Plaque mediated disease

Question 1

Where can you find plaque?

Answer 1

Gingival (above the gumline), subgingival (below the gumline), smooth surface (side of tooth), approximal (inbetween teeth), fissure, crevice of gingiva

Question 2

What is the initial phase of dental caries and is it reversible?

Answer 2

a white spot appears and yes

Question 3

Which area of the mouth is most vulnerable?

Answer 3

molars, harder to reach

Question 4

What are some causes of human caries?

Answer 4

eating sugar, low salivary flow, low exposure to fluoride

Question 5

What causes dental caries?

Answer 5

bacteria are involved in the formation of lesions on the basis of their function

Question 6

Which type of bacteria causes the most problems in terms of caries?

Answer 6

acidogenic as they can produce acid from sugar

Question 7

Which two bacteria are best at being acidoduric and acidogenic?

Answer 7

mutans streptococci and lactobacilli

Question 8

What does the ecological plaque hypothesis explain?

Answer 8

the polymicrobial nature of caries

Question 9

What is disease a result of?

Answer 9

the shift in balance of the resident microflora

Question 10

What is demineralization?

Answer 10

loss of calcium and phosphate

Question 11

Below which pH are you at risk of caries?

Answer 11

5.5

Question 12

How can we prevent sugars from producing cariogenic species?

Answer 12

eat less sugar

Question 13

How can we prevent selection for cariogenic species?

Answer 13

physical removal by oral hygiene techniques such as flossing or by increasing the host’s capacity to clear the cariogenic species

Question 14

How can we prevent low pH from increasing risk of caries?

Answer 14

fluoride exposure, enamel repair

Question 15

How can we prevent an increase in organic acids from sugar fermentation to decrease pH?

Answer 15

buffer capacity of host saliva, some bacteria use organic acids in food chain

Question 16

What does periodontal disease refer to?

Answer 16

disease of supporting tissues of the tooth

Question 17

The environment of gingival crevices is aerobic. True or false?

Answer 17

False

Anaerobic

Question 18

There is lack of protein in gingival crevices. True or false?

Answer 18

False, an abundance of proteins

Question 19

Gingivitis is irreversible. True or false?

Answer 19

False, it is a reversible inflammation of the gums

Question 20

What is the fluid that surround the gingiva called?

Answer 20

Gingival curricular fluid, which is very proteinaceous in nature

Question 21

The bacteria in the gingival crevice need to be able to metabolise what?

Answer 21

Protein

Question 22

The bacteria in the gingival crevice need to be able to metabolise what?

Answer 22

True

Question 23

Is gingivitis a precursor for periodontal disease?

Answer 23

Yes

Question 24

According to the ecological plaque hypothesis, what are the characteristics of periodontal disease?

Answer 24

high subgingival biofilm levels, strong inflammatory response, high GCF flow, bleeding, high pH & temp, obligately anaerobic proteolytic biofilm

Question 25

According to the ecological plaque hypothesis, what are the characteristics of effective oral hygiene?

Answer 25

low subgingival biofilm levels, minimal inflammation, low GCF flow, presence of gram positive , facultative, saccharolytic biofilm, periodontal health

Question 26

How are periodontal diseases classified?

Answer 26

gingival diseases, chronic periodontitis, necrotising periodontal disease, aggressive periodontitis

Question 27

In chronic periodontitis, in addition to gingivitis what else occurs?

Answer 27

loss of attachment, which is irreversible, alveolar bone loss may also occur, leads to increased depth and bleeding on probing

Question 28

Why is the flora in healthy gingivae and in periodontal disease very different?

Answer 28

Some periodontopathogens can attach to the mucosa and form a biofilm coating on the tongue as there are lots of nutrients and large surface area. Thought to be a reservoir of infection

Question 29

Could tongue piercings be a risk factor for periodontal disease?

Answer 29

yes as they increase number of bacteria in the mouth

Question 30

What does necrotising mean?

Answer 30

to destroy tissue

Question 31

What are the characteristics of necrotising periodontal disease?

Answer 31

underlying systemic infection, painful, causes halitosis, grey pseudo-membrane forms on the gingivae

Question 32

What are the bacteria responsible for necrotising periodontal disease?

Answer 32

spirochaetes and fusobacteria

Question 33

Aggressive periodontitis is associated with high levels of what?

Answer 33

AA, which produces a very potent leukotoxin which destroys WBCs

Question 34

What are the characteristics of aggressive periodontitis?

Answer 34

Rare condition, usually in female teenagers, leads to a rapid loss of attachment

Question 35

How can aggressive periodontitis be treated?

Answer 35

with tetracycline/ metronidazole/ amoxicillin because of anaerobic nature of bacteria

Question 36

What is pregnancy gingivitis caused by?

Answer 36

presence of steroid hormones in GCF

Question 37

What is Group A Strep gingivitis?

Answer 37

Gingivitis caused when bacteria that causes sore throats gets into the gingival crevices

Question 38

What are the features of diabetes gingivitis?

Answer 38

inflammation, impaired healing and may increase insulin resistance

Question 39

What is HIV periodontal disease characterised by?

Answer 39

presence of opportunistic pathogens

Question 40

Is there an association between periodontal disease and general health?

Answer 40

yes, linked to CVD, respiratory disease, diabetes, risk of premature labour and risk of low birth weight

Question 41

Why does periodontal disease put you at risk of other conditions?

Answer 41

inflammation related to gram negative species results in toxic metabolites and increased LPS, the periodontium is very vascular so inflammatory mediators can reach far sites and oral bacteria can enter bloodstream