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Eval Science Midterm 2 > Lecture 11: Childhood Caries > Flashcards

Lecture 11: Childhood Caries Flashcards

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Biology 101 flashcards
1
Q

Epidemiology

A

study of health and disease in populations

- distribution and determinants

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2
Q

determinants are influenced by:

A 
heredity
biology
physical environment
social environment
lifestyle
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3
Q

Descriptive Study

A

studies prevalence, severity (morbidity/mortality), age-adjusted distribution in the population

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4
Q

Analytic Study

A

Tries to answer a specific question

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5
Q

Primary data

A

mail survey
epidemiological/screening survey
telephone interview

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6
Q

Secondary Data

A

Medicaid
Vital Statistics
Cancer Registry

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7
Q

Dental Caries

A

Demineralization of the hard tissues of the teeth caused by bacterial acids.

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8
Q

_______ is one of the most common diseases among 5 to 17 year olds

A

dental caries

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9
Q

Ancient Disease Caries

A

prehistoric man; low prevalence and severity

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10
Q

5th-16th century dental caries

A

no change in prevalence between the AngloSaxon period to the Middle Ages in British Studies; mostly cervical lesions

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11
Q

17th - 20th Century Caries

A

High prevalence of disease; mostly occlusal and proximal lesions associated with changes in diet circa 1600

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12
Q

early 20th century caries

A

low prevalence in “developing”countries, high prevalence in developed” nations

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13
Q

Late 20th Century Caries

A
  • increasing prevalence in developing countries

- decrease in caries incidence in children and young adults in developed countries - the “caries decline”

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14
Q

Worm Theory

A

Mesopotamia, 5000 BC

Caries caused by a worm, fumigation devices used to remove the worm.

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15
Q

Vital Theory

A

Tooth is an integral part of the body, vitally affected by the body.
Disease processes take place from the “inside-out”
Tooth decay originates from within the tooth itself.

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16
Q

Chemical (acid) theory

A

17th and 18th centuries
decay arises from acids formed in the oral cavity.
Assumed that acids were inorganic.

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17
Q

Parasitic (specific) theory

A

Microorganisms infiltrate the enamel, leading to decomposition.
Recognition that enamel is organic.

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18
Q

chemo-parasitic theory

A

(1881 W.D. Miller proposed):

microorganisms in the oral cavity cement carbohydrates and produce acids that can initiate demineralization.

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19
Q

____ was associated with dental caries in 1914

A

Lead

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20
Q

prior to WWII there were reports on the association between caries and:

A

poverty and race

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21
Q

by 1960s, caries is known as:

A

multifactorial infectious disease

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22
Q

necessary factors of caries

A

cariogenic bacteria and fermentable carbohydrates

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23
Q

non-specific plaque hypothesis

A

total plaque microflora

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24
Q

specific plaque hypothesis

A

only a few species involved

25
Q

ecological plaque hypothesis

A

shift in hemeostatic balance

26
Q

extended ecological plaque hypothesis

A

non-pathogenic bacteria can adapt to produce acid

27
Q

Caries definition:

A

an infections, communicable disease resulting in destruction of tooth structure by acid-forming bacteria found in dental plaque, an intraoral biofilm in the presence of sugar.

28
Q

Epidemiologic triangle (corners)

A

host, environment, agent

29
Q

Agent

A

microorganisms involved

30
Q

Microbes involved in caries

A

Streptococcus mutans - most cariogenic for enamel
Streptococcus sobrinus
Viellonella

31
Q

Mutans Streptococci (ms)

A

greater ms counts, greater caries prevalence

32
Q

MS are caries conductive because:

A
  1. ability to adhere to tooth surface
  2. produce copious amounts of acid
  3. survive at low pH
33
Q

Environment

A

Fermentable carbohydrates

34
Q

Simple Sugars vs. Complex Sugars

A

Sucrose > glucose > lactose > fructose

35
Q

Vipeholm Study (1947)

A
  • incr. sugar intake - incr caries
  • incr. risk if sugar was sticky form
  • between meal ingestion of sugar was worse.
  • variation among individuals.
  • incr in caries disappeared when sticky candies withdrawn.
36
Q

Homewood House Study

A

(in Australia in 1942)

  • sucrose-restricted diet among 81 children aged 4 to 9 years.
  • at the start of the study, 78% of the children were caries-free.
  • 52% continued to be at age 13
  • significantly higher that 13 year olds in general population (only 0.4%)
37
Q

Equation for etiology of dental caries

A

bacteria + CHO —> acid —> demineralization —- caries

38
Q

Protective factors

A
  • salivary flow and components
  • proteins, antibacterial components, and agents
  • fluoride, calcium, ad phosphate
39
Q

Pathological Factors

A
  • Reduced salivary function
  • Bacteria: Mutans streptococci, and lactobacilli
  • Dietary Components: frequency and carbohydrates
40
Q

Determinants and Risk Factors

A 
age
gender
race and ethnicity
socioeconomic status
geography
41
Q

Deterrence

A 
saliva (antibacterial, antibodies to cariogenic bacteria, buffering)
plaque removal -OH
dietary habits
fluoride therapy
sealants
caries vaccine
antibiotics
other
42
Q

how do we measure dental caries?

A

counts, proportions, rates, indices

43
Q

prevalence

A

number of people in a population who have a given disease at a given point in time.

44
Q

prevalence measures:

A

the frequency of all current cases of a disease (old and new)

45
Q

Incidence

A

a measure of the number of lesions/period of time

*limited in that they only measure the numbers of new initial lesions per unit of time

46
Q

DMFT and DMFS

A

describe the amount - the prevalence - of dental caries in an individual

  • D -decayed
  • M -missing
  • F -filled
  • T -teeth OR - S -surfaces
47
Q

DMFS values of 7 or higher can be considered:

A

to indicate severe disease in children up to age 17

*about 20% of US children

48
Q

Limitations of prevalence

A
  • provides past history only
  • does not provide rate of lesion development
  • does not indicate if caries is active or inactive
  • does not provide the frequency of occurrence of new lesions
49
Q

Prevalence =

A

D + M + F

50
Q

Untreated Caries =

A

D/DMF

51
Q

Treated Caries =

A

F/DMF

52
Q

Tooth Fatality =

A

M/DMF

53
Q

DMF index: limitations

A 
invalid: perio, ortho, aesthetics, prevention
root caries
sealants
teeth at risk
DMFS vs DMFT
54
Q

deft (s) or dft (s)

A 
d = decayed
e = indic. extraction
f = filled

*index is useful up to the age of 6, after which shedding becomes the dominant factor

55
Q

Significant Caries Index (SiC Index)

A

bring attention to the individuals with the highest caries values in each population under investigation

56
Q

SiC Index breakdown

A
  • individuals sorted according to their DMFT values
  • one third of population with the highest caries scores is selected
  • the mean DMFT for this subgroup is calculated. THIS VALUE IS THE SiC INDEX.
57
Q

SiC Example

A

45% are caries free. (DMFT =0), mean DMFT is 1.91, and the Sic index is 4.61

58
Q

poor children 2 to 9 in each racial/ethnic group have higher percentage of

A

untreated primary teeth than nonpoor children

59
Q

practical significance of the epidemiology of dental caries?

A
  • planning, funding, and delivery of services. (ex. water fluoridation, clinics, medicaid)
  • training: numbers and type of professionals

Eval Science Midterm 2 (3 decks)

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