INP midterm - ORAL HEALTH

Question 1

What are dental caries?

Answer 1

they are biofilm-mediated, sugar driven, multifactorial, dynamic disease that results in the phasic demineralization and remineralization of dental hard tissues

Question 2

How do dental caries form?

Answer 2

dynamic process that has three phases:

a. demineralization (loss of mineral when plaque pH falls to less than 5.5)
b. equilibrium
c. remineralization (occurs when plaque pH rises above the critical level to neutral or alkaline levels)

vertical transmission and primary infection of OVERGROWN mutans streptococci -> proliferation and accumulation of mutans streptococci -> demineralization of the tooth structure form the acid that comes from the breakdown of sugars that the bacteria feed off of -> low pH favors the growth of Streptococcus mutans

Question 3

What are early childhood caries?

Answer 3

an oral infectious disease, previously called baby bottle tooth decay, which is the presence of one or more decayed, missing or filled tooth surface in and primary (baby) tooth in a pre-school-aged child (up to 6yrs old)

Question 4

What is the impact of early childhood caries?

Answer 4

ECC lead to cavities, but also lead to a lot of pain and infection, difficulty chewing ( –> poor nutrition –> impaired growth & development because they go for easy to chew foods that are often nutrient-poor), alters spacing for adult teeth

Question 5

Who is at higher risk for early childhood caries?

Answer 5

low-income, minority, and immigrant children are disproportionately affected

Question 6

What makes a food cariogenic?

Answer 6

risk of promoting caries/producing or promoting the development of tooth decay

Question 7

What characteristics of food make them cariogenic (give examples)?

Answer 7

• -> sticky consistency
• -> time on tooth surfaces (retention/oral contact time)
• -> if they are simple sugars or highly fermentable CHO
• -> highly processed
• -> foods that lower pH in mouth

examples: sticky candy, crackers, cake

Question 8

What does non-cariogenic mean (give examples)?

Answer 8

has beneficial effects that inhibit carie development, usually by stimulation saliva production, strengthening teeth, or killing/suppressing carie-causing oral bacteria

examples: cheese, nuts, milk, vegetables

Question 9

What does cariostatic mean (give examples)?

Answer 9

food and other substances that do not contribute to the formation of caries/foods that do not cause a drop in pH in the oral cavity and help form a protective coating on the teeth and neutralize acid levels of the mouth formed by bacteria

examples: proteins, eggs, meat, fish, sugarless gum, also vegetables

Question 10

How does fluoride improve oral health?

Answer 10

• -> helps prevent mineral loss caused by plaque acids
  - -> has an antimicrobial effect on acidogenic plaque bacteria
  - -> inhibits growth of S. mutans found in dental plaque and in low concentrations inhibits bacterial enzymes, thus reducing acid production from catabolism of fermentable carbohydrates
• -> promotes re-mineralization of early decay
  - -> F ions replaces some of the existing ions which increases the stability of the enamel crystals bc fluoridated molecules are less soluble to organic foods

Question 11

What are the risks of too much F?

Answer 11

risk of dental fluorosis, which is characterized by white striations or opaque flecks, white or dark brown and yellow staining or pitting of the tooth enamel/enamel becomes brittle and gets damaged

Question 12

What is periodontal disease?

Answer 12

initiated by oral bacteria interactions in plaque biofilm also by destruction of soft tissue that attaches tooth to bone due to abnormal inflammatory immune response of the gums -> eventual loss/destruction of supportive tissue that holds the tooth in place and eventual tooth loss

Question 13

What are the consequences of periodontal disease?

Answer 13

consequences of the disease are

   - -> gingival bleeding and recession, formation of deep pockets between the gingiva and tooth and loss of periodontal ligaments and bone structure that support teeth
   - -> it is considered a MOBILE microbiome meaning that there are microbes that reside in the mouth that can migrate to the fetus and cause pregnancy complications such as preterm birth and preterm labor
   - --> the nutritional status/what we eat can impact immunity and wound healing which can impact periodontal disease

Question 14

What are the stages of periodontal disease?

Answer 14

1) healthy gums and tooth
2) gingivitis which is the early stage of periodontal disease – presence of plaque buildup and calculus buildup (form of hardened dental plaque) inflames the gums and bleeds easily; there is a calcification on the gum line that is not easily brushed off like plaque
3) PD which is where pockets forms between the tooth and gingiva -> loosening of the gums means that food and other things can get stuck in there and more bacteria can proliferate -> eventual/moderate bone loss and destruction of soft tissue
4) Advanced PD, which is severe bone loss and deep pockets; the teeth are in danger of falling out

Question 15

How do eating disorders affect oral health?

Answer 15

Anorexia Nervosa – xerostomia due to prescribe medications which impacts saliva flow -> hyposalivation can increase risk of periodontal disease and can impact the ability to eat and influences food choices

Bulimia Nervosa – enamel loss resulting from exposure to acidic gastric juices and vomiting which exposes the oral cavity to acidic contents; altered salivary gland function and gland swelling and oral mucosal lesions -> self-induced vomiting leads to irritation of oral tissues and destruction of dental enamel -> increased insult of acidic GI contents from purging leads to tooth erosion of the surfaces of the teeth

Question 16

What are the risk factors and risk behaviors related to poor oral health seen in adults and the elderly?

Answer 16

1) reduced health literacy
2) low rates of oral care utilization
3) low protein diets
4) diets rich in non-protective factors and poor in protective factors (vitamin deficiencies)
5) inadequate Ca and P intake (affect remineralization of tooth enamel)

Lot of risk in elderly population (poor nutrition, compromised immune systems)

Question 17

Which vitamins are important for oral health (and why)

Answer 17

Vitamin A
–> maintains integrity of epithelial cells

Vitamin B complex
–> integral to cell metabolism, repair, and proliferation

Vitamin C
–> provides ROS scavenger to prevent oxidative damage

Vitamin D
–> enhances absorption of minerals

Question 18

What is the relationship between obesity and dental caries?

Answer 18

factors related to feeding practices and dietary intake such as sweetened beverages and frequent, non-structured snacks

Question 19

What is the relationship between obesity and periodontal disease?

Answer 19

our diet may impact body weight such that a high BMI is associated with periodontal disease due to systemic inflammation; important to note that obesity increases the risk for chronic diseases such as diabetes which leads to a double burden on our oral health

Question 20

What is the relationship between diabetes and periodontal disease

Answer 20

–> blood glucose control is essential to reducing periodontal disease risk and limiting progression

–> glycemic control influences severity and progression of periodontal disease (i.e. I assume not consuming a high-carbohydrate diet or a diet rich in sugars that can lead to plaque buildup)

–> impacts the ability to heal and increases risk for infection & can cause impaired or delayed wound healing and raises inflammation