Lecture 2

Question 1

strep mutans

Answer 1

good marker for disease but not necessarily the etiological agent of disease

acidogenic (produces acid) and acidouric (thrives in acidic environments)

Question 2

strep sobrinus

Answer 2

1 of primary colonizers; more acidogenic, more acidouric than strep mutans, but strep mutans in in higher concentration taking over colonization

Question 3

potential roadblock on basis of its location

Answer 3

supragingival - above the gingiva; facultative anaerobes

subgingival - below the gingiva; will have more anaerobic bacteria

Question 4

potential roadblock on basis of pathogenicity

Answer 4

cariogenic - generally acidogenic and gram-positive

periopathogenic- mostly basophilic and gram-negative

Question 5

CAMBRA-Caries Management by Risk Assessment

Answer 5

Step 1 - caries risk assessment through:
disease indicators, risk factors, protective factors
Step 2- categorize risk (low? moderate? severe?)
Step 3- determine the associated clinical protocols or interventions (customize plan for every patient)

Question 6

Disease indicators

Answer 6

WREC

white spot lesions, restoration w/in 3 years, enamel lesions, or cavities/dentin

Question 7

risk factors

Answer 7

B- bacteria
A- absence of saliva
D- Diet/lifestyle, destructive lifestyle habits

Question 8

protective factors

Answer 8

S- saliva/sealants
A- antibacterials
F- fluoride/ Ca2+/PO3-4
E - Effective diet Lifestyle Habits
R - Risk-based reassessment

Question 9

What is the difference between detection and diagnosis?

Answer 9

detection = cavity; picking up clues

diagnosis = risk factors; trying to come up with a reason why it’s there

Question 10

What are groups at risk?

Answer 10

infants/children

young adults

special needs

Question 11

common meds that cause xerostomia

Answer 11

• tylenol PM (Benadryl)
• bp meds
• antidepressants
• pyschoactive drugs
• muscle relaxants
• alcohol containing mouth rinses
• asthma meds/inhalers

Question 12

Remineralization can only occur in the presence of what?

Answer 12

calcium and phosphate ions

Question 13

What are some other protective factors aside from saliva and fluoride?

Answer 13

chlorhexidine, calcium and phosphate, xylitol

Question 14

fluoride

Answer 14

primary mode is topical

F- accumulation in plaque

F- affect on enzymatic functions challenge the bacteria

Question 15

Describe how risk is categorized

Answer 15

extreme: high plus severe salivary hypofunction
high: any disease indicators, but can be only w/ multiple risk factors
moderate: risk factors present, likely no disease indicators
low: no disease indicators, few risk factors, outweighed by protective factors

Question 16

CRA (age 0-6) contributing conditions

Answer 16

fluoride exposure, sugary foods/drinks, eligible for gov. programs, caries experience of mother/caregiver/siblings, dental home

Question 17

CRA (age 0-6) general health conditions

Answer 17

special health care needs

Question 18

CRA (age 0-6) clinical conditions

Answer 18

restorations/cavitated carious lesions, non-cavitated carious lesions, teeth missing due to caries, visible plaque, dental/orthodontic appliances present (fixed or removable), salivary flow

Question 19

CRA disease indicators

Answer 19

visible cavitations, radiographic lesions, white spot lesions, cavity in last 3 years

Question 20

CRA risk factors

Answer 20

visible plaque, inadequate salivary flow, hyposalivary medications, acidic beverages, frequent snacking (1-3 times a day), appliances present, deep pits and fissures

Question 21

CariScreen testing

Answer 21

saliva sample reads atp of bacteria; low risk 1-1500; high risk 1501-9999