ICP-L4: Caries Basics: Enamel Homeostasis and the Development of Caries Flashcards
what are caries?
Loss of tooth substance by acids that are metabolically produced by bacteria
what are primary caries?
Lesions on unrestored surfaces
what are secondary caries?
Recurrent caries next to fillings
what are residual caries?
the decayed material left in a prepared cavity and over which a restoration is placed.
what are active caries?
considered to be progressive
what are arrested caries?
caries still present, but no longer progressing
what are rampant caries?
multiple active carious lesions in the same px
what are hidden caries?
usually in dentine and only detectable by radiography
what are white spot lesions?
first sign of caries visible by naked eye, usually visble with strong white light
what are brown spot lesions?
usually an inactive white spot lesion discoloured by the uptake of dye
what are rampant caries?
multiple active carious lesions in the same patient
what are hidden caries?
usually in dentine and only detectable by radiography
are white spot lesions reversible?
yes
what 3 factors does the growth of dental decay depend on?
diet, bacteria and host factors
what is the appearance of white spot lesions?
dull and chalky; white due to microporosity (small holes) from demineralisation that allow for light scattering
what 2 factors affect the demineralisation and remineralisation of enamel?
pH and Ca 2+ concentration (under acidic pH can be released from salivary proteins to counteract demineralisation)
what are the 4 ain properties of saliva?
remineralisation, buffer, lubricant, and antimicrobial properties
what is the normal pH rang of saliva?
7.1-8.4
what are the % components of saliva?
99% water
1% organic compounds (proteins and carbohydrates etc) and inorganic ions (calcium and phosphate etc)
what is the cause of xerostomia?
a reduction in saliva production
what factors might affect saliva production?
- Autoimmune e.g. Sjorgen syndrome
- H&N radiotherapy
- Salivary gland disease
- Medication e.g. TCAs, SSRIs, antihistamines and anti-inflammatory agents (NSAIDs- Aspirin), amongst others
- Aplasia of salivary glands
what are the 2 main advantages of calcium and phosphates in saliva?
- prevents enamel dissolution
- enables remineralisation of initial carious lesions
what wis a disadvantage of calcium and phosphates in saliva?
there is a possiblilty of unwanted precipitation
salivary proteins release ca2+ in ______ conditions
acidic
what is DMFT/S
an abbreviation used in Dentistry to assess caries the prevalence of caries in an individual, it stands for decay (D), missing (M), filled (F) and teeth (T)/surfaces (S)
demineralisation can be caused by:
2 things
- by acids (loss of tooth mineral), and results in: caries; gustatory Acids dietary sources erosion
- by tooth mechanical wear attrition; abfraction; abrasion
what is the aetiology of dental caries?
1) Teeth - require a tooth surface for environment
2) Fermentable carbohydrates - source of energy for bacteria to perform anaerobic respiration.
3) Cariogenic bacteria - bacteria which produces acid and utilises fermentable carbohydrates as their main source of energy
4) Time - is require for the demineralisation process to occur.
during demineralsiation, there is a _______ pH and Ca2+, whereas during remineralisation, pH and Ca2+ is _______.
during demineralsiation, there is a lower pH and Ca2+, whereas during remineralisation, pH and Ca2+ is higher.
what happens to Ca2+ conc when the PH of saliva drops?
Ca conc increases to prevent demineralisation.
it does this by decreasing conc gradient = less calcium from reacts
how does calcium conc change?
salivary proteins
xerostomia causes _____ caries
rampant
What is the minimally invasive approach in the management of caries?
Make more natural saliva
(i.e. sugar free chewing gum)
Mimic functions of saliva
(Tooth mousse)
