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Patient Care III > Plaque and Other Dental Deposits > Flashcards

Plaque and Other Dental Deposits Flashcards

1
Q

Within __ weeks, a nearly mature microbiota is established in the gut of a baby

A

2

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2
Q

After approximately __ years, the entire human microbiota is formed and comprised of very complex bacterial species

A

2

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3
Q

From this moment on, the human
body contains _______ times more
bacteria than human cells

A

1.3 to 10

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4
Q

Colonization of the oral cavity starts…

A

close to the time of birth

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5
Q

Most bacteria within the human body maintain themselves within their host by…

A

adhering to a surface, including within the oral cavity

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6
Q

How are organisms removed from the oral cavity?

A
  • Swallowing, mastication, or blowing the nose
  • Tongue and oral hygiene implementation
  • The wash-out effect of the salivary, nasal, and crevicular fluid outflow
  • The active motion of the cilia of the nasal and sinus walls
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7
Q

Most organisms can survive in the oropharynx when they adhere to…

A

either soft tissues or the hard surfaces

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8
Q

What are the six major ecosystems of the oral cavity?

A

-tonsils
-tongue
-floor/roof of mouth
-subgingival tissue
-saliva
-crowns, implants, etc.

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9
Q

What is a biofilm in nature?

A

A thin, slimy film of bacteria that adheres to a surface

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10
Q

What is a biofilm composed of?

A

microbial cells that interact closely with neighboring cells mutually benefiting each other when one organism removes another’s waste products and uses them as an energy source

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11
Q

What is a biofilm encased in?

A

matrix that acts as a barrier

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12
Q

What does a plaque matrix do?

A

Surrounds the bacteria within the plaque biofilm

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13
Q

What is a plaque matrix composed of?

A
  • inorganic and organic components that originate from the bacteria
  • Major components: polysaccharides derived from bacterial metabolism of carbs
  • Minor components: salivary glycoproteins
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14
Q

Water channels are commonly found in biofilms which form…

A

primitive circulatory system that removes waste products and brings fresh nutrients to the deeper layers of the film

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15
Q

What are the main inorganic components of biofilm?

A
  • Calcium
  • Phosphorus
  • Trace amounts of sodium, potassium, fluoride
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16
Q

Main source of inorganic components of supragingival plaque is primarily…

A

saliva

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17
Q

As the mineral content in saliva increases, the biofilm mass becomes calcified to form…

A

calculus

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18
Q

What is the definition of dental plaque?

A

a structured, resilient, yellow-grayish substance that adheres tenaciously to intraoral hard surfaces, including removable and fixed restorations

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19
Q

The extracellular matrix makes it impossible to remove plaque by…

A

rinsing or with use of sprays

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20
Q

What is dental plaque composed of primarily?

A

microorganisms

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21
Q

____________ plaque is found at or above the gingival margin

A

Supragingival

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22
Q

__________ plaque is found below the gingival margin, between the tooth and the gingival pocket

A

Subgingival

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23
Q

When plaque is in direct contact with the gingival margin, it is called ________ plaque

A

marginal

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24
Q

Supragingival plaque and tooth-associated subgingival plaque are critical in…

A

calculus formation and root caries

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25
Q

Tissue-associated subgingival plaque is important in…

A

the tissue destruction that characterizes different forms of periodontitis

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26
Q

Where is the initial growth of supragingival plaque?

A

along gingival margins and interdental spaces
- may also originate from grooves, cracks, or pits

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27
Q

Where does plaque growth later?

A

coronal direction

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28
Q

What is materia alba?

A

Soft, white, accumulation of bacteria, food matter, and tissue cells

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29
Q

What does materia alba consist of?

A

salivary proteins, bacteria, desquamated epithelial cells/disintegrating food debris

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30
Q

Is materia alba easily displaced with water spray?

A

YES

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31
Q

Is plaque easily displaced with water spray?

A

NO

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32
Q

What patient population generally has materia alba?

A

older patients

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33
Q

What is calculus?

A

Hard deposit that forms via the mineralization of dental plaque and that is generally covered by a layer of unmineralized plaque

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34
Q

Biofilm becomes mineralized by _________ and _________ salts from the saliva

A

calcium and phosphate

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35
Q

Biofilm formation usually starts between the ___ and ___ day of plaque formation

A

1st and 14th

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36
Q

Calcifying plaques may become 50% mineralized in ___ days

A

2

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37
Q

Calcifying plaques may become 60-90% mineralized in ___ days

A

12

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38
Q

_______ is the primary source for supragingival calculus formation

A

Saliva

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39
Q

_________________ provides the minerals for subgingival calculus

A

gingival crevicular fluid

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40
Q

Why does calculus play a major role in periodontitis?

A

keeps plaque close to the gingival tissues and makes it difficult to remove the irritant (plaque)

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41
Q

What is the irritant: plaque or calculus?

A

plaque

42
Q

How can calculus be removed?

A
  • Cannot be removed with a toothbrush, floss, etc.
  • Must be removed professionally with periodontal instrumentation
43
Q

What can accelerate calculus formation?

A

smoking and mouth breathing

44
Q

What are the features of supragingival calculus?

A
  • Coronal to the gingival margin
  • White or yellowish in color
  • Derives minerals from the saliva
  • Commonly found adjacent to salivary gland ducts
  • Approximately 30% mineralized
45
Q

What can you do to see supragingival calculus?

A

blow air on it

46
Q

Where is most of the supragingival calculus found?

A
  • lingual of mand anteriors
  • buccal of max 1st molars
  • adjuacent to salivary gland ducts
47
Q

What percent of supragingival calculus is mineralized?

A

30%

48
Q

What are the features of subgingival calculus?

A
  • Located below the crest of marginal gingiva; not clinically visible
  • Explorer and radiographs are best for detecting
  • Derives minerals from inflammatory exudate
  • Dense, dark brown or black due to blood components and/or bacterial degradation
  • Can be tenacious and firmly attached to the tooth
  • Approximately 60% mineralized
49
Q

What is more mineralized: supragingival or subgingival calculus?

A

SUBgingival

50
Q

What percent of subgingival calculus is mineralized?

A

60%

51
Q

What is subgingival calculus dervied from?

A

minerals from inflammatory exudate

52
Q

How can you best detect subgingival calculus?

A

Explorer and radiographs are best for detecting

53
Q

What color is subgingival calculus?

A

Dense, dark brown or black due to blood components and/or bacterial degradation

54
Q

Where does calculus attach to teeth?

A
  • Surface irregularities on enamel and cementum (cingulum, CEJ, root concavities, furcations)
  • Areas of demineralization
  • On cementum
55
Q

Where does calculus attach to the cementum?

A
  1. Organic pellicle
  2. Mechanical locking into surface irregularities
  3. Close adaption to gentle depression or sloping mounts of unaltered cementum
  4. Bacterial penetration into cementum surfaces
56
Q

What are the three phases of dental plaque accumulation?

A
    1. Formation of pellicle on tooth surface
    1. Initial adhesion/attachment of bacteria
    1. Colonization/plaque maturation
57
Q

Where does the pellicle originate from?

A

saliva

58
Q

What is the pellicle?

A

Thin, protein-based, structureless membrane

59
Q

Pellicle can be detected on clean enamel surfaces within _____ minute(s) after their introduction into the mouth

A

one

60
Q

What is the pellicle primarily made of?

A

glycoproteins

61
Q

Pellicle takes approximately __ days for it to develop into its condensed, mature structure

A

7

62
Q

Bacteria that adhere to tooth surfaces do not contact the enamel directly, but interact with the acquired enamel…

A

pellicle

63
Q

What are the two layers of the pellicle?

A
  • a thin basal layers that is very difficult to remove, even with harsh chemical and mechanical treatments
  • a thicker globular layer that is easier to detach
64
Q

Dental enamel is permanently covered with an _________ _____ from the moment that teeth erupt

A

acquired pellicle

65
Q

What is the significance of the pellicle?

A
  • protective (barrier against acid)
  • lubrication
  • nidus for bacteria (development of plaque)
  • aides in the attachment of calculus
66
Q

The metabolic activity of the primary colonizers modifies the local microenvironment in ways that can…

A

influence the ability of other bacteria to survive in the dental plaque biofilm

66
Q

Colonizing bacteria can be detected within ___ minutes after introduction of sterile enamel into the mouth

A

3

67
Q

What are the three phases of colonization?

A
    1. Transport to the surface
    1. Initial reversible adhesion
    1. Strong attachment
68
Q

The primary colonizing bacteria adhered to the tooth surface provides new receptors for attachment by other bacteria as part of a process known as

A

coadhesion

69
Q

Biofilm maturation is a highly specific event that involves a __________ aggregation of different bacteria

A

nonrandom

70
Q

The transition from early supragingival dental plaque to mature plaque growing below the gingival margin involves a shift in…

A

the microbial population from primarily gram-positive organisms to high numbers of gram-negative bacteria

71
Q

What are the stages of biofilm formation?

A

Stage 1- pellicle formation
Stage 2 - bacterial colonization (day 1-14)
Stage 3 - plaque maturation (14-24)

72
Q

At what stage/day is gingivitis evident?

A

stage 3 - plaque formation
day 14-24

73
Q

What happens on day 1 of biofilm formation?

A

gram (+) cocci

74
Q

What happens on days 2-4 of biofilm formation?

A

filamentous forms grow on cocci; intercellular matrix forms and connects colonies

75
Q

What happens on days 4-7 of biofilm formation?

A

filamentous forms increase; rods and fusobacteria appear

76
Q

What happens on days 7-14 of biofilm formation?

A

vibrios and spirochetes appear; gram (-) species increase; clinical inflammation visible

77
Q

What happens on days 14-24 of biofilm formation?

A
  • Plaque is composed of densely packed vibrios, spirochetes and filamentous bacteria
  • Biofilm is well-established; channels established to distribute nutrients, remove wastes, allow free-flowing bacteria to form new colonies
78
Q

What are the steps from pellicle to biofilm formation?

A
79
Q

Approximately _______% cocci during first 4 hours

A

47-85

80
Q

Most abundant colonization occurs on what parts of the tooth initially?

A

proximal surfaces, fissures and gingival sulcus

81
Q

Initial colonizers are gram ___ aerobic and faculative organisms

A

positive

82
Q

Secondary colonizers are…

A

P. intermedia, P. gingivalis, Capnocytophaga species, spirochetes, motile rods, gram (-) anaerobic organisms

83
Q

When energy sources are introduced (sucrose) microorganisms produce…

A
  • Acid
  • Intracellular polysaccharides (reserve energy source)
  • Extracellular polysaccharides (glucans [dextrans] and fructans [levans])
84
Q

What is dextrans?

A

Viscous, sticky substances that anchor bacteria to pellicle and stabilize plaque mass

85
Q

What is levans?

A

energy source

86
Q

What are the factors that affect plaque accumulation?

A
  • Mechanical removal (forces from mastication, toothbrushing, tongue movement, etc.)
  • Availability of nutrients
  • Undisturbed environment
  • Interaction between bacteria and host immune response
87
Q

Organisms in biofilm _________X more resistant to antibiotics

A

1000-1500

88
Q

Biofilm matrix has properties that slowdown _________ penetration

A

antibiotic

89
Q

Do some patients form plaque faster than others?

A

Yes! Heavy and light plaque formers exist! However, in both cases, it takes days before the plaque is clinically visible. Patients cannot justify poor oral hygiene by being heavy plaque formers.

90
Q

_____ _____ is rapidly liquefied by bacterial enzymes and cleared from the mouth by salivary flow/muscles of mastication

A

Food debris

91
Q

Dental plaque is or is not a derivative or food debris?

A

IS NOT

92
Q

Plaque can or cannot be removed by spraying water?

A

cannot

93
Q

As plaque matures, it becomes resistant to…

A

mechanical removal

94
Q

Biofilm forms in 3 stages and matures within _______ days

A

14-24 days

95
Q

As bacteria search for nutrients, they migrate where?

A

sub gingivally

96
Q

Host defends itself via inflammatory response; ________ is initiated

A

gingivitis

97
Q

What should you know about materia alba?

A
98
Q

What should you know about dental plaque?

A
99
Q

What should you know about calculus?

A

Patient Care III (8 decks)

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