ICP-L4: Caries Basics: Enamel Homeostasis and the Development of Caries

Question 1

what are caries?

Answer 1

Loss of tooth substance by acids that are metabolically produced by bacteria

Question 2

what are primary caries?

Answer 2

Lesions on unrestored surfaces

Question 3

what are secondary caries?

Answer 3

Recurrent caries next to fillings

Question 4

what are residual caries?

Answer 4

the decayed material left in a prepared cavity and over which a restoration is placed.

Question 5

what are active caries?

Answer 5

considered to be progressive

Question 6

what are arrested caries?

Answer 6

caries still present, but no longer progressing

Question 7

what are rampant caries?

Answer 7

multiple active carious lesions in the same px

Question 8

what are hidden caries?

Answer 8

usually in dentine and only detectable by radiography

Question 9

what are white spot lesions?

Answer 9

first sign of caries visible by naked eye, usually visble with strong white light

Question 10

what are brown spot lesions?

Answer 10

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

Question 11

what are rampant caries?

Answer 11

multiple active carious lesions in the same patient

Question 12

what are hidden caries?

Answer 12

usually in dentine and only detectable by radiography

Question 13

are white spot lesions reversible?

Answer 13

yes

Question 14

what 3 factors does the growth of dental decay depend on?

Answer 14

diet, bacteria and host factors

Question 15

what is the appearance of white spot lesions?

Answer 15

dull and chalky; white due to microporosity (small holes) from demineralisation that allow for light scattering

Question 16

what 2 factors affect the demineralisation and remineralisation of enamel?

Answer 16

pH and Ca 2+ concentration (under acidic pH can be released from salivary proteins to counteract demineralisation)

Question 17

what are the 4 ain properties of saliva?

Answer 17

remineralisation, buffer, lubricant, and antimicrobial properties

Question 18

what is the normal pH rang of saliva?

Answer 18

7.1-8.4

Question 19

what are the % components of saliva?

Answer 19

99% water

1% organic compounds (proteins and carbohydrates etc) and inorganic ions (calcium and phosphate etc)

Question 20

what is the cause of xerostomia?

Answer 20

a reduction in saliva production

Question 21

what factors might affect saliva production?

Answer 21

• 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

Question 22

what are the 2 main advantages of calcium and phosphates in saliva?

Answer 22

• prevents enamel dissolution

- enables remineralisation of initial carious lesions

Question 23

what wis a disadvantage of calcium and phosphates in saliva?

Answer 23

there is a possiblilty of unwanted precipitation

Question 24

salivary proteins release ca2+ in ______ conditions

Answer 24

acidic

Question 25

what is DMFT/S

Answer 25

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)

Question 26

demineralisation can be caused by:

2 things

Answer 26

• by acids (loss of tooth mineral), and results in: caries; gustatory Acids dietary sources erosion
• by tooth mechanical wear attrition; abfraction; abrasion

Question 27

what is the aetiology of dental caries?

Answer 27

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.

Question 28

during demineralsiation, there is a _______ pH and Ca2+, whereas during remineralisation, pH and Ca2+ is _______.

Answer 28

during demineralsiation, there is a lower pH and Ca2+, whereas during remineralisation, pH and Ca2+ is higher.

Question 29

what happens to Ca2+ conc when the PH of saliva drops?

Answer 29

Ca conc increases to prevent demineralisation.

it does this by decreasing conc gradient = less calcium from reacts

Question 30

how does calcium conc change?

Answer 30

salivary proteins

Question 31

xerostomia causes _____ caries

Answer 31

rampant

Question 32

What is the minimally invasive approach in the management of caries?

Answer 32

Make more natural saliva
(i.e. sugar free chewing gum)

Mimic functions of saliva
(Tooth mousse)