Oral disease

Question 1

What causes dental caries ?

Answer 1

Weak organic acid produced by Streptococcus mutants cause the enamel to demineralise at pH 5.5

Question 2

What are the key factors of development of dental caries ?

Answer 2

Bacteria
Carbohydrates
Weak organic acids
Time and frequency

Question 3

What are the stagnation areas ?

Answer 3

Gingival margins of the teeth, in the fissures, edges of dental restoration

Question 4

What bacteria initiatesthe process of caries and what type of food helps the spread ?

Answer 4

• Streptococcus mutants
• Only carbohydrates (cariogentic food)

Question 5

What is the difference between Intrinsic sugars and Extrinsic sugars ?

Answer 5

• Intrinsic sugars: Natural sugars [occurs within the cell structure] [fructose]

Extrinsic sugars: Added to foods or cooking process as free sugars [lactose sucrose]

Question 6

What is the healing phase after an acid attack known as ?

Answer 6

Remineralisation

Question 7

How does caries initially appear ? vs after demineralisation ?

Answer 7

Initial-> White spot lesions
After demineralisation –> brown lesions

Question 8

What are the stages of a cavity?

Answer 8

1 White spot lesions
2 Demineralisation
3 Break in enamel bacteria travels to dentine
4 Cavity is produced (reversible)
6 Progression of carious attacks surrounding pulp chamber (Irreversible) Inflammation is too great
7 Pulp chamber is breached = carious exposure of contents occurs = pulp death
8) RCT required if the tooth is saveable or extraction if not

Question 9

What is the difference between reversible pulpits or irreversible

Answer 9

Reversible pulpitis treating the underlying problem treats the pulpitis

Irreversible pulpitis results in increased blood flow = a pressure build-up causing the compression of the blood vessels = Pulp death=nerve death= alveolar abscess

Question 10

What is an alveolar abscess ?

Answer 10

Occurs after irreversible pulpitis that causes blood supply to be cut off due to inflammatory pressure then death of the pulp

Question 11

what causes an acute alveolar abscess ?

Answer 11

Pulp decomposes and infected material passes out the tooth via apical foramen into the alveolar bone at the apex of the tooth = another inflammatory response in the tissue surrounding the apex = pus/acute alveolar abscess

Question 12

What are the symptoms of an alveolar abscess ?

Answer 12

• Extremely painful, continual throbbing, surrounding gum is swollen + red
• Affected teeth become loose [due to swelling of the periodontal ligament]
• Half of face may swell and a slight temperate may be represent
• Pain is due to increased pressure of blood within rigid confines of periodontal ligament and alveolar bone.

Question 13

What are the stages of inflammation ?

Answer 13

1 - Pain
2 - Swelling
3- Redness
4 - Heat
5 - Loss of function
6 - Raised body temperature

Question 14

What is the role of saliva in oral health ?

Answer 14

Water [transport]
Inorganic ions and minerals [buffer to maintain pH]
Enzymes [ptyalin]
Anti-bodies [immunoglobulins] ]
Leucocytes [WBC

Question 15

What is the name of the condition that causes ‘dry mouth’/reduced saliva flow? and why does it occur ?

Answer 15

Xerostomia = Dry mouth [reduced saliva flow]

Due to: Aging, Dehydration, some autoimmune disorders [sjoren’s syndrome], medication/drug side effects

Question 16

What are the bad affects of Xerostoma on the oral cavity?

Answer 16

More food debris accumulation
Halitosis [bad breath]
Less buffer = more acid attacks
Poor lubrication = difficulty in speech and deglutition

Question 17

What methods/instruments can be used when diagnosing caries?

Answer 17

Blunt probe/sickle probe/right angle [Occlusal surface]
Briault probe [interproximal]
Horizontal bite wings
Caries dye

Question 18

What are the preventive measures that are used to prevent caries ?

Answer 18

Diet–> fewer cariogentic foods reduced frequency
Good oral hygiene at home as well as regular scalings
Using fluoride
Fissure sealants carried out by the dentist

Question 19

Explain tooth erosion and how it affects the teeth?

Answer 19

Caused by extrinsic acid on the teeth or any acid
Affects Labial/palatal surfaces + occlusal surface of lower molars, teeth become hypersensitive teeth

Question 20

Explain tooth abrasion and how it affects the teeth?

Answer 20

Harsh brushing
Affects neck of the teeth on the buccal or lingual surfaces causes hypersensitive teeth

Question 21

Explain tooth attrition and how it affects the teeth?

Answer 21

loss of enamel on the incisal or occlusal edges due to normal wear and tear, natural teeth onto ceramic restorations or bruxing [clenching/grinding]

Question 22

Explain tooth Abfraction and how it affects the teeth?

Answer 22

Loss of enamel around the neck to the tooth due to overloading a single standing tooth

Affects buccal/lingual/palatal

Question 23

What disease affects the supporting structures of the teeth?

Answer 23

Periodontal diseases

Question 24

What is the name of the periodontal disease that starts in childhood ?

Answer 24

Juvenile periodontitis

Question 25

What is the first stage of periodontal disease that results in the gingiva becoming inflamed in one localised area?

Answer 25

Gingivitis

Question 26

What is the disease associated to chronic generalised inflammation?

Answer 26

Chronic gingivitis - spreads deep in the cementum and periodontal ligament then to the alveolar bone

Question 27

What micro-organism causes Periodontal disease and how is it initiated ?

Answer 27

Bacterial infection
(Actinomyces, Porphyromonas, Gingivalis and Prevotella intermedia)

Accumulation of bacterial plaque biofilm [transparent film of saliva] at the gingival margins.

Micro-organisms feed off the remanets of food debris and multiply. If not cleared causes chronic inflammation on the gum margins

Question 28

What acts as an active role of periodontal disease? and what plays a passive role?

Answer 28

Active role: Plaque
Passive: Calculus

Question 29

What is Supragingival calculus and how can it be removed ?

Answer 29

Visible calculus on the crown on teeth presented above the gum and appears yellowish

can be removed in a dental cleaning

Question 30

What is Subgingival calculus and how can it be removed ?

Answer 30

Brown plaque formed beneath the gingival margins harder to remove

Requires deep periodontal scaling often using anaesthetic

Question 31

Define False pocketing?

Answer 31

Inflammation causing the gingival crevice to seem deeper, however no loss of attachment between the junctional epithelium is present

Question 32

Define True pocketing ?

Answer 32

Is the destruction of the base of the gingival crevice and its attachment to the tooth [junction epithelium and tooth surface]

Question 33

Define subacute pericoronitis ?

Answer 33

Infection of the gingival flap that’s lies over the partially erupted tooth [operculum/ 3rd molar]

Question 34

Treating Subacute pericoronitis

Answer 34

Irrigation of any food debris under the operculum via chlorhexidine

Hot salt-water rinses

Antibiotics if pt has a temperature usually metronidazole

Operculectomy or extraction of the tooth

Question 35

What is Acute herpetic gingivitis ?

Answer 35

caused by herpes simplex virus presents as tiny blistes that can leave acute herpetic gingivo-stamatits (painful ulcers)

Question 36

What is ANUG? what are the affects of it? and what bacteria causes it

Answer 36

Acute necrotising ulcerative gingivitis

causes halitosis, pain, the gingival that’s affected appears red with a covering layer of yellow/grey sloughing membrane where the gum margin is destroyed

Bacillus fusifromis and Treponema vincenti

Question 37

How do 90% of cancers that affect the soft tissues initially present themselves as ?

Answer 37

Lesions (squamous cell carcinoma)

Question 38

What factors link to oral cancers

Answer 38

• Smoking
• Drinking
• Both combined
• Sun light
• Diet
• Genetics

Question 39

How will a squamous cell carcinoma appear?

Answer 39

Appears as a painless ulcer for more than 2-3 weeks beneath/on the side of tongue or the floor of the mouth

Question 40

What can also be represent with an ulcer that can indicate cancer ?

Answer 40

Presence of a white/red patch of oral mucous membrane [leucoplakia and erythroplakia]