Quiz 3. Carious Lesions

Question 1

Dental Caries Intro

Answer 1

One of the most common diseases in humans
#1 in children
Causes pain/disability
Lead to infection, tooth loss

Question 2

G.V Black, founder of modern dentristy

Answer 2

Added microbic plaque was the source of acids which is still believed today

Question 3

Multifactorial Disease Process

Answer 3

There must be Time, Susceptible Tooth, Plaque Microorganisms, Substrate (Food, Carbs) present in order for a Caries to form

Question 4

Caries are:

Answer 4

Tooth covered by a film of bacteria that’s exposed to a carb substrate and bacterial metabolizes it.
Weak acid byproducts are produced
If enough acid changes pH, enamel demineralized

Question 5

Description of Carious Lesions

Answer 5

Categorized where located. 4 General areas
Pit and fissure caries (occlusal surface grooves)
Smooth surface caries (anterior)
Root surface caries
Secondary/recurrent caries (on tooth surface adj to an existing restoration)

Question 6

Incipient lesion

Answer 6

Initial stage of tooth decay, hasn’t penetrated enamel

Looks like white spot on enamel

Question 7

How caries move

Answer 7

Start in enamel (hard to get through), get to junction, then dentin (spreads quickly)

Question 8

Caries stages

Answer 8

Incipient
Progess of Demineralization
Over or frank lesions

Question 9

All Caries start as incipient lesion

Answer 9

but not all turn out overt, can stop

Question 10

Overt or frank lesions

Answer 10

characterized by actual cavitation (loss of enamel integrity)

Question 11

Rampant decay occurs if:

Answer 11

development of overt lesions is rapid/extensive (on more than one tooth)
After excessive and frequent intake of sucrose (carbs) and presence of xerostomia

Question 12

Direct Connection of Bacterial Biofilm to the body of a lesion

Answer 12

Demineralization
Remineralization
Enamel Rods (interlocking structure)
Ragged profile created from demineralization
Progression depends on pH in saliva, flow, rate

Question 13

Caries almost always

Answer 13

start in the shape of a triangle

Question 14

Dental Caries Bacteria

Answer 14

Mutans Steptococcus (main)
Lactobacillus: rod shaped
300 species of bacteria in plaque

Question 15

Mutans Streptococci and caries (MAIN)

Answer 15

Major pathogenic species involved in caries.

Found in large numbers in plaque that forms instantly over developing smooth surface lesions

Question 16

MS and caries are able

Answer 16

to produce extracellular glucans and acids (byproducts)

It causes damange through lactic acid (mostly) and other acid

Question 17

What pH does enamel loss occur

Answer 17

5.5 or lower is demineralization

Question 18

Lactobacilli and Caries

Answer 18

They aren’t required for caries development but can contribute to it.
Common after irradiation therapy for head and neck cancer, saliva is stickier

Question 19

Sources of Acids

Answer 19

Sources of acid in oral biolfilm ecology:
Dietary
Bacterial
Environmental
Intrinsic (bulimina)
May all work in combination

Question 20

Diet

Answer 20

Solid/sticky sugars 40min to neutralize
Liquid sugars 20 min to neutralize
Times don’t start until fully out of teeth
Amount of sugars and frequency and time all affects caries rate

Question 21

Tooth Susceptibility (Most)

Answer 21

1st and 2nd molars

Mand premolars

Question 22

Tooth Susceptibility (Least)

Answer 22

Anterior teeth (Tongue, self cleaning)

Question 23

Major Salivary Glands

Answer 23

Parotid
Submand
Sublingual
Saliva helps to prevent caries

Question 24

Saliva

Answer 24

Repairs damage by neutralizing acids and replacing lost materials (remineralized)

Question 25

Parotid Gland

Answer 25

Secrete sodium bicarbonate (neutralize acid) | Initiate carb digestion

Question 26

Function of Saliva

Answer 26

``` Lubrication Clearance of food Buffer for pH 6.4-6.7 Antibacterial Ca, P, and Flouride saturation (used to remineralize) ```

Question 27

Conditions in which caries happen

Answer 27

Coronal dentin caries (crown of tooth) Occur at pH 6 Secondary/recurrent caries

Question 28

Coronal Dentin Caries

Answer 28

``` Enamel protects underlying dentin Dentin protects pulp Pits and Fissures (susceptible) Smooth surface Interproximal (more susceptible, harder to remove bacterial from flossing) ```

Question 29

Root caries

Answer 29

Must have root exposed | Risk factors are age, gender, flouride exposure, illness, oral hygiene

Question 30

Secondary/Recurrent Caries

Answer 30

Occur from imperfections in/around restoration Chance of happening again 50% Prevention is key Applying flouride-releasing materials to bone the tissue

Question 31

The Stephan Curve

Answer 31

Drop and recovery curve w/ sucrose

Question 32

Demineralization and Remineralization Principles

Answer 32

Demineralization is caused my plaque acid. Remineralization needs same ions w/ flouride as catalyst Flouride chemically stronger than Ca

Question 33

Fluorohydroxyapatite vs Hydroxyapatite

Answer 33

Flouri. is more resistant to acid damage

Question 34

Depth of Remineralization

Answer 34

Topical procedures are successful in stimulating surface remineralization