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Operative > Diagnosis and Management Dental Caries > Flashcards

Diagnosis and Management Dental Caries Flashcards

1
Q

Is enamel or dentin more mineralized?

A

Enamel is more mineralized 96%. Dentin is only 70%

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2
Q

True or false: Enamel hydroxyapatite contains more magnesium and carbonate than the dentin hydroxyapatite

A

False

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3
Q

True or False: Caries progression rate is twice as fast in dentin than enamel?

A

True

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4
Q

Tobacco consequence on caries formation

A

Increases risk for caries due to dry mouth and staining of the teeth, and smokeless tobacco has high sugar content

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5
Q

What is the most and least frequently involved teeth for caries

A

Most frequently involved: First molar mandibular

Least: mandibular incisor

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6
Q

Is dental caries a disease of poverty

A

Yes

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7
Q

What medications impair salivary flow?

A

Meth amphetamine, anti-depressants, and antihistamines

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8
Q

What bacteria can be inherited by a child from caretakers kiss or through feeding premasticated food?

A

Strep mutans

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9
Q

When is dental caries formed?

A

When the rate of decay of the tooth caused by lactic acid produced by cariogenic bacteria exceeds the rate of repair initiated by rate of repair by the phosphate and calcium ions in saliva

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10
Q

What is specific plaque hypothesis?

A

Only certain bacterial species are responsible for the formation and aggravation of dental caries. Plaque is assumed to be pathogenic when the disease is present

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11
Q

Non-specific plaque hypothesis

A

Caries was attributed to a general overgrowth of oral bacteria. Quantity of plaque rather than the quality aid in the development of caries

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12
Q

Streptococcus mutans description

A 
Non-motile
Gram positive
Aerobic but can survive in anaerobic environment
Ferment sucrose (lactic acid)
Produce high volumes of acids
Involved in INITIATION of dental caries
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13
Q

Lactobacillus description

A 
Gram positive
Non-spore forming
Anaerobic 
Low affinity for tooth surface
Favor DEEP DENTINAL CARIES
Don’t produce as high volume of acids or as fast as s. Mutans
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14
Q

Actinomyces description

A

Gram positive
Non-motile rods
Ferment glucose
ROOT SURFACE CARIES

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15
Q

Critical pH for enamel
Fluorapatite
Dentin
Cementum

A

Critical pH for enamel is 5.3-5.5
Fluorapatite is 4.5
Dentin is 6.2
Cementum is 6.4

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16
Q

What is the optimal pH of saliva

A

7.2-7.4

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17
Q

Why is fluoride used as a protective mechanism

A

Because it takes the oral cavity a longer time (lower pH) for it to demineralize

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18
Q

5 zones of dentinal caries

A

Zone 2 and 3 affected
Zone 4 and 5 infected

Zone 1: normal dentin
Zone 2: subtransparent dentin
Zone 3: transparent dentin
Zone 4: turbid dentin
Zone 5: infected dentin
19
Q

Where is root surface caries mostly seen? (senile)

A

In older patients

20
Q

Smooth surface caries , earliest change in loss of transparency. The chalky color (white spot) is due to what

A

Loss of enamel subsurface (demineralized enamel)

21
Q

Incipient caries is limited to what and appears as

A

The enamel, and radiographically has not penetrated the DEJ

Appears as opaque white when air dried and disappear when wet

22
Q

Cavitated caries appears as waht

A

Advanced into dentin, and radiographically has penetrated DEJ. Tooth has change in color and loss of translucency

23
Q

Is remineralization possible in incipient or cavitated caries?

A

Incipient

24
Q

Rampant (Acute) caries is described as

A

Infectious disease process that involves several teeth. Patient usually young with signs of gross dietary inadequacy, poor oral hygiene or systemic illness. Decay is many soft, light colored cavities in the mouth.

Slide 309

25
Q

Arrested (Chronic) caries

A

Evidence of slow or arrested lesion following periods of several active phases

Persisted for a long time

Slow progression- sclerosis of dentinal tubules and deposition of secondary dentin
-discolored/ dark brown w/ eburnated dentin

26
Q

Initial (primary caries)

A

Caries that develop on unrestored teeth

27
Q

Recurrent (secondary) caries

A

Caries that occurs at the interface of a restoration in which the restoration wasn’t completely sealed (microleakage) or due to operator error (decay remaining)

28
Q

What is forward caries

A

Caries progressing from enamel to dentin

29
Q

What is backward caries

A

Caries progressing from dentin to enamel

30
Q

GV Black’s classification

CLASS I

A

Class 1: pits and fissures of occlusal molars and premolars. Occlusal 2/3 of of buccal and lingual surfaces of molars
Lingual surfaces of anterior teeth

31
Q

GV Black’s classification

CLASS II

A

Class II: Proximal surfaces of posterior teeth

32
Q

GV Black’s classification

CLASS III

A

Class III: proximal surfaces of anterior teeth (incisors or canines)

33
Q

GV Black’s classification

CLASS IV

A

Class IV: proximal surfaces and incisal angle of anterior teeth

34
Q

GV Black’s classification

CLASS V

A

Class V: cervical 1/3 of of facial or lingual teeth that occur in gingival cavity

35
Q

GV Black’s classification

CLASS VI

A

Class VI: occlusal or incisal cusp tip, and anything else not mentioned

36
Q

Most used method to detect dentinal caries?

A

Mirror and explorer

37
Q

ICDAS (International Caries Diagnosis and Assessment System)

Two code system is what

A

Presence of restorations/ sealants (0-8) and caries (0-6)

38
Q

Caries score on ICDAS

A

0- no or slight change in enamel translucency
1- first visual change in enamel
2- distinct visual changes in enamel
3- localized enamel breakdown in opaque or discolored enamel
4- underlying dark shadow from dentin
5- distinct cavity visible dentin
6- extensive distinct cavity with visible dentin, involving more than half the surface

39
Q

First digit restoration and sealant codes

A 
0- no sealant
1- partial sealant
2- full sealant
3- tooth-colored restoration
4- amalgam restoration
5- stainless steel crown
6- porcelain, gold, pfm crown or veneer
7- defective restoration
8- temporary restoration
40
Q

What is used to feel in the ICDAS system

A

Perio probes

41
Q

What is the role of fluoride

A

Inhibits demineralization. Enhances remineralization. Inhibits plaque bacteria.

42
Q

Drawback of sdf (silver diamine fluoride)

A

Black staining when applied to current caries

43
Q

What is chlorheidine gluonate used for

A

For patients with high or extreme caries to reduce mutans streptococci and lactobacilli levels in the plaque biofilm

44
Q

Significance of xylitol gum

A

Natural sugar nonfermentable by oral bacteria. Reduces levels of mutans streptococci in plaque and saliva and decreases adhesion of microorganisms to tooth surfaces. Disrupts vertical transmission of pathogens from caregiver to child

Operative (2 decks)

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