EXAM 1 Flashcards
case 1-3
Clinical crown
tooth above the gumline, exposed to the oral cavity
anatomical crown
from CEJ (cementoenamel junction) to cusps
periodontal ligaments
fibers that connect the tooth to the alveolar bone
enamel
outer calcified tissue
covers the anatomical crown
no living cells, cannot repair damage from decay/wear but can strenghthen with fluoride
gingiva
soft tissues that protect the roots of teeth
pulp chamber
soft tissue at the center of tooth
contains nerves, blood vessels and connective tissue
lined by odontoblasts
dentin
beneath enamel and cementum
most of tooth
contains dentinal tubules that allows heat/cold to stimulate the nerves > sensitivity if enamel is worn
causes tooth color
alveolar bone
bone that surrounds roots of the teeth
root canal
chamber of tooth root that contains the pulp
cementum
hard connective tissue that covers the tooth root
if exposed through gingival recession causes sensitive to temp
ameloblasts
form the enamel
odontoblasts
form the dentin
pulp canal
in tooth roots
pulp chamber
in tooth crown
periodontium
made of gingiva, cementum, periodontal ligament and alveolar bone
cements the tooth in place
periodontal ligament
collagenous connective tissue fibers
holds tooth to its socket
factors that influence the oral cavity
- diet (incl. vitamins)
- stage of development
-medical conditions
-socioeconomic status
carbohydrates affect oral cavity
monosaccharides = quick metabolism > rapid decrease in pH and more acid in plaque
they are more cariogenic than complex sugars.
proteins affect oral cavity
lack of protein affects structural integrity of dentition, can decay the structure supporting teeth and delays healing.
if within 0-12 months of life: can affect tooth eruption, tooth loss and increased caries risk
excess protein: decreased Ca2+ retention and bone health
fats affect on oral cavity
omega 3 fats decrease inflammation (aka periodontal disease)
can prevent caries as they prevent carbs from adhering to teeth
leading cause of dental caries
diet deficiencies and high sugar intake
demineralization
pH LESS than 5.5
sugary diets
loss of calcium, phosphate and carbonate
plaque is cariogenic and forms white spot (reversible) if untreated can cause cavitated lesion
remineralization
pH greater than 5.5
healthy plaque, balanced diet, fluoride
gain of minerals, reforms hydroxyapatite crystals
macrominerals
needed in larger amounts (100+ mg)
Ca, P, Mg, Na, K, Cl
microminerals/ trace elements
small amounts needed (few mg)
Fe, Zn, I, F, Cr, Co, Mn, Mo, Se,
Calcium
most abundant mineral
99% in skeleton (bones/teeth)
involved in bone remodeling and various functions
calcium deficiency
most common in women an lead to osteoporosis
needed for teeth mineralization
phosphorus
85% in bones + teeth
function: bone development, buffer, metabolism, cell structure
all P thats ingested is absorbed
phosphorus deficiency
causes enamel + dentin hypoplasia
hypoplasia
underdevelopment
Fluoride
deposited in bones and teeth from water/soil
gives us demineralization resistance
prevents plaque formation
improved tooth morphology
quick absorption in stomach
water = best source of F
fluoride deficiency/excess
deficiency: increased caries risk
excess: fluorosis = patches in enamel
flouride in tooth decay
forms calcium fluorapatite which is more stable that calcium hydroxyapatite
decreases tooth decay
caries
caused by tooth demineralization, break down of enamel
can remineralize
if reaches pulp = pulpitis
most common disease in children
types of caries
smooth surface
pit and fissure (occlusal)
root cavity
radiolucent
dark, soft tissue
ex: caries
radioopaque
light, hard tissue
Ex: restoration
radiographs
can’t tell active from arrested caries
need examination too
caries is deeper than it appears, 30% decay needed to see on xray
bitewing/ interproximal
shows contact points between distal surface and alveolar bone level
detect caries + periodontal bone loss
best for detection caries on posterior teeth
PA
shows crowns, contact points, roots, + surrounding bone
can see infection at apicies, alveolar lesions or caries in anterior teeth
gingival structure: alveolar mucosa
tissue beyond the mucogingival junction
less attached and more red
non-keratinized, softer and flexible for cheek and lip movement
gingival structure: attached gingiva
adjacent to free gingiva
keratinized, attached to bone
gingival structure: free gingiva
not attached
forms collar around the tooth
sulcar epithelium attaches it to the tooth
sulcus
trough around the tooth
1-3 mm
gingival margin
boarder of gingiva that touches the tooth
interdental papillae
fill space between adjacent teeth
the pointy edge that fills interdental space
muco-gingival junction
line that divides attached gingiva and alveolar mucosa
hydroxyapatite crystals
made of calcium and phosphate ions
primary mineral found in tooth enamel
start forming before teeth erupt
enamel strength
more minerals = stronger enamel to protect against acid
bacterial acid
streptococcus mutans metabolize sugars and produce acids > low pH in mouth and demineralizs the tooth
early caries lesion
white spot (reversable)
sealants
applied to molars in children to prevent pit and fissure cavities
assessments
dentists assess the patients as a whole to understand how their medical history affects their oral health.
assessment techniques
- inspection: use vision/smell/hearing to look for abnormalities
- Palpation: using hands to feel for abnormalities
- percussion: tapping fingers/instruments
- auscultation: listening with a stethoscope
bimanual palpation
use both hands to feel structure
ex: a gland
bilateral palpation
palpating both sides of the body at the same time
ex: lymph nodes
digital palpation
use 1 finger to asses tissues
ex: intraoral structures
TMJ exam
uses inspection, palpation and ausculation
thyroid exam
palpation, ask pt to swallow and stick tongue out
need thyroid collar for x rays
should not be visible
goiter
abnormal enlargement
symptoms: coughing, hard to breathe, hoarseness, hard to swallow
follicular epithelial cells
secrete tyrosine derived hormones and thyroglobulin
c cells
secrete calcitonin
colloid
storage depot of thyroid hormones
T3 vs T4
T3 = active form
hypothyroidism
deficiency of TH
can be born with underdeveloped thyroid
primary hypothyroidism
problem with thyroid
most common= autoimmune destruction (hashimotos)
antibodies destroy the gland or block TH synthesis
secondary hypothyroidism
problem with pituitary
tertiary hypothyroidism
problem with hypothalamus
when is removal of thyroid necessary
pt has hyperthyroidism, goiter, thyroid nodules, thyroid cancer
causes of hypothyroidism
- radiation treatment: pt had hyperthyroidism and radioactive iodine killed cells
- medications that interfere with TH production
- Iodine deficiency (rare)
diagnosis of hypothyroidism
low lvls of T3 + T4
defect in thyroid = high TSH bc neg fb
defect in Hypo, pit = low TSH bc not produced
TRH vs TSH
regulating: secreted from hypothalamus
stimulating: from thyrotrophs in ant. pituitary
role of TSH
increases synthesis and secretion of TH
trophic effect on thyroid gland when TSH is high for too long and causes hypertrophy and hyperplasia
hypertrophy
enlargement of organ
hyperplasia
lots of cell growth
TH synthesis
tyrosine residues on thyroglobulin are iodated
stored in thyroid follicles
T3/T4 circulation
bound to plasma proteins or free
thyroid disease symptoms
delayed wound healing, prone to infections, eexcess mucopolyscaccharides (cant constrict blood vessels), hemostasis
treatment of hypothyroidism
levoxyl (synthetic T4)
can cause dry mouth > inc caries risk, bad breath, periodontal disease
signs of infection
swelling, bad breath, bitter taste, pain, fever, sensitivity, swollen glands or jaw
radiolucency
exudate or pus from gingival sulcus
fistula
gum absess
dry mouth (xerostomia relief)
xylitol, limit caffeine, no alcohol mw, no tobacco, drink h2o
synonymn for thyroiditis
hashimotos
iodine deficiency
causes congenital hypothyroidism
can cause intellectual disability
3’/5’ monodeiodinase
converts t4 to t3
physiological effects of hypothyroidism
inc Na/K atpase activity, inc o2 consumed, bmr and heat production
promotes bone formation and growth
th= essential for maturation of CNS
TSH induces the synthesis of b1 receptors and inc HR and contractility
