Oral disease Flashcards
What causes dental caries ?
Weak organic acid produced by Streptococcus mutants cause the enamel to demineralise at pH 5.5
What are the key factors of development of dental caries ?
Bacteria
Carbohydrates
Weak organic acids
Time and frequency
What are the stagnation areas ?
Gingival margins of the teeth, in the fissures, edges of dental restoration
What bacteria initiatesthe process of caries and what type of food helps the spread ?
- Streptococcus mutants
- Only carbohydrates (cariogentic food)
What is the difference between Intrinsic sugars and Extrinsic sugars ?
- Intrinsic sugars: Natural sugars [occurs within the cell structure] [fructose]
Extrinsic sugars: Added to foods or cooking process as free sugars [lactose sucrose]
What is the healing phase after an acid attack known as ?
Remineralisation
How does caries initially appear ? vs after demineralisation ?
Initial-> White spot lesions
After demineralisation –> brown lesions
What are the stages of a cavity?
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
What is the difference between reversible pulpits or irreversible
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
What is an alveolar abscess ?
Occurs after irreversible pulpitis that causes blood supply to be cut off due to inflammatory pressure then death of the pulp
what causes an acute alveolar abscess ?
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
What are the symptoms of an alveolar abscess ?
- 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.
What are the stages of inflammation ?
1 - Pain
2 - Swelling
3- Redness
4 - Heat
5 - Loss of function
6 - Raised body temperature
What is the role of saliva in oral health ?
Water [transport]
Inorganic ions and minerals [buffer to maintain pH]
Enzymes [ptyalin]
Anti-bodies [immunoglobulins] ]
Leucocytes [WBC
What is the name of the condition that causes ‘dry mouth’/reduced saliva flow? and why does it occur ?
Xerostomia = Dry mouth [reduced saliva flow]
Due to: Aging, Dehydration, some autoimmune disorders [sjoren’s syndrome], medication/drug side effects
What are the bad affects of Xerostoma on the oral cavity?
More food debris accumulation
Halitosis [bad breath]
Less buffer = more acid attacks
Poor lubrication = difficulty in speech and deglutition
What methods/instruments can be used when diagnosing caries?
Blunt probe/sickle probe/right angle [Occlusal surface]
Briault probe [interproximal]
Horizontal bite wings
Caries dye
What are the preventive measures that are used to prevent caries ?
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
Explain tooth erosion and how it affects the teeth?
Caused by extrinsic acid on the teeth or any acid
Affects Labial/palatal surfaces + occlusal surface of lower molars, teeth become hypersensitive teeth
Explain tooth abrasion and how it affects the teeth?
Harsh brushing
Affects neck of the teeth on the buccal or lingual surfaces causes hypersensitive teeth
Explain tooth attrition and how it affects the teeth?
loss of enamel on the incisal or occlusal edges due to normal wear and tear, natural teeth onto ceramic restorations or bruxing [clenching/grinding]
Explain tooth Abfraction and how it affects the teeth?
Loss of enamel around the neck to the tooth due to overloading a single standing tooth
Affects buccal/lingual/palatal
What disease affects the supporting structures of the teeth?
Periodontal diseases
What is the name of the periodontal disease that starts in childhood ?
Juvenile periodontitis
What is the first stage of periodontal disease that results in the gingiva becoming inflamed in one localised area?
Gingivitis
What is the disease associated to chronic generalised inflammation?
Chronic gingivitis - spreads deep in the cementum and periodontal ligament then to the alveolar bone
What micro-organism causes Periodontal disease and how is it initiated ?
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
What acts as an active role of periodontal disease? and what plays a passive role?
Active role: Plaque
Passive: Calculus
What is Supragingival calculus and how can it be removed ?
Visible calculus on the crown on teeth presented above the gum and appears yellowish
can be removed in a dental cleaning
What is Subgingival calculus and how can it be removed ?
Brown plaque formed beneath the gingival margins harder to remove
Requires deep periodontal scaling often using anaesthetic
Define False pocketing?
Inflammation causing the gingival crevice to seem deeper, however no loss of attachment between the junctional epithelium is present
Define True pocketing ?
Is the destruction of the base of the gingival crevice and its attachment to the tooth [junction epithelium and tooth surface]
Define subacute pericoronitis ?
Infection of the gingival flap that’s lies over the partially erupted tooth [operculum/ 3rd molar]
Treating Subacute pericoronitis
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
What is Acute herpetic gingivitis ?
caused by herpes simplex virus presents as tiny blistes that can leave acute herpetic gingivo-stamatits (painful ulcers)
What is ANUG? what are the affects of it? and what bacteria causes it
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
How do 90% of cancers that affect the soft tissues initially present themselves as ?
Lesions (squamous cell carcinoma)
What factors link to oral cancers
- Smoking
- Drinking
- Both combined
- Sun light
- Diet
- Genetics
How will a squamous cell carcinoma appear?
Appears as a painless ulcer for more than 2-3 weeks beneath/on the side of tongue or the floor of the mouth
What can also be represent with an ulcer that can indicate cancer ?
Presence of a white/red patch of oral mucous membrane [leucoplakia and erythroplakia]
