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Cariology I > FINAL EXAM > Flashcards

FINAL EXAM Flashcards

1
Q

describe dental caries lesions

A
  • lesions that occur due to activity within plaque that covers a tooth
  • considered signs and symptoms of metabolisms within plaque
  • can occur on enamel, dentin, or cementum
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2
Q

in the formation of dental caries lesions, the ___ is left undisturbed for a period of time on any tooth surface, causing the potential for a ___ to form

A
  • biofilm (plaque)
  • caries lesion
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3
Q

what is the best definition of dental caries lesions?

A

a multifactorial process of demineralization and concurrent remineralization, and is often reversible

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4
Q

describe dental plaque

A
  • a biofilm (a natural, physiological process)
  • an active community of microorganisms that work together
  • if left on a tooth too long, it will make a white, chalky lesion on the tooth
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5
Q

what is the multifactorial model of the caries process?

A
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6
Q

what are the host factors that contribute to caries lesions

A
  • tooth anatomy, texture of surface, protected surfaces
  • salivary flow rates
  • salivary quality and buffering capacity
  • systemic disease
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7
Q

what are the environmental factors that contribute to caries lesions

A
  • diet: including fermentable carbohydrates, frequency of meals, acidity of meals
  • oral hygiene and compliance
  • fluoride exposure
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8
Q

what are the bacterial factors that contribute to caries lesions?

A
  • streptococcus: mutans ans sobrinus
  • lactobacilli
  • other non-cariogenic bacteria can become cariogenic for short periods of time under certain conditions
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9
Q

describe strep mutans

A
  • gram positive organism
    • peptidoglycan layer in cell wall
  • primary causative agent in the formation of dental cavities
  • metabolizes sucrose to lactic acid
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10
Q

describe enamel after eruption

A
  • once erupted, enamel is in dynamic transformation
  • teeth slowly erupt, therefore enamel undergoes subclinical changes, due to exposure to oral microbes, and salivary minerals
  • once fully erupted into occlusion, enamel is also subjected to mechanical modifications
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11
Q

what is the origin of dentin?

A

mesodermal

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12
Q

what is the composition of dentin?

A
  • 75% inorganic
  • 20% organic
  • 5% water
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13
Q

dentin has ___ mechanisms and works in concert with ___

A
  • reparative (odontoblasts)
  • pulp (dentino-pulpal organ)
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14
Q

what is the composition of enamel?

A
  • 95% mineral
  • 5% water
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15
Q

what is dentin?

A
  • living tissue made up of tubules, each of which contain an odontoblast
  • is a series of tubules extending from pulp to the DEJ, which are widest at the pulp and hardest at the DEJ
    • 1/5 as hard as enamel
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16
Q

how are caries lesions classified?

A
  • according to their anatomical site
    • pit and fissure (common on occlusal), smooth surface (enamel caries, root caries)
  • cavitated vs. non-cavitated
  • activity level
    • active vs. inactive
  • primary (lesions on natural, intact tooth surfaces) vs. secondary (recurrent, adjacent to a filling/restoration - same etiology as primary caries) vs. residual (demineralized tissue that has been left behind before a filling is placed)
17
Q

compare treatment of active vs. inactive lesions

A
  • inactive lesions do not require any restorative action because the caries process has been arrested
  • if active, steps should be taken to influence the metabolic activities and possibly the ecological balance in the biofilm in favor of arrest rather than further demineralization
18
Q

what are the disease causing factors of the caries balance?

A

BAD disease-causing factors include the following:

  • Bad bacteria - acid-producing bad bacteria
  • Absence of saliva
  • Dietary habits (poor) - frequent sugars and acids lead to demineralization and a low pH, allowing bad bacteria to thrive, starting the decay process
19
Q

what are the protective factors of the caries balance?

A

SAFE protective factors include the following:

  • Saliva and sealants - saliva neutralizes acid, encouraging good bacteria to thrive and aids remineralization. sealants seal the chewing surfaces of the teeth most susceptible to decay.
  • Antimicrobials - helping rid the bad bacteria and establish health-promoting bacteria
  • Fluoride - strengthening the tooth surfaces against demineralization, promoting remineralization
  • Effective (healthy) diet
20
Q

what are the functions of saliva relative to the teeth?

A
21
Q

what are the functions of saliva relative to food?

A
22
Q

what are the functions of saliva relative to microbes?

A
23
Q

describe how dental biofilms are formed

A
  1. pellicle formation - minutes to hours
  2. attachment of a single bacterial cell - 0-24 hours
  3. growth of attached bacteria leading to the formation of distinct microcolonies - 4-24 hours
  4. microbial succession (and coadhesion) - leads to increased species diversity and continued growth of microcolonies
  5. climax community/mature biofilm - >/= 1 week
24
Q

describe the ADA classification of a sound tooth

A
25
Q

describe the ADA caries classification of initial caries

A
26
Q

describe the ADA caries classification of moderate caries

A
27
Q

describe the ADA caries classification of advanced caries

A
28
Q

for a low risk patient, describe the frequency of radiographs, frequency of caries recall exams, antibacterials/chlorhexidine/xylitol, and fluoride recommendations

A
  • frequency of radiographs - BWX every 24-36mo
  • frequency of caries recall exams - every 6-12mo
  • antibacterials/chlorhexidine/xylitol - per saliva test if done
  • fluoride - OTC fluoride-containing toothpaste twice daily; optional: NaF varnish if excessive root exposure or sensitivity
29
Q

for a moderate risk patient, describe the frequency of radiographs, frequency of caries recall exams, antibacterials/chlorhexidine/xylitol, and fluoride recommendations

A
  • frequency of radiographs - BWX every 18-24mo
  • frequency of caries recall exams - every 4-6mo
  • antibacterials/chlorhexidine/xylitol - per saliva test if done; xylitol 6-10g/day
  • fluoride - OTC fluoride-containing toothpaste twice daily plus 0.05% NaF rinse daily; initially 1-2 app NaF varnish, then 1 app at 4-6mo recall
30
Q

for a high risk patient, describe the frequency of radiographs, frequency of caries recall exams, antibacterials/chlorhexidine/xylitol, and fluoride recommendations

A
  • frequency of radiographs - BWX every 6-18mo or until no cavitated lesions are evident
  • frequency of caries recall exams - every 3-4mo
  • antibacterials/chlorhexidine/xylitol - chlorhexidine gluconate 0.12% (10ml rinse for 1min daily for 1wk each month), xylitol (6-10g/day)
  • fluoride - 1.1% NaF toothpaste 2x daily; optional 0.2% NaF rinse daily then OTC 0.05% rinse 2x daily; initially 1-3 app NaF varnish, then apply at each 3-4mo recall
31
Q

for a extreme high risk patient, describe the frequency of radiographs, frequency of caries recall exams, antibacterials/chlorhexidine/xylitol, and fluoride recommendations

A
  • frequency of radiographs - BWX every 6mo or until no cavitated lesions are evident
  • frequency of caries recall exams - every 3mo
  • antibacterials/chlorhexidine/xylitol - chlorhexidine gluconate 0.12% (10ml rinse for 1min daily for 1wk each month), xylitol (6-10g/day)
  • fluoride - 1.1% NaF toothpaste 2x daily; OTC 0.05% NaF rinse when mouth feels dry, after snacking, breakfast, and lunch; initially 1-3 app NaF varnish, then apply at each 3mo recall
32
Q

what is the one factor that differentiates a high risk patient with an extreme high risk patient?

A

extreme risk patients will have the same criteria as high risk patients, but with the addition of dry mouth or special needs

33
Q

enamel is of ___ origin

A

ectodermal

Cariology I (3 decks)

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