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CARIOLOGY > Lecture 1 (Part I - Caries Etiology, Pathogenesis and modifying factors of Dental Caries) > Flashcards

Lecture 1 (Part I - Caries Etiology, Pathogenesis and modifying factors of Dental Caries) Flashcards

1
Q

an infectious microbiological disease of the teeth that results in localized dissolution and destruction of calcified tissues.

A

Dental Caries (Then)

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2
Q

Dental caries is a biofilm-mediated, sugar-driven, multifactorial, dynamic disease that results in the phasic demineralization and remineralization of dental hard tissues.

A

Dental Caries (Now)

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3
Q

The balance between pathological and protective factors influences the initiation and progression of caries.

A

Dental Caries (Now)

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4
Q

Dental caries is a ____, ____, ____, ____ that results in the phasic demineralization and remineralization of dental hard tissues.

A
  • biofilm-mediated
  • sugar-driven
  • multifactorial
  • dynamic disease
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5
Q

It is a biofilm-mediated, sugar-driven, multifactorial, dynamic disease that results in the phasic demineralization and remineralization of dental hard tissues.

A

Dental Caries

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6
Q

is the name of the disease.

A

Dental Caries

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7
Q

is the symptom of the disease.

A

The caries lesion or cavitation

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8
Q

The management at the ____ is inadequate and would lead only to recurrence and ultimately to tooth loss.

A

Lesion Level

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9
Q

Treat the ____ (person/individual level), not the ____ which is just a symptom of the disease.

A

Treat the disease (person/individual level), not the lesion which is just a symptom of the disease.

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10
Q

Treat the disease (in what level: ____), not the lesion which is just a symptom of the disease.

A

person/individual level

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11
Q

a complex disease.

A

Caries

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12
Q

____ and ____ should be done at the tooth, person and community levels.

A

Prevention and management

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13
Q

Prevention and management should be done at the tooth, ____ and____ levels.

A

person and community levels.

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14
Q

FACTORS INVOLVED IN THE CAUSATION OF DENTAL CARIES:

A
  • Oral microorganism in the biofilm
  • Host (tooth, oral fluids, genes)
  • Substate (cariogenicity of consumed
    carbohydrates, oral clearance, eating frequency and
    food detergency)
  • Significant length of time for the 3 factors to interact
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15
Q
  • tooth
  • oral fluids
  • genes
A

Host

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16
Q
  • Cariogenicity of consumed
  • carbohydrates
  • oral clearance
  • eating frequency
  • food detergency
A

Substrate

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17
Q

Pathogenesis of dental caries involves disturbances in two types of ____/____ that exists in the oral cavity

A

homeostasis/ physiological equilibrium

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18
Q

Pathogenesis of dental caries involves disturbances in two types of homeostasis/ physiological equilibrium that exists in the oral cavity:

A
  • Disruption of microbial homeostasis in the ‘biofilm’
  • Disruption of the mineral homeostasis between the tooth and the oral fluid
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19
Q

Disruption of microbial homeostasis in the ____.

A

biofilm

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20
Q

Disruption of the mineral homeostasis between the ____ and ____.

A

tooth and the oral fluid

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21
Q

A ____ is defined as the population or community of bacteria living in organized structures at an interface between a solid and liquid

A

biofilm

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22
Q

Age

A

Tooth

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23
Q

Exposure to fluoride

A

Tooth

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24
Q

Tooth/surface morphology

A

Tooth

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25
Q

Root surface exposure

A

Tooth

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26
Q

Quantity/Flow rate

A

Oral fluid/saliva

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27
Q

Quality/Buffering capacity

A

Oral fluid/saliva

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28
Q

common clinical sites of caries initiation

A

Tooth

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29
Q

Base of pits and fissures

A

Tooth

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30
Q

Root Surfaces

A

Tooth

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31
Q

Smooth enamel surfaces that shelter plaque

A

Tooth

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32
Q

areas cervical to the contact areas

A

Tooth

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33
Q

distal surface of most posterior tooth

A

Tooth

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34
Q

areas cervical to the heights of contour on the facial and lingual

A

Tooth

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35
Q

Chronically low salivary flow rate is one of the strongest indicators of increased caries risk

A

Host Salivary Factors

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36
Q

Chronically ____ is one of the strongest indicators of increased caries risk

A

low salivary flow rate

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37
Q

SALIVA: NATURE’S ANTICARIES AGENT

A
  • Bacterial Clearance
  • Buffers
  • Remineralization
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38
Q

flushes planktonic bacteria

A

Bacterial Clearance

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39
Q

Bacterial clearance flushes ____ bacteria

A

planktonic

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40
Q

Bacterial Clearance direct ____ activity

A
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41
Q

Direct antibacterial activity

A

Bacterial Clearance

42
Q

Bicarbonate ions

A

Buffers

43
Q

Sialin and urea hydrolyzed to form ammonia causing pH to rise

A

Buffers

44
Q

____ and ____ hydrolyzed to form ammonia causing pH to rise

A

Sialin and urea

45
Q

Sialin and urea hydrolyzed to form ammonia causing

A

pH to rise

46
Q

supersaturated with calcium and phosphate ions

A

Remineralization

47
Q

Researchers initially believed that
____ were less important in determining caries risk than were environmental influences, such as microbial and dietary factors

A

genetic factors

48
Q

Clearance rate

A

Substrate

48
Q

An individual’s ____ can potentially prevent the existence of certain beneficial bacteria or allow pathogenic species to reside and contribute to its unique microbiome.

A

genotype

48
Q

Eating frequency

A

Substrate

49
Q

Food detergency

A

Substrate

50
Q

Cariogenicity of consumed carbohydrates. Sucrose
is more cariogenic than glucose and fructose.

A

Substrate

51
Q

____ is more cariogenic than glucose and fructose.

A

Sucrose

52
Q

Why is sucrose the most cariogenic among all the carbohydrates?

A
  • it is a relatively small molecule
  • can easily enter the plaque
  • sucrose for energy production and the process produces acid
  • Sucrose is also used by bacteria to produce extracellular polysaccharide called dextrans
  • It will help plaque stick to the tooth surface, making it more difficult to remove
53
Q

Bacteria like to use ____ for energy production and the process produces ____.

A

Bacteria like to use sucrose for energy production and the process produces acid

54
Q

is also used by bacteria to produce extracellular polysaccharide called dextrans.

A

Sucrose

55
Q

Sucrose is also used by bacteria to produce extracellular polysaccharide called ____.

A

dextrans

56
Q

ORAL BACTERIA IN BIOFILM:

A
  • Microbial load
  • Plaque composition
  • Plaque acidogenicity
  • Plaque aciduricity
  • Presence of fluoride in plaque
57
Q

Properties of bacteria that contribute to Microbial Pathogenicity and Cariogenicity:

A
  • Acidogenicity
  • Acidurity
  • Adherence
58
Q

ability to produce acid from a fermentable substrate

A

Acidogenicity

59
Q

ability to survive in an acidic environment

A

Acidurity

60
Q

ability to attach to tooth surface

A

Adherence

61
Q

A gelatinous (soft, translucent and tenaciously adhering) mass of bacteria adhering to the tooth surface.

A

Dental Plaque (Then)

62
Q

An aggregate of microorganisms in which cells adhere to each other and/or to a solid substrate exposed to an aqueous surface.

A

Biofilm (Now)

63
Q
A
64
Q

The bulk of the volume (~90%) of ____ is comprised of a gel-like matrix of extracellular polysaccharides produced by oral bacteria.

A

dental plaque biofilm

65
Q

The gelatinous nature of the plaque limits outward diffusion of metabolic products and thus serves to prolong the retention of acids.

A

Biofilm (Now)

66
Q

produces lactic acid from sucrose

A

Acidogenic

67
Q

can live in pH as low as 4.2

A

Aciduric

68
Q

Acidogenic produces lactic acid from

A

Sucrose

69
Q

Aciduric - can live in pH as low as

A

4.2

70
Q

is the collective term for all the serotypes

A

mutans streptococci

71
Q

can produce great amounts of acids

A

Mutant Streptococci and Lactobacilli

72
Q

are tolerant of acidic environments

A

Mutant Streptococci and Lactobacilli

73
Q

are vigorously stimulated by sucrose, and appear to be the primary organisms associated with caries in humans.

A

Mutant Streptococci and Lactobacilli

74
Q

Streptococcus mutans

A

Humans

75
Q

Streptococcus sobrinus

A

Humans

76
Q

Streptococcus rattus

A

Rats

77
Q

Streptococcus cricetus

A

Hamsters

78
Q

Streptococcus ferus

A

Wild rats

79
Q

Streptococcus macacae

A

Primates

80
Q

Streptococcus downei

A

Primates

81
Q

Mutans Streptococci

A

Enamel Caries

82
Q

MS and Lactobacilli species

A

Dentin Caries

83
Q

Actinomycetes species e.g. Actinomycetes
viscosus)

A

Root Caries

84
Q

S mutans is only one of more than 500 species found in the dental plaque

TRUE OR FALSE

A

TRUE

85
Q

S mutans is detectable in 10 to 20% of people who have severe caries

TRUE OR FALSE

A

FALSE - S mutans is not detectable in 10 to 20% of people who have severe caries

86
Q

was an American dentist and the first oral microbiologist

A

Willoughby Dayton Miller (1853-1907)

87
Q

EVOLVING THEORIES ON ETIOLOGY OF DENTAL CARIES:

A
  • Miller’s Chemoparasitic Theory
  • Nonspecific Plaque Hypothesis (NSPH)
  • Specific Plaque Hypothesis (SPH)
88
Q

all plaque are pathogenic

A

Nonspecific plaque hypothesis

89
Q

plaque is pathogenic only if associated with clinical disease.

A

Specific plaque hypothesis

90
Q

The goal of therapy is to suppress the cariogenic plaques and to replace them with pathogen-free plaques - Walter Loesche

A

Specific plaque hypothesis

91
Q

According to this hypothesis, a certain change in the environment of the residential plaque flora provides pathogenicity to specific species that produce the disease only at specific sites.

A

The Ecological Plaque Hypothesis (1991)

92
Q

First to colonize biofilm are

A
  • S. oralis
  • S mitis
  • S. sanguis
93
Q

Only ___% is S. mutans

A

1%

94
Q

30-60 minutes after acid attack, buffers in saliva can increase the ____

A

pH

95
Q

there is equilibrium of minerals between tooth surface and oral fluids

A

neutral pH

96
Q

When pH goes ____ 5.5, minerals (HA) at the tooth surface are dissolved to maintain equilibrium of the oral fluid

A

down below

97
Q

When pH ____, the oral fluids become supersaturated with phosphates and calcium.

A

goes up

98
Q

At pH ____ in the presence of Fluoride, there is reprecipitation of hydrofluorapatite

A

Less than 4.5

CARIOLOGY (8 decks)

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