Dental Deposits Flashcards
why does deposit matter
impacts oral health
impacts facial image
nutrient source for bacteria
deposit types
soft deposits: food debris, materia alba, acquired pellicle, biofilm
hard deposits: calculus
food debris
unstructured
nutrient source for cariogenic bacteria
usually removed with tongue of rinsing unless between teeth
materia alba
cottage cheese
minimal adherence
unorganized structure
contains: salivary proteins/lipids, microorganisms, epithelial cells, leukocytes
acquired pellicle
thin, acellular film, usually translucent
contains: salivary glycoproteins, macromolecules
protective layer
formation begins immediately
formed in 30-90 minutes
easily disrupted
acquired pellicle significance
- protection: against acids, remineralization and demineralization
- lubrication: speech and mastication
- biofilm formation
- attachment of subsequent calculus
biofilm
dynamic, non-mineralized
contains: microorganisms, polysaccharides, proteins
collects on moist oral surfaces
complex bacterial colonies and yeasts, protozoa, viruses
primary risk factor for gingivitis and dental caries
may cause oral malodor
biofilm lifecycle
stage 1: attachment: bacterial cells attach to pellicle layer, easily removed
stage 2: multiplication and colonization: adhesion (irreversible attachment), coaggregation and growth upwards
stage 3: matrix formation: extracellular protective matrix for protection (proteins, glycolipids, DNA)
stage 4: biofilm growth: cell division and recruitment, diverse microbiome, cell to cell communication and signalling
stage 5: maturation/dispurtion: bacteria break free of attached biofilm, move from one localized area to another, cycle starts again in new area
supragingival biofilm
bacteria gram positive aerobic rods and cocci with few motile species
diet and saliva is nutrient source
subgingival biofilm
gram negative and motile bacteria
more associated with periodontal disease
bacteria invades the epithelial and connective tissue oft he periodontium
nutrient source is GCF and blood
evolution of biofilm microorganisms
days 1-2: gram positive cocci, little inflammation, Streptococci mutans and Streptococcus sanguinis
days 2-4: cocci persist, more gram positive filamentous form and slender rods, grows into the cocci layer and replace them, addition of Actinomyces viscosus
days 4-7: mixed flora of rods, filamentous forms, and fusobacteria, biofilm thickens, greatest development at gingival margin and spreads coronally
days 7-14: vibrios and spirochetes, increase of gram negative and anaerobic bacteria, inflammation is visible
days 14-21: gram negative vibrios and spirochetes, gingivitis present, bleeding
bacterial traits
health: gram positive, aerobic, non-motile
disease: gram negative, anaerobic, motile
assessment and record of biofilm
location: supra or sub gingival
quantity: light, moderate, heavy or non-existent
extent: localized or generalized
what is the most effective way to combat biofilm
physical disruption
calculus
mineralized biofilm
hard tenacious mass
no living microorganisms, covered in biofilm
colour can range
builds up near salivary glands
why are calculus deposits a problem
they provide the perfect surface for bacteria biofilms to form on
calculus formation rate and mineral source
rate: forms after biofilm matures, 10-20 days, dependent on: salivary mineral content, hygiene, diet
mineral source: supra - saliva, sub - gingival crevicular fluid and inflammatory exudate
calculus composition
70-80% inorganic components: calcium, sodium, magnesium, hydroxyapatite
20-30% organic components: desquamated epithelial cells, leukocytes, carbs, salivary mucins
calculus attachment
acquired pellicle
irregularities in tooth surface
direct contact
importance of calculus removal
difficulty in home care
rough texture attracts biofilm
promotes gingivitis and periodontitis
aesthetics
stains
discolorations of the tooth that occur by:
-adhering to tooth surface
-pigmenting calculus or soft deposit
-incorporation in tooth structure or restorative material
staining significance
aesthetics
evaluation of patient habits
rough surface can promote biofilm formation
staining location
extrinsic: removable with scaling/polishing
intrinsic: cannot be removed with scaling, other interventions
staining origin
exogenous: from external sources, tobacco stain, bacteria, foods
endogenous: from internal sources, tetracycline, pupal trauma, developmental conditions
stain removal
prevention is best
use least abrasive polish and avoid excessive polishing
