Oral Micro Exam 3 Review Flashcards
What are some of the factors that result in dental caries?
(1) Microorganisms, (2) metabolic substrates, (3) teeth and their environment and (4) time. Take away any one of these four factors and you can significantly decrease if not entirely prevent caries.
What is the chemical formula of hydroxyapatite?
Ca_10(PO_4)6(OH)2
How do ion substitutions affect hydroxyapatite tooth structure?
Fluoride can substitute at the hydroxyl group and strengthen enamal (thereby effectively decreasing effective pH) Carbonates usually substitute for the phosphates.
What is critical pH of enamel?
The pH below which dissolution predominates in the oral cavity is about 5.5; this is termed the critical pH.
What are some of the key elements of the sucrose pathway?
Invertase breaks sucrose into fructose and glucose, fructosyl tranferase creates levans “snack food” as an extracellular insoluble polysaccharide chain and glucosyl transferse creates a “gum drop dome” out of glucose monomers
What is the acidogenic theory of caries formation and the role of sucrose in the process?
Some plaque bacteria are cabable of fermenting carb substrates to produce acid, causing plaque pH to fall < critical levels. Repeated exposure–>demineralization @ susceptible sites on tooth surface.
What are the differences between the terms aciduricity, acidophilic, and acidogenic?
Aciduricity is the ability to withstand low pH, acidophilic refers to bacteria that grow well in acidic environments and acidogenic refers to bacteria that metabolize products resulting in acidic byproducts
What are some of the differences between hetero-fermenters and homo-fermenters?
Homolactic fermenters produce two molecules of lactic acid per molecule glucose while heterolactic bacteria produce lactic acid and something else (such as ethanol, CO2 or acetic acid from one molecule of glucose)
What is the concept behind replacement therapy?
The idea is that by inoculating with genetically modified, less pathogenic S. mutans strains patients can avoid developing caries.
How might probiotic therapies someday impact caries development and treatment?
We could promote the colonization of benign bacteria to take up space and prevent the infiltration of pathogenic strains of bacteria like Strep. Mutans, actionmyces, and lactobacillus.
How may STAMP someday impact caries develompent and treatment?
In vitro biofilms treated with S. mutans (STAMP=Specifically-targeted anti-microbial peptides) resisted recolonization with S. mutans. Once established an ecosystem resists change.
How might Biofilm interference someday impact caries development and treatment?
Biofilm interference could inhibit biofilm formation or obstruct quorum sensing.
What is the relationship between critical pH and carbonate content in enamel?
Carbonate allows our teeth to flex a little and be more resilient to stress. The more carbonate present–>the less acid requied for it to reach the critical pH.
Which ions can substitute for calcium in hydroxyapatite?
Lead, strontium, radium, etc.
Which ion can substitute for phosphate in hydroxyapatite?
Carbonate
Which ion can substitute for the hydroxyl group in hydroxyapatite?
Fluoride
Which sites in the oral cavity are generally most susceptible to developing caries?
Pits and fissures, approximal surfaces of adjacent teeth, cervial margin just coronal to the gingival margin, exposed root surfaces, margins of deficient restorations and tooth surfaces adjacent to dentures and bridges
What are two general characteristics of caries-susceptible sites?
Favorable for plaque retention (hard to ‘mow the lawn’ and limited access for saliva
What is the progressive development for plaque deposits in the oral cavity?
Salivary proteins–>pellicle–>plaque biofilm–>calculus
What is the pellicle?
Acellular, homogeneous, organic film that forms on enamel and other hard surfaces by selective adsorption of salivary proteins and glycoproteins
What characteristics typify the pellicle?
Forms spontaneously on teeth, bacteria are not necessary for formation, can be removed only by meticuluous cleaning, reforms in a few hours and it forms an environment suitable for bacterial pioneer species adherence and multiplication
What is plaque biofilm?
Soft, non-mineralized bacterial deposit that forms on teeth
What is plaque biofilm composed of?
Plaque-tooth interface (generally pellicle), microbial layers and colonies and intercellular matrix (insoluble).
What are the main parts of the insoluble intercellular matrix of plaque biofilm?
Carbohydrates: glucans, fructans and other polysaccharides (primary component of the matrix) and protein.
What may happen when dietary carbohydrates, especially simple sugars are fermented by some plaque bacteria?
They produce acid (H+) and extracellular polymers (glucans and fructans). As the plaque thickens, the effects of saliva decrease, making the acid accumulation more pronounced. If too much acid is produced and accumulates, caries may form.
What is calculus?
Plaque biofilm in which inorganic deposits have caused mineralization. Calculus greatly increases risk for developing periodontitis
What evidence indicates that caries is an infectious disease?
Experiments conducted with gnotobiotic animals have shown that caries is an infectious disease. These experiments have also shown that both sugar and plaque bacteria (specifically. Strep. Mutans, Lactobacillus and Actinomyces) are required to cause disease.
What are some properties that make Streptococcus mutans so cariogenic?
(1) Excellent sugar transport @ low pH, (2) acid production (it is a homolactic fermenter), (3) aciduricity and acidophilic, (4) produces insoluble glucan and (5) produces intracellular polysaccharide (“snacks”) extracellular levan