PERDENT (intro to dental caries)

Question 1

is a multifactorial, transmissible,
infectious oral disease caused primarily
by the complex interaction of cariogenic
oral flora (biofilm) with fermentable
dietary carbohydrates on the tooth
surface over time.

Answer 1

DENTAL CARIES

Question 2

characterized by
localized demineralization and loss of
tooth structure

Answer 2

dental caries

Question 3

During an acid attack
PH level will go down
to critical level:

Answer 3

5.5 for enamel

6.2 for dentin

Question 4

The low pH level will
trigger Phosphate and
Calcium minerals from
the tooth to the Biofilm
in attempt to balance or
to reach equilibrium.

Answer 4

DEMINERALIZATION

Question 5

When pH neutralizes, the
concentration of soluble
calcium and phosphate is
supersaturated relative to that
in the tooth, mineral can then
be added back to partially
demineralized enamel

Answer 5

ReMINERALIZATION

Question 6

Repeated demineralization events may
result from a predominantly pathologic environment causing the localized dissolution and destruction of the calcified dental tissues,

Answer 6

caries lesion or a “cavity.”

Question 7

factors that can affect the process of

demineralization and remineralization

Answer 7

Number and type of microbial flora in the biofilm

diet
oral hygiene
genetics
dental anatomy
use of fluorides and other chemotherapeutic agents

salivary flow and buffering capacity

inherent resistance of the tooth structure and composition.

Question 8

is a term historically
used to describe the soft,
tenacious film
accumulating on the
surface of teeth.

Answer 8

Dental plaque

Question 9

has been more recently
referred to as a plaque
biofilm, or simply biofilm

Answer 9

Dental plaque

Question 10

is composed mostly of bacteria,
their by-products, extracellular
matrix, and water.

Answer 10

biofilm

Question 11

Teeth normally have a biofilm
community dominated by

Answer 11

Streptococcus sanguis and S.
mitis

Question 12

The population size of mutans
streptococci (MS) or S.

Answer 12

mutans on
teeth varies.

Question 13

tooth habitats for cariogenic biofilms

Answer 13

Pits and fissures

Smooth enamel surfaces

Root surfaces (cervical areas)

Subgingival areas

Question 14

provide excellent mechanical shelter for organisms
and harbor a community dominated by S. sanguis and

other streptococci

Answer 14

pits and fissures

Question 15

immediately gingival to
the contact area are the second most susceptible areas to caries

Answer 15

Smooth Enamel Surfaces

Question 16

particularly near the cementoenamel junction (CEJ), often is unaffected by the action of hygiene procedures such as flossing because it may have concave anatomic surface contours (fluting) and occasional roughness at the termination of the enamel.

Answer 16

root surfaces

Question 17

Caries originating on the root is
alarming because:

Answer 17

1.it has a comparatively rapid
progression.
2.it is often asymptomatic.
3.it is closer to the pulp.
4. it is more difficult to restore.

Question 18

Accomplished primarily by
proper tooth brushing and
flossing, is another ecologic
determinant of caries onset
and activity.

Answer 18

oral hygiene

Question 19

Careful mechanical cleaning
of teeth disrupts the biofilm
and leaves a clean enamel
surface.

Answer 19

oral hygiene

Question 20

The cleaning process does
not destroy most of the oral
bacteria but merely removes
them from the surfaces of
teeth.

Answer 20

oral hygiene

Question 21

is an extremely important
substance for the proper digestion
of foods, and it also plays a key
role as a natural anticaries agent

Answer 21

saliva

Question 22

protective mechanisms
that maintain the normal oral flora
and tooth surface integrity include
bacterial clearance, direct
antibacterial activity, buffers, and
remineralization

Answer 22

saliva

Question 23

anticaries properties of saliva

Answer 23

Bacterial Clearance

Direct Antibacterial Activity

Buffer Capacity
Remineralization

Question 24

The amount of saliva secreted
varies greatly over time. When
secreted, saliva remains in the
mouth for a short time before
being swallowed.

Answer 24

bacterial clearance

Question 25

Adults produce ___ of saliva a day, very little of which occurs during __.

Answer 25

1-1.5 L, sleep

Question 26

most effective during mastication or oral stimulation, both of which produce large volumes of saliva.

Answer 26

flushing

Question 27

play an important role in the protection of soft tissue in the oral cavity from infection by pathogens, they have little effect on caries because similar levels of antibacterial proteins can be found in caries-active and caries- free individuals.

Answer 27

direct bacterial activity

Question 28

also can dilute and buffer biofilm acids.

Answer 28

Large volumes of saliva

Question 29

may have significantly higher caries susceptibility.

Answer 29

Individuals with decreased salivary production (Dry mouth)

Question 30

medical term for Dry mouth.

Answer 30

Xerostomia

Question 31

`xeros = stomia =

Answer 31

= dry = conditions of the mouth

Question 32

is to reduce the potential for acid formation.

Answer 32

buffer capacity

Question 33

Without a means to control precipitation of these ions, the teeth literally would become encrusted with mineral deposits.

Answer 33

remineralization

Question 34

provides a constant opportunity for remineralizing enamel and can help protect teeth in times of cariogenic challenges.

Answer 34

remineralization

Question 35

Acidogenic Acido = genic =

Answer 35

Acid forming/producing

Question 36

The eventual metabolic product of cariogenic diet is

Answer 36

acid,

Question 37

leads to the development of caries, the exposure to acidity from other sources also may result in caries.

Answer 37

acid

Question 38

Cariogenic Cario = genic =

Answer 38

Caries forming/producing

Question 39

clinical characteristics

Answer 39

Pits and Fissures Smooth enamel surfaces Root surfaces

Question 40

the earliest evidence of caries on the smooth enamel surface of a crown is a

Answer 40

white spot.

Question 41

are chalky white, opaque areas that are revealed only when the tooth surface is desiccated and are termed noncavitated enamel caries lesions.

Answer 41

white spots

Question 42

is affected less by drying and wetting

Answer 42

hypocalcified enamel

Question 43

caries partially or totally disappears visually when the enamel is hydrated (wet),

Answer 43

Noncavitated (white spot)

Question 44

(international caries dectection assessment system) ICDAS 1 2 3 4 5 6 7

Answer 44

1 - Sound surface 2 - First visual change in enamel (seen only after prolonged air‐drying or restricted to within the confines of a pit or fissure) 3 - Distinct visual change in enamel 4 - Localized enamel breakdown (without clinical visual signs of dentin involvement) 5 - Underlying dark shadow from dentin 6 - Distinct cavity with visible dentin 7 - Extensive distinct cavity with visible dentin

Question 45

buccal and linggual grade 1 (B1) grade 2 (B2) grade 3 (B3) grade 4 (B4) grade 5 (B5)

Answer 45

GRADE 1- white or discolored enamel, no cavitation clinically. GRADE 2- small cavitation in enamel. GRADE 3- moderate sized cavity in enamel with exposed dentin GRADE 4- large cavity in enamel and moderate cavity in dentin GRADE 5- extensive cavity in enamel and substantial loss of denitn

Question 46

occlusal grade 1(o1) grade 2(O2) grade 3(o3) grade 4(o4) grade 5(05)

Answer 46

GRADE 1- white or brown discoloration in enamel, no clincial cavitation, no radiographic GRADE 2- small cavity formation GRADE 3- moderate sized cavity and radiolucency in the outer third GRADE 4- Big cavitation in the middle third GRADE5- very big in the iner third