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BDS 1 > Oral Environment > Flashcards

Oral Environment Flashcards

1
Q

What is gingival crevicular fluid?

A

It is an inflammatory exudate that can be collected at the gingival margin or within the gingival crevice. The biochemical analysis of the fluid offers a non invasive means of assessing the host response in periodontal disease).

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2
Q

What are the purpose of oral fluids?

A

For protection, taste, buffering, antimicrobial properties and remineralisation.

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3
Q

What kind of glands are salivary glands?

A

Exocrine glands as they secrete into a duct.

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4
Q

What can cause xerostomia (dry mouth)?

A

Drug side effects, poor oral health.

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5
Q

Where are your minor salivary glands located and what secretions can they produce?

A

Minor salivary glands in buccal (cheeks, mucous), labial (in lip, mucous), lingual (tongue, serous and mucous), palatal (hard and soft palate, mucous).

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6
Q

What salivary gland is most stimulated when sleeping?

A

Submandibular gland produces 70% of salivary secretions when sleeping. No contribution from parotid gland when sleeping.

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7
Q

What factors affect unstimulated salivary flow rate?

A

These include carcadian rhythms, previous stimulation, medications and salivary gland diseases.

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8
Q

What is the organic and inorganic composition of saliva (including percentages)?

A

Inorganic- water (99.5%) and ions (0.2%).

Organic- proteins (0.3%) and lips/carbohydrates.

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9
Q

Why do proteins have a limited buffering effect?

A

This is because their main buffering action is under pH5.

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10
Q

What does amylase do and what property does it have?

A

Amylase breaks down starch within the oral cavity. It hydrolyses the 1-4 alpha starch glycosidic link. It has a DIGESTIVE property.

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11
Q

What does lactoferrin do and what property does it have?

A

Lactoferrin protects and stores iron. It can donate a hydrogen ion to carry oxygen. It has an ANTIBACTERIAL property. Lactoferrin is a globular glycoprotein.

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12
Q

What is lysozyme and what property does it have?

A

It is a DIGESTIVE enzyme that attacks bonds in bacterial walls.

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13
Q

What is lactoperoxidase and what property does it have?

A

Allows the release of oxygen from hydrogen peroxidase. It has an ANTIBACTERIAL property.

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14
Q

What do cystatins do?

A

It is an ANTIMICROBIAL that stops the breakdown of protein on cysteine chain of amino acids.

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15
Q

What is gustin and what is the effect it can have on your oral health if it is absent?

A

Gustin is responsible for taste. It is a zinc containing protein and a PDE5 inhibitor. It targets erectile disfunction- a side effect can be loss of taste/ dry mouth (xerostomia). It produces bicarbonate- which is a good BUFFER.

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16
Q

What are histatins and what property do they have?

A

Histatins inhibit the precipitation of calcium phosphate. This allows the remineralisation of enamel due to calcium and phosphate present. Histatins have an antimicrobial and buffering effect.

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17
Q

What are statherins and what property?

A

They prevent the precipitation of calcium triphosphate. It has an anti-calculus affect.

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18
Q

What are plasma-deprived proteins?

A

They spill over into saliva. They contains proteins and blood group substances. Hormones and drugs are plasma derived substances.

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19
Q

What does lipase do?

A

Lipase hydrolyses triglycerides. In von ebner glands on tongue.

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20
Q

What are mucoproteins?

A

They have an ability to bind to tooth and epithelial surfaces. THEY PROTECT AND LUBRICATE. It promotes bacterial aggregation which increases clarence.

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21
Q

What are proline-rich proteins?

A

They have an anti calculus effect. It is present on the surface of enamel and allows for REMINERALISATION of teeth.

22
Q

Name antibacterial proteins in saliva.

A

Lactoferrin, lactoperoxidase, lysozyme, immunoglobulins. histatins and cystatins.

23
Q

Name anti calculus proteins in saliva.

A

Statherins

24
Q

Name buffering proteins in saliva (ALLOW REMINERALISATION).

A

Bicarbonate, histatins, proline rich proteins (remineralisation). Phosphate (important in sleep).

25
Q

Name lubricating proteins in saliva.

A

Mucoproteins and PRG.

26
Q

Name digestive proteins in saliva.

A

Amylase, lipase, protease.

27
Q

What happens in the first stage of saliva secretion?

A

Primary secretion in acinus. Na and Cl are produced into the lumen (NaCl). NaK ATPase helps t pump Cl into cell.

28
Q

What happens in the second stage of saliva secretion?

A

Happens in striated duct cells. CO2 and H2O to produce by carbonate with the action of the carbonic anhydrase enzyme. NaKpump drives the H2 release from carbonic anhydrase breakdown- exits acinus. NaCl is reabsorbed and K and bicarbonate is secreted. Saliva then becomes hypertonic to plasma because of the method of resorption of Na.

29
Q

What is the average volume of saliva in your mouth (ml)?

A

1.1ml.

30
Q

Where in the oral cavity is the high salivary flow present?

A

Lower, lingual regions.

31
Q

Where in the oral cavity is the slow salivary flow present?

A

Buccal and labial regions.

32
Q

What is the meaning of cariogenic?

A

The impact sugars have on the progress of dental caries.

33
Q

What is the meaning of prevalence?

A

The overall amount.

34
Q

What salivary gland produces more posterior secretions than the other?

A

The sublingual gland produces more posterior secretions than the submandibular gland.

35
Q

What is clearance and what factors relate to it?

A

Clearance refers to the rate at which substances are removed from the mouth. It is related to factors such as salivary film, velocity, location in mouth.

36
Q

Why should topical preparations of fluoride be flavourless?

A

Topical preparations of fluoride should be flavourless to not stimulate salivary glands- this is due to low saliva rates retaining beneficial substances

37
Q

What is the Stephan curve and explain what information it provides?

A

A graph of plaque pH over time. There is a fast drop of plaque pH when a sucrose rinse was given. There is a long period of time to go up to normal pH after the rinse! The plaque goes beyond critical pH so the teeth start to demineralise. If the patient continually exposes their teeth to sugar this curve will continuously happen therefore the pH of the mouth will be under the critical pH for longer- longer time to demineralise. More caries.

38
Q

What is the critical pH?

A

It is pH5.5. It is when saliva and plaque are saturated with Ca and Phosphate, this inhibits the formation of hydroxyapatite. It is the highest pH at which there is a net loss of enamel from the teeth, which is generally accepted to be about 5.5 for enamel.

39
Q

What does chewing gum do to teeth with reference to the Stephan curve?

A

Lower drop and quicker recovery when chewing gum as this stimulates saliva. Chewing gum increases salivation to re-mineralise teeth.
Increased salivary flow rate will neutralise plaque acid by- increasing bicarbonate (buffer).

40
Q

What is the large initial increase in salivary flow rate to to chewing gum because of?

A

The stimulation of mechanoreceptors in the periodontal ligament.

41
Q

How can gum be used as an oral health aid?

A

Gum chewing does not remove plaque however, it does increase the pH slightly. Therefore it could promote remineralisation even though the pH increase is quite small.

42
Q

What are alternative sweeteners?

A

Alternative sweeteners have a sweet taste, but can not be metabolised to acids by plaque bacteria.
These are called ‘sugar-free’, and are either:
 Bulk caloric / low caloric sweeteners
 Non-calorie, high-intensity sweeteners

43
Q

What are types of bulk caloric sweeteners?

A

Sucrose, fructose, glucose and galactose. They are cheap in industry.

44
Q

What are types of non caloric sweeteners?

A

Sucralose, saccharin, cyclamates, aspartame. They cannot generate caries.

45
Q

What are types of low caloric sweeteners?

A

Mannitol, sorbitol, xylitol.

46
Q

What does bacteria use sucrose to do?

A

Bacteria uses sucrose to produce infrastructure where bacteria lives, distinguish between two types of plaque biofilm. Mature plaque (not as permeable)- the ability of bacteria to penetrate it.

47
Q

What is Sjogrens syndrome and what procedure can you put in place to help with the symptoms?

A

Sjogrens syndrome- liquid in goggles to keep eyes hydrated. Autoimmune disease- dry eyes and mouth.

48
Q

What effect does radiotherapy have on salivary flow?

A

Radiotherapy increases vascularization and damages glands and epithelia. Therefore a decrease in salivary flow.

49
Q

What are consequences of decreased salivary flow?

A
  • dental caries and oral disease increased.
  • dysaestheia- BURNING MOUTH.
  • impaired oral function.
  • diminished taste perception.
50
Q

How can you manage/treat xerostomia?

A

If there is functioning gland tissue present, stimulate salivary flow,
by chewing, or by drugs (sialogogues)
If there is no functioning gland tissue, saliva substitutes may be used:
Mucin-based; cellulose-based
Water alone is not very effective.

BDS 1 (14 decks)

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