Lecture 18 : Clinical Correlation_Caries Flashcards
What is Caries?
- Infectious Disease
- Multifactorial
- Biofilm, bacteria
What year did the US Public Health Service create the Dental Hygiene Unit?
1938
ECC is ___ times more common than asthma.
5 times
What is AAPD Policy Statement #2?
Teach moms how to brush their baby’s teeth as soon as they come out.
Twice a day
Soft Brush of appropriate size for age
In Children under age 3, a smear of rice-sized amount of fluoridated toothpaste should be used.
In children ages 3-6, a pea-sized amount of fluoridated toothpaste should be used.
AAPD Policy Statement #3
Professionally applied flouride varnish for kids at risk of ECC is recommended.
True or False.
Kids whose mothers have higher levels of Step mutans, a result of untreated carries, have a higher risk of acquiring the organism earlier than children whose mothers have low levels.
True
AAPD Policy Statement #5
Make sure to work with Medical Providers to ensure all infants and toddlers have access to dental screenings, counseling, and preventative procedures.
AAPD Policy Statement #6
Educating Legistlatures, policy makers, and third party payors regarding the consequences of and preventive strategies for ECC .
What is Caries?
Decay and crumbling of the tooth.
What happens in Caries?
Bacteria in the Dental Plaque “eat” the carbohydrates from our diet.
~Bacteria Secrete Acids
~~Acids lower oral pH
~~~ENAMEL demineralizes at pH of 5.5 of below
~~~~This results in Carious Lesion
What happens in Caries?
Bacteria in the Dental Plaque “eat” the carbohydrates from our diet.
~Bacteria Secrete Acids
~~Acids lower oral pH in the saliva
~~~ENAMEL demineralizes at pH of 5.5 of below
~~~~This results in Carious Lesion
Where do caries start to hit (the location)?
~Pit and Fisure,
~~Smooth Surfaces
New Caries =?
New Lesion,
attachs previously INTACT tooth surface
Recurrent Lesion=?
Occurs around the margins of a restoration,
i.e., there used to be a lesion there, you treated it, and then it’s recurred.
Residual lesion=?
Carries left behind before filling a restoration (a filing)
~Sometimes done on purpose to avoid a pulp exposure.
~~Generally we want to get all the carries out especially around the margins of our restorations.
Active vs. Arrested Lesions
Active Lesion = Dull, not shiny
Arrested Lesion (inactive) = Hard, pretty shiny, if nothing is seen radiographically, then it’s an Arrested Lesion. Don’t have to treat Arrested Lesions.
Describing Caries..
White Spot Lesion =
Where the enamel is starting to decalsify
Describing Caries..
Remineralized Area =
Arrested Lesion
Describing Caries..
Incipient/initial lesion =
Just in the enamel, doesn’t have to be treated with a filling yet, or surgically as what we should say. It can be remineralized at this stage because it has not gotten to the Denten
Describing Caries..
Rampant Caries
Carries all over the mouth
What is the American Dental Association Carries Classification System?
Initial Caries,
Moderate Caries
Severe Caries
What is the American Dental Association Carries Classification System?
Initial Caries,
Moderate Caries
Severe Caries
What is Initial Caries?
When it’s just starting to break down the enamel
Corresponds to E1 or E2
What is Moderate Caries?
Gotten into the denten
Corresponds to D2
What is Severe Caries?
Well into the denten, the processes are changing because the collagen in the denten is breaking down in that area
Corresponds to D3
E1 =?
When it’s in the first half of the enamel
E2 =?
The lesion has gone into the second half of the enamel
D1 =?
First third of Denten
D2 =?
Middle Third of Denten
D3 =?
Really close to the pulpil tissue
What kind of disease is Caries?
Caries is an Infectious Disease
Bacterial Disease
Is Caries a Manageable Disease?
Yes
Can Caries Disease be Prevented?
Yes
What bacteria causes Caries?
Microbes that cause Caries:
Step Mutans (Primarily),
Lactobacillus,
Actinomyces
What bacteria causes Caries?
Microbes that cause Caries:
Step Mutans (Primarily),
Lactobacillus,
Actinomyces
What are the Requirements for Caries?
Host,
Bacteria,
Food Source,
Time
A susceptible host must have biofilm sticking to tooth, if it’s not sticking to the tooth, host is not susceptible.
Also need teeth for caries, Denturists have 0% chance of caries
What is Demineralization?
Bacteria eat the Carbs from your Diet
Acid is the Bacteria’s waste product
The Acid results Demineralized your Enamel
What is Demineralization?
Bacteria eat the Carbs from your Diet
Acid is the Bacteria’s waste product
The Acid results Demineralized Enamel
What is Remineralization?
Saliva rinses away the Carbs
Saliva buffers the acid waste products
Minerals in Saliva (Calcium, Phosphate) re-enter tooth
If we have good oral hygiene,
knocks away bacteria, spits most of it out, gets nice smooth surface, so..
destroys biofilm so bacteria can’t attach
How does a Carious Lesion Occur?
A Carious lesion (cavity) occurs when demineralization is greater than demineralization over time.
What does Saliva do?
Saliva…:
Raises pH to non-demineralizing levels
Flushes away floating microbes
Has Antibacterial Properties
Minerals in Saliva (Calcium and Phosphate ions) re-enter the tooth and remineralize the enamel
Saliva aids in Remineralization
What does Home Care do?
Home Care…:
Removes the bacterial habitat, keeps it clean so a new habitat can’t form, keeps bacteria homeless
Bacteria can’t stick = bacteria can’t cause demineralization
How can diet aid in reducing caries?
Avoid frequent sugar consumption, (Step mutans love sugar)
leads to starving bacteria, so bacteria can’t create acid waste products on you
What does Fluoride do in regards of Remineralization?
Makes teeth less susceptible to acid demineralization,
So the enamel is a little bit stronger
What does Caries need?
Host + Food + Bacteria
What are Caries spread?
Infectious Disease
How do you combat Caries?
Good oral hygiene,
Fluoride helps a lot in patients with a lot of lesions, Healthy dietary choices and healthy salivary flow help combat caries.
What does DMFT stand for?
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What do Early Childhood Caries (ECC) lead to?
…..
What does AAPD stand for?
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What is AAPD Policy Statement #1?
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What is sound tooth structure?
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