crystals
Can be replaced by fluoride = fluoride appetite crystals
Ameoloblast form the rods and
when rod is made they die off
Acellular means
it cannot repair itself or respond to stimuli/environment (made of Ca++, phosphate, and hydroxyl ions)
Dentin
Vital tissue, made up of hydroxide appetite crystals, but the crystals are smaller than the enamels so it makes it softer.
Organization of dentin is by
tubules and the odontoblasts live within the tubules forever allowing them to respond to external threats and be able to repair itself
Infectious
Caused by microorganisms that invade tissue - cariogenic bacteria in biofilm on tooth surface
Transmissible
able to be passed from one person to another
Vertical transmission
mom to infant
Horizontal transmission
Someone to someone else of the same age groups (siblings/classmates)
Ecological shift in the oral microbiome (oral dysbiosis) that leads to
the development of pathogenic biofilms
Caries, the hole in the tooth is actually
the sign and symptom of the disease itself -> the disease happens before the lesion
Caries lesion
ramification of the disease process -> the hole is the result of the disease
Caries disease is
the shift in the microbiome
What 4 aspects do you need to make caries?
Host, fermentable carbohydrates, Cariogenic biofilm, and time
Lateral spread
when the lesion get into the dentin - looks like a cone- but actually much larger.
From outside in caries
Enamel cavitation -> dentin destruction -> bacterial invasion -> demineralization -> Sclerotic dentin -> Reactionary (tertiary) dentin
Demineralization
Always moving along the tubules
Sclerotic Dentin
Primary defense
The odontoblast send minerals into the tubules to block off the bacteria from moving forward
Reactionary (tertiary) dentin
Secondary-sense bacteria before it comes
Odontoblast live here trying to quickly lay tertiary dentin or reactionary dentin to protect what’s coming
ADA caries classification system
sound, initial, moderate, and advanced
Sound
No clinically detectable lesion, dental hard tissue appears normal in color, translucency, and gloss.
No surface change or adequately restored.
ICDAS 0
No radiolucency
Initial
Earliest clinically detectable lesion compatible with mild demineralization. Lesion limited to enamel or to shallow demineralization of cementum/dentin. Mildest forms are detectable only after drying. When established and active lesions may be white or brown and enamel has lost its normal gloss.
Visually noncavitated - White spot lesion
ICDAS 1 and ICDAS 2
Radiolucency may extend to DEJ or outer 1/3 of dentin.
Moderate
Visible signs of enamel breakdown or signs of the denintin is moderately demineralized.
Est, early cavitated, shallow cavitation, microcavitation.
ICDAS 3 and 4
Radiolucency extends into the middle 1/3 of the dentin
Advanced
Enamel is fully caveated and dentin is exposed. Dentin lesion is deeply/severely demineralized.
Spread/disseminated, late cavitated, deep cavitation
ICDAS 5 and 6
Radiolucency extends into the inner 1/3 of the dentin
