Week 12 Cariology Flashcards
what is the recipe for caries
tooth, biofilm and food source
what are the bacteria types that cause caries
-strep mutans
- strep sanguis
- strep mitis
-bacteroides melaninogenicus
- lactobacillus
when does lactobacillus appear
as environment becomes more anaerobic
what bacteria is considered normal oral flora and slows the growth of strep mutans
strep mitis
describe bacteroides melaninogenicus
obligate anaerobe
-associated with periodontal disease
describe dental plaque
- gelatinous mass of bacteria adhering to tooth surface
-biofilm
describe cariogenic bacteria metabolism
bacteria consume sugars and the waste product is acid
what pH does enamel deminerlize at? dentin?
enamel- 5.5
dentin 6.2
how long does pH remain below 5.5 for after each sugar exposure
20-60 minutes
what is the food source for caries
fermentable carbohydrates
what is preferred carb source for strep mutans
sucrose
what is the epidemiology for caries
-younger children (2-8) have had minor decrease in caries prevalence
- carier prevalence has remained constant for older children
- minority youth still at highest risk
- lower income youth still at most risk
what are some things that have been introducted to decrease caries rates
fluoride toothphaste
electric toothbrushes
water picks
- fluoridated water
education
why have caries not decreased significantly over the last 30 years
bad diet and drugs
what are the sites for caries initiation
-pits and fissures
- smooth surfaces: interproximal contacts (class 2 and 3) and near gingiva (class 5)
- root surfaces
where are pit and fissure caries found and what class is this
-class 1
- occlusal surfaces of posterior teeth
-buccal surface of posterior molars: buccal pit
- lingual surface of lateral incisors
what is the most prevalent location for caries and how can they be prevented
pit and fissure. prevent with sealants
how do you detect pit and fissure caries
- not a stick- use explorer to drag along surface to check for softness
-clinical visualization- shadowing - radiographs
how long does it take for caries to form in pit and fissures
presence of high concentrations of strep mutans in pits and fissures is followed by caries in 6-24 months
when is it important to place sealants
shortly after eruption of teeth
how do you diagnose buccal and lingual caries
visually
how do you diagnose interproximal caries
with bitewings not PAs
what are smooth surface caries associated with
high sugar intake
- soda sippers
describe root surface caries
- comparatively rapid succession
- often asymptomatic
-closer to pulp
-more difficult to restore
what are recurrent/secondary caries
caries developed at margin of a restoration
how do you visually diagnose caries
color: dark means probably arrested
-matte vs shiny: matte is lots of caries, shiny is a little bit of caries
how do you feel for caries
if soft and leathery its a cavity
what factors should be considered in managing caries
-general health
- xerostomia: radiation and chemotherapy, medical conditions, medications
-fluoride exposure
going towards caries management and moving away from:
caries prevention and caries treatment
how do we prevent caries
- oral hygiene instructions: plaque free surfaces dont decay
- dietary counseling: identify sources and reduce frequency and ingestion
- sealants
what are sealants
- thin resin coating placed on chewing surfaced os teeth with or without enameloplasty
how do you arrest caries
- fluoride
- oral hygiene environment: reduce biofilms
- dietary changes
- professional cleanings
- address xerostomia
what is the intermediate option to managing caries
resin infiltration
what is E2
inner surface of enamel close to dentin
what is D1
outer surface of dentin
when can you use resin infiltration
up to D1
when is silver diamine fluoride used
in kids
what are the terms for classifying and determining mangament of carie
-sound tooth structure
-initial caries
- moderate caries
-advanced caries
define sound tooth structure
no clinically detectabl elesion. dental hard tissue appears normal in color, translucency, and gloss
define initial caries and what tooth layers are affected
- E1, E2 or D1
-earliest detectable lesion compatible with mild demineralization.
-lesion limited to enamel or to shallow demineralization of cementum/dentin.
-mildest forms are detectable only after drying. - when established and active lesions may be white or brown and enamel has lost normal gloss
define moderate caries and what tooth layers are affected
-D2
visible signs of enamel breakdown or signs the dentin is moderately demineralized
define advanced caries and what tooth layers are affected
- D3
- enamel is fully cavitated and dentin is exposed. dentin lesion is deeply or severely demineralized
