Enamel homeostasis & the development of caries Flashcards

1
Q

Give some examples of tooth mineral loss by mechanical wear (3)

A
  • Attrition (grinding)
  • Abfraction (acid+chewing)
  • Abrasion
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2
Q

Define primary caries

A

Lesions on unrestored surfaces

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3
Q

Define secondary caries

A

Lesions adjacent to fillings

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4
Q

Define residual caries

A

Demineralised tissue left behind before a filling is place

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5
Q

Define active caries

A

Caries that is considered to be progressive

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6
Q

Define arrested caries

A

Caries that is no longer progressing

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7
Q

What is a white spot lesion?

A

First sign visible by naked eye, usually visble with strong white light

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8
Q

What is a brown spot lesion?

A

Usually an inactive white spot lesion discoloured by the uptake of dye

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9
Q

What is rampant caries?

A

Multiple active carious lesions in the same patient

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10
Q

What is hidden caries?

A

Caries that are usually in dentine and only detectable by radiography

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11
Q

Why do the earliest visible lesions appear as chalky white spots?

A

As micropores appear in the enamel surface which scatter light to give off a white appearance

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12
Q

Explain subsurface demineralisation

A

Acid from the bacteria leach past tooth surface and start demineralising the sub surface to eventually erode away the enamel surface

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13
Q

What happens to the Ca2+ concentration in saliva when pH of the mouth drops to 4?

What is the benefit of this change occur?

A
  • Vastly increases

- To protect the enamel surfaces

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14
Q

How are calcium levels in the saliva so rapidly increased during a cariogenic attack?

A
  • At normal pH: Calcium binding salivary proteins hold onto Ca2+.
  • At acidic pH: The proteins undergo changes to allow the release of these Ca2+ molecules
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15
Q

Name some salivary proteins related to tissue maintenance (4)

A
  • Proline-rich proteins
  • Histidine-rich proteins
  • Cysteine-rich proteins
  • Tyrosine-rich proteins
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16
Q

What could cause xerostomia? (5)

A
  • Autoimmune disease
  • H&N radiotherapy
  • Salivary gland disease
  • Medication
  • Aplasia of salivary glands
17
Q

What is Iatrogenic Xerostomia?

A

When drugs cause xerostomia

18
Q

Explain the changes to the Stephan curve for a xerostomic patient

A

pH levels will rise back to 7 at a much slower rate

19
Q

What is the modern day approach to cariology?

A
  • Minimally invasive
  • Therapeutic rather than surgical
  • Treatment of Caries and Erosion with Drugs based on Salivary Proteins
  • Molecular Dentistry