Module 1: Caries Environment Article Flashcards
Who is the author of the Caries Environment Article?
Hara and Zero
According to the article what is the key etiological condition necessary for caries to form?
Plaque biofilm
What is the main point of the article?
The interaction between the: saliva diet pellicle tooth structure and how these things modify the pathogenicity of the biofilm
What is saliva’s role in carious lesion development?
It provides the medium transporting harmful products to the tooth surface.
It also flushes away harmful things too
What two qualities of saliva are important to the caries process?
Saliva composition
Saliva flow rate
What are some protective qualities of saliva
Clear cariogenic food away from mouth
Neutralized acid
reduces the demineralization rate by providing calcium and phosphate and fluoride
Increasing salivary output can have a postive effect, what can stimulate such an increase?
Mastication stimulates the mechanoreceptors in the gingiva which some think initiates saliva release via reflex action
What evidence is there that chewing can increase saliva flow?
Research has shown that sugar free gum chewing has been correlated to lower caries levels, despite the lack of any antiocariogenic ingredients
What are the inorganic constituents of saliva that we are interested in?
Ca2+ ion PO4- F- H2CO3 (Carbonic Acid) HCO3- (Hydrogen carbonate ion) HPO4- (Hydrogen phosphate ion)
What is the main buffer component of saliva?
Hydrogen carbonate (HCO3-)
How much does the concentration of Hydrogen carbonate increased when stimulated saliva is tested compared to unstimulated saliva
12x increase in buffering ion
What surfaces show slower oral clearance from saliva
Maxillary teeth are slower compared to mandibular
Buccal surfaces are slower than lingual
Which specific surfaces have the slowest clearance in the mouth?
Buccal surfaces of maxillary anteriors
Which specific surfaces have the fastest clearance rates?
Lingual surfaces of mandibular teeth
Why are the lingual surfaces of the mandibular anterior teeth so quickly cleared?
Due to their proximity to the sublingual and submandibular salivary glands
What surfaces benefit from the location of the parotid duct?
Buccal surfaces of maxillary molars
What are three factors that can lead to the reduction of salivary flow rate?
Age
Radiation therapy
Medication
What are some of the organic components of saliva that can impact carious lesions?
Secretory IgA
Lysozyme
Lactoferrin
Peroxidases
How does lysozyme destroy bacteria?
By disrupting bacterial cell walls
How do lactoferrins help destroy bacteria
Messing with bacteria’s ability to take in iron
Which organic component of saliva can mess up a bacteria’s ability to metabolize glucose?
Lactoperoxidase
What cariogenic bacterial species is secretory IgA thought to be effective against?
Strep mutans
What is the acquired pellicle?
An acellular
Bacteria free
Organic film
What forms the pellicle
salivary glycoproteins and proteins from various sources
What are the two steps of pellicle formation?
- Adsorption of proteins to the hydrophobic regions of the tooth via electrostatic interactions
- Protein aggregates or micelle like structures adsorb to the uncovered sites and simultaneously interact with the proteins from step 1
What enzyme might be a part of the pellicle and give it an ability to prevent ion conductivity at the pellicle surface?
Transglutaminase
How thick is the acquired pellicle
.1-1.0 microns
From an etiological standpoint, what is the main driver of the caries process?
Diet
Why are complex carbs like starches not as cariogenic as simple sugars?
They are not soluble in oral fluids and diffuse very slowly in biofilm
What is arguably the most cariogenic simple sugar?
Sucrose
What are the two main reason that sucrose is so cariogenic?
- Sucrose is freely soluble in dental plaque
2. Sucrose is part of the intra and extracellular synthesis of glucans
How is sucrose specifically invloved with glucan formation?
The enzymes that make glucans and fructans (glucosyltransferases) have a high affinity for sucrose
What does the formation of glucans help to favor?
the accumulation of strep mutans
