intro to dental caries

Question 1

What is caries?

Answer 1

Dental caries is a multifactorial, transmissible, infectious oral disease caused primarily by the complex interaction of cariogenic oral flora (biofilm) with fermentable dietary carbohydrates on the tooth surface over time.

Question 2

What 4 things does dental caries need to grow?

Answer 2

1. Fermentable carbohydrates2. Microorganisms in plaque 3. Susceptible tooth surface4. Time

Question 3

What are 2 modifying factors affecting dental caries?

Answer 3

saliva| fluoride

Question 4

On which island was the Evidence for dietary causes of caries found?

Answer 4

Tristan da Cunha

Question 5

Which 2 scientists investigated the dietary cause of dental caries at the island of Tristan da Cunha?

Answer 5

Sampson| Barnes

Question 6

What did Sampson discover In 1932

Answer 6

He examined most of the islanders and found the only 1.82% of them had dental caries He found that the islanders only had sugar on very rare occasions

Question 7

What did Barnes discover In 1937?

Answer 7

He repeated the same survey (5 years after Sampson) and found 4.6% of adult teeth now had cariesHe found that 10 ships had called into the island in the last 3.5 yrs and that this was an increase to how much they usually got

Question 8

Name 2 other studies that investigated the dietary cause of dental caries in

Answer 8

1. Vipeholm study carried out by Gustaffson in 1954, Sweden 2. Hopewood House Study carried out in the mid 1900s in Australia

Question 9

What was Vipeholm study?

Answer 9

It took place in a mental asylum The patients were split into 3 groups:1: Sugar with slight retention tendency (in solution)2: Sugar in sticky form at meals (specially baked bread)3: Sugar in sticky form in between meals (toffees)

Question 10

What results were found from the Vipeholm study?

Answer 10

The controls group and group 1 didn't get many cases of cariesGroup 2 (the ones having sticky bread and started getting quite a bit of caries over the yearsIn Group 3 (the ones having toffees) the caries rate increased significantly

Question 11

What was the problem with the Vipeholm study?

Answer 11

It is unethical as the. patients were being experimented on without consent

Question 12

What was the Hopewood House Study?

Answer 12

Took place in a children’s home where they noticed that the children in this home had a very low rate of caries as they only ate uncooked veg no sugar or flour

Question 13

What is the prevalence of caries in adults in the uK?

Answer 13

31% of adults have caries

Question 14

What percentage of the UK population have had at least one filling?

Answer 14

Over 80% of the population have at least one filling| On average each adult has seven fillings

Question 15

What are the 5 ways caries ca be classified?

Answer 15

1. By site (approximal etc)2. By tissue (enamel etc)3. Primary or secondary 4 .Active, inactive or rampant5. Cavitated or non-cavitated

Question 16

What is the agrees mechanism of caries?

Answer 16

acidogenic (acid-producing) bacteria metabolise carbohydrates, releasing acids which lower the local pH and cause dissolution of hard dental tissue

Question 17

When does cavitation occur?

Answer 17

Cavitation (holes) will only occur if the dissolve-remineralise cycle get interruptedSo if you snack between meals you are disrupting the remineralisation process as you are introducing another acid attack

Question 18

What are some common dietary culprits that can disturb the demineralisation remineralisation cycle?

Answer 18

1. Tea/coffee/drinks with sugar (sipped or lots of cups per day)2. Biscuit snacking3. Mints/boiled sweets4. General grazing habits rather than ‘3 square meals’

Question 19

What can we recommend to patients to prevent the build up of caries?

Answer 19

1. Can give Diet advice 2. Oral hygiene advice to reduce/disrupt the cariogenic biofilm 3. Can place a Protective resin coating on hard to reach areas (fissure sealants)4. Fluoride supplementsToothpaste, Varnish Tablets/drops/rinses

Question 20

What are some operative treatments we can use to treat cavities?

Answer 20

When caries has spread >1/3rd into dentine of a radiograph we may give the patient a filling