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Operative > Midterm 1: Cariology I Pit & Fissure Caries > Flashcards

Midterm 1: Cariology I Pit & Fissure Caries Flashcards

1
Q

What are dental caries?

A

Disease where ecological shift within dental biofilm environment

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2
Q

What is biofilm?

A

Aggregation of microorganisms in which cells adhere to each other forming small communities
held together by extracellular polymeric matrix
Ex. Dental plaque

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2
Q

What does acidogenic mean?

A

something that produces acid
Ex. cariogenic bacteria

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2
Q

What does it mean to be of higher cariogenicity?

A

more acid
acidogenic

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3
Q

In dental caries, the population shifts from a balanced population of microorganisms of ____________________ to a microbiological population of _______________.

A

low cariogenicity
high cariogenicity

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3
Q

What does the microbiological population of high cariogenicity increase production of?

A

organic acids

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4
Q

What does the microbiological population of high cariogenicity promot?

A

dental hard tissue net mineral loss
carious lesions

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5
Q

What is the disease of dental caries driven by?

A

frequent access to fermentable dietary carbohydrates

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6
Q

What does demineralization mean?

A

chemical process by which minerals are removed from dental hard tissues (enamel/dentin/cementum)
occurs through dissolution by acids or chelation
can be replaced with remineralization

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6
Q

What is a carious lesion?

A

The clinical manifestation of caries disease
can have a few or many

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7
Q

What does cariogenic mean?

A

the ability to cause dental caries
Ex. a cariogenic diet contains sugar

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8
Q

What does cavitated mean?

A

Denotes a loss of surface intergrity
refers to total loss of enamel and exposure of underlying dentin
inability to biologically replace loss of hard tissue

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9
Q

What is dental plaque?

A

organized community of many different microorganisms that forms itself into a biofilm
can vary from healthy to harmful microorganisms

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10
Q

What are monosaccharides?

A

Simplest forms of carbohydrates

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11
Q

What does noncavitated mean?

A

initial caries lesion development before cavitation occurs
change in color, glossiness, or surface structure

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12
Q

What is a pellicle?

A

A thin cellular membrane of salivary proteins adsobed to the enamel or cementum

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13
Q

What is remineralization?

A

The chemical process by which minerals (esp Ca) are replaced into the substances of the dental hard tissue
requires supersaturation with calcium and phosphate ions, fluoride, and adequate buffering

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14
Q

What 3 factors must be considered in evaluating Caries Disease?

A
  1. Personal Factors
  2. Oral environmental factor
  3. Factors that directly contribute to caries development
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15
Q

What is a substrate?

A

material metabolized by specific microorganisms in dental plaque to produce acids that lead to demineralization

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15
Q

What are the 4 requirements for active caries disease process to occur?

A
  1. susceptible tooth area
  2. acid producing bacteria from biofilm
  3. fermentable carbohydrates in diet
  4. time
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16
Q

What are some causes of Caries disease?

A
  1. bacteria
  2. diet
  3. saliva
  4. genetics
  5. biofilm dysfunction - prolonged exposure to low pH: 100%
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17
Q

What is the primary pathogen in the biofilm?

A

Streptococcus Mutans

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18
Q

What does the carbonate ion do to the carbonated hydroxyapatite?

A

makes the mineral more acid-soluble than pure hydroxyapatite

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18
Q

What is dentin primarily composed of?

A

small thin crystal flakes embedded in a protein matrix of cross-linked collagen fibers

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19
Q

What is the structure of enamel?

A

repeating molecular units of hydroxyapatite
Ca19(PO4)6(OH)2

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20
Q

What mineral is in enamel and dentin?

A

carbonated hydroxyapatite
a calcium phosphate with numerous impurity inclusions

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21
Q

What are some susceptible tooth surfaces?

A
  1. occlusal of posterior teeth
  2. lingual anteriors
  3. mesial/distal approximal surfaces
  4. free smooth surfaces (gumline)
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21
Q

Dental caries is a _________ disease that results in localized destruction of tooth tissues by acids that are produced in mouth as oral bacteria ferment ____________.

A

Biofilm
dietary carbohydrates

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22
Q

What does the odontoblast do?

A

secretes organic matrix
regulates mineralization

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23
Q

What is dentin composed of?

A
  1. tubules
  2. inorganic apatite crystals
  3. organic matrix
  4. water
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24
Q

What are some other tooth surfaces caries disease can occur on that are not considered susceptible?

A
  1. white spot lesion (smooth surface)
  2. root caries on exposed cementum
25
Q

What is a biofilm?

A

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

26
Q

What happens if the pH in the biofilm becomes too acidic? What pH would it have to drop below for this to happen?

A

Demineralization of tooth enamel
pH < 5.5

27
Q

Caries are not caused by an infectious agent but what?

A

a shift in oral microflora to caries-causing bacterial types in response to shift in pH

28
Q

What are some fermentable carbohydrates?

A
  1. Sugars (sucrose, glucose, fructose, lactose)
  2. Starches
29
Q

What are two examples of cariogenic bacteria?

A
  1. stretococci mutans
  2. lactobacilli
30
Q

What is the process called where bacteria convert glucose, fructose, and sucrose into acids?

A

glycolysis

31
Q

A shift in plaque ecology, in which ______________ bacteria, such as S sanguinis are less able to survive. When pH neutral, S sanguinis keeps acid production low and increases remineralization.

A

Acid-sensitive

32
Q

Increased sugar intake results in _________ acid production

A

more frequent

33
Q

When the pH drops, there is an ecological shift from _______________ and _______________ to ____________, ______________, and ________________.
** all bacteria names

A

S. sanguinis
S. gordonii

S. mutans
lactobacilli
bifidobacteria

34
Q

What is the solubility of enamel?

A

pH 5.5

35
Q

What is cavitation?

A

collapse of enamel surface due to compromised dentin structure
no longer support enamel rods
reach dentin
may reach pulp

36
Q

Where does pit/fissure formation begin?

A

cusp tips

37
Q

What causes the formation of pits and fissures?

A

imperfect fusion at interfaces

38
Q

Variations in ____________________ anatomy affects caries suceptibility.

A

pit and fissure anatomy

39
Q

Depth of a pit is very near ___________.

A

dentin

40
Q

What fills the inaccessible spaces of pits and fissures?

A

biofilm

41
Q

What can diffuse into pits and fissures filled with biofilm?

A

Fermentable carbohydrates

42
Q

What are the signs of an incipient occlusal lesion?

A

chalky enamel bordering
darkly stained plaque

43
Q

Does incipient occlusal lesions require surgical treatment?

A

No

44
Q

What part of dentin responds to the chemical threat of caries?

A

Vital dentin

45
Q

What is the ICDAS system?

A

How to diagnose pit and fissure caries
International Caries Detection and Assessment System
0-6 scale
visual criteria

46
Q

Describe an ICDAS 0.

A

sound tooth structure
no change after air drying
no hypoplasia (incomplete development)
no wear
no erosion
no histological depth

47
Q

Describe an ICDAS 1.

A

changes in enamel after drying
colored changes
limited to pits and fissures
histological depth:
90% enamel
10% dentin

48
Q

Describe an ICDAS 2.

A

Distinct change in enamel
seen when wet
widening of pit/fissure
50% into inner enamel
50% into outer dentin

49
Q

Describe an ICDAS 3.

A

localized enamel breakdown
no underlying dentin shadowing
widening of fissure
77% into dentin

50
Q

Describe an ICDAS 4.

A

underlying dark shadow in dentin
WITH or WITHOUT enamel breakdown
88% into dentin

51
Q

Describe an ICDAS 5.

A

distinct cavitation
dentin visible
involving less than half the tooth surface
100% into dentin

52
Q

Describe an ICDAS 6.

A

Extensive cavitation within dentin
involves more than half the tooth structure
100% reaching inner third of dentin

53
Q

Secondary prevention covers ICDAS ______ to ______

A

1-3

54
Q

Tertiary prevention covers which ICDAS classifications?

A

4-6

55
Q

What is CAMBRA?

A

Caries Management by Risk Assessement
Focus on treating/preventing disease at patient level rather than surgical/restorative approach

56
Q

What is CAMBRA used for?

A

determine patient’s caries risk
rate as: extreme/high/moderate/low risk

57
Q

CAMBRA risk assessment is based on:

A
  1. disease indicators
  2. risk factors
  3. protective factors
58
Q

What does fluoride do?

A

Rinses
Gels
Varnishes
Toothpastes
Fluoridated water

59
Q

How do you form a crystal nucleus?

A

Take a partly dissolved crystal and remineralize with calcium, phosphate, and fluoride

60
Q

What is the main characteristic of a crystal nucleus?

A

acid resistant
fluorapatite-like coating on crystals

61
Q

What does CPP-ACP do?

A

aids in remineralization with nano particles of hydroxyapatite

62
Q

What do sealants do?

A

creates a smooth occlusal surface
removes food source of bacteria

63
Q

TRUE OR FALSE

Dental caries are transmissible.

A

TRUE

64
Q

What is vertical transmission?

A

Passage of bacteria from mother to baby during the period after birth

65
Q

What is horizontal transmission?

A

Transfer of bacteria between individuals of the same generation

66
Q

Prolonged periods of low pH leads to what?

A

demineralization of teeth
ultimate damage to the tooth

67
Q

Treatment strategies aim to eliminate the biofilm dysfunction, or prolonged periods of __________ (high/low) pH.

A

low

68
Q

How does saliva help against dental caries?

A

hydrate
neutralize and support the pH

Operative (8 decks)

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