Module 1: What Are Caries Flashcards
Is the cavitation the early or late stage of the disease process?
Late
How do carious lesions start?
Loss of surface integrity
What part of the crown is vulnerable?
Any uncovered portion of the tooth
What are the three steps of a Lesions Assessment?
See it: Visually on the surface
Feel it: Drag the explorer to assess surface texture
Radio it: Use it to verify the histological depth of lesion
How do active smooth surface caries look on visual examination?
They look dry and feel rough
If treated properly, can active smooth surface caries be remineralized?
Yes
What do inactive smooth surface caries look like
Hard
Smooth
Shiny
Black to Brown to White in Color
What are the three Stages of Caries Progression?
Initial
Moderate
Extensive
Besides Initial, Moderate, and Extensive…how else are caries categorized?
Active or Inactive
How do active Dentine lesions appear?
Soft, flaky, and/or leathery
How do inactive Dentive lesions appear?
Shiny and hard on probing
What are three ingredients that allow for caries development?
Tooth
Bacteria
Sugar sources
What are the three parts of the ven diagram that allow caries to form?
Host factors
Bacterial factors
External factors
What are some examples of host factors?
Tooth anatomy, texture, protected surfaces
Salivary quality and flow rates
Salivary pH and buffering capacity
Systemic disease
How can a caries infection be described?
A multifactorial pH mediated disease
Why might diabetic patients have a lot of carious lesions?
Due to a reduced salivary flow rate
What are some Environmental/External Factors?
Diet:
Fermentable carbs, frequency of meals, acidity of meals
Oral hygiene and compliance
Fluoride exposure
What do the bacteria create in order to adhere to teeth?
Sticky glucans
What does the acidic byproducts from the bacteria do to weaken the enamel?
It removes calcium and phosphates
What are some of the bacterial factors that must be present for carious development?
Mutans Streptococci
Lactobacilli
Other non-cariogenic bacteria can become cariogenic for short periods of time under certain conditions
What is the theory that states that some typically non carious bacteria can become cariogenic if the pH of the oral environment remains acidic for an extended period of time?
Extended ecological plaque hypothesis
Who came up with the ecological plaque hypothesis?
Marsh
What does Marsh’s ecological plaque theory reconcile?
the non specific and specific bacterial hypotheses
What is the non-specific bacterial hypotheses?
All bacteria is bad and should be removed
What doe the ecological hypothesis say?
There are several varieties of bacteria that may be cariogenic and that the pH of the environment play a significant role in carious development
What is the first step in the process of decay?
The dissolution of minerals in the enamel
What is the imperfect mineral structure of enamel and dentin?
Calcium deficient carbonated hydroxyapatite
What direction do the enamel rods run in?
Perpendicular to the DEJ
What is detectable ahead of the advancement of the lesion towards the DEJ?
Tubular sclerosis or sclerotic/translucent dentin
What is the most common reaction of the pulpodentinal complex to adverse insult?
Deposition of minerals in the dentin tubules
Why is it called translucent dentin?
The dentin appears translucent due to reduced light scattering
What happens when the carious lesion makes it to the DEJ
A light brown discoloration will appear in the dentin which is the first sign of dentin demineralization
What part of the odontoblast is housed in each dentin tubule?
The odontoblastic process
Are the odontoblastic processes peritubular or intertubular?
Peritubular
What is more mineralized? Odontoblastic processes or intertubular dentin?
Odontoblast processes
What sensations are delivered to the nerves in the pulp via the odontoblastic processes?
Pain
Pressure
Temperature
What degrades the dentin once the bacteria has come into direct contact with it?
Acid and proteolytic enzymes
What happens in the zone of destruction?
Dentin that has been exposed directly to bacteria will decompose
What might happen before the dentinal invasion by the bacteria
Reactive/Reparative dentin may form
How are dead tracks in dentin formed?
When the bacteria invades below the zone of destruction and quickly progresses through the tubules
What is it called when a bacterial invasion causes two or more dead tracts to coalesce?
Liquefactive foci
What will the decomposing/ed dead tracts make up?
The zone of bacterial penetration
Besides during embryonic development, when do we see amelogenin expression?
During pathological conditions like carious lesions
What might amelogenin be an important precursor for?
Reactionary dentin matrix formation
When does primary dentin form?
before eruption
When does secondary dentin form?
forms through root formation
When does tertiary dentin form?
In response to stimuli from the bi-products of bacterial invasion in advance of the bacteria
What can mimic carious lesions in children that ingested high levels of fluoride before the age of 8?
Fluorosis
What do teeth look like that have mild fluorosis?
The teeth look like they have white flakes, frosty edges, or fine lace like white lines
“Snow capped appearance on incisal edges”
What can occur in severe cases of fluorosis?
Pitting and staining
Besides fluorosis what are two other conditions that mimic the look of carious lesions?
Hypocalcification
Amelogenesis imperfecta
What type of inheritance pattern has Amelogensis imperfecta been linked to?
X chromosome and sporadic
What is another mimic of caries that be attributed to low birth weight, prematurity, maternal illness, smoking, drug use, liver disease or drug use
Hypoplasia
What is erosion caused by?
Acids of non-bacterial origin
What causes abraction lesions?
Microfractures in the cervical tooth structure due to destructive excursive forces
Why can abfraction, abrasion, attrition, and erosion lesions be mistaken for arrested/inactive carious lesions?
Because they form hard, shiny surfaced lesions
