Ch. 17 Dental Soft Deposits, Biofilm, Calculus, and Stain

Question 1

Dental biofilm and other soft deposits

Answer 1

Dental biofilm
Acquired pellicle
Materia alba
Food debris

Question 2

Acquired pellicle

Answer 2

Thin, acellular tenacious film formed of proteins, carbs and lipids

Can form over any tooth or prosthesis

Thickest around gingival margin

*Forms immediately upon exposure to saliva, fully formed within 30-90 mins

Supra=clear translucent until disclosing solution

Significance: protection, lubrication, nidus (where things can multiply) for bacteria, attachment of calculus

Not resilient enough to withstand pt oral self care

Question 3

Dental biofilm

Where it adheres and what the micro biome is composed of

Answer 3

Can adhere to acquired pellicle, teeth and restorations

Oral micro biome composed of microorganisms, their genetic makeup and environments of oral cavity

Question 4

Stages in dental biolfilm formation

Answer 4

1. Formation (initial attachment)
2. Bacterial multiplication and colonization (microorganisms =primarily grow)
3. Matrix formation (continues to grow)
4. Biofilm growth
5. Maturation (disperse-single cells or clumps)

Question 5

Days 1-2 in biofilm growth
Days 2-4
6-10
10-21

Answer 5

Gram positive cocci

Matures by 72 hrs and capable of initiating inflammatory process
-forms into rods

Matured to just gram negative rods

Gingivitis clinically evident

Question 6

Supragingival biofilm forms in ___ layers
Sub in __

Answer 6

2
4

Question 7

Dental biofilm

Inorganic elements
Organic elements

Answer 7

Calcium, phosphorus, fluoride

Carbohydrates and proteins

Question 8

Biofilm is heaviest on
Lightest on

Accumulation areas

Answer 8

Lingual, posteriors and proximal surfaces
Anteriors

Crowding, rough teeth, opposite missing teeth or in between teeth (occluding or neighboring)

Question 9

Critical pH for enamel demineralization

Critical pH for root dentin demineralization

Answer 9

5.5

6.7 (more porous=happens faster than enamel)

Question 10

Significance of dental biofilm

Answer 10

Caries, periodontal disease, gingivitis

Question 11

Development of dental caries

Answer 11

Cariogenic food stuff > dental biofilm > acid formation > demineralization >cavitated lesion

Question 12

Materia alba

Answer 12

Soft whitish cottage cheese like texture and appearance

Visible without application of disclosing agent

Can be removed with water spray, oral irrigator or tongue action

Question 13

Food debris

Answer 13

Collection at cervical third and proximal embrasures

Vertical food impaction

Question 14

Calculus can form on

Supra gingival primarily around ___

Answer 14

Clinical crowns of natural teeth
Dental implants
Dentures
Other dental prosthesis

Around CEJ

Question 15

Calculus composition
Inorganic content

Answer 15

Calcium
phosphorus carbonate
sodium
magnesium
Trace elements
Fluoride in calculus
Crystals and calculus compared with teeth and bone

Question 16

Calculus composition
Organic content

Answer 16

Epithelial cells
Leukocytes
Mucin from saliva

Question 17

Most mineralized tissue in body is the

Answer 17

Dental enamel

Question 18

Calculus formation time

Answer 18

Untouched
12 days
-average time required for primary soft deposit to change to mature mineralized stage

24-48 hours
-mineralization can begin when pts personal daily oral hygiene inadequate

Question 19

Calculus formation steps

Answer 19

1. Pellicle
2. Biofilm
3. Biofilm mineralized

Question 20

What impacts amount of calculus

Answer 20

Salivary flow
More saliva more calc

Question 21

Microorganisms in biofilm layer perpetuate ____ ____ both ___ & ___

Answer 21

Inflammatory state

Supra and sub gingivally

Question 22

Daily control of biofilm is essential

Prevention of calculus by what chemotherapeutic agents

Answer 22

Pyrophosphates
Zinc citrates
Triclosams
Chemotherapeutics (in toothpaste and mouthwash)

Question 23

Apatite

Answer 23

Group of phosphate minerals usually
Hydroxyapatite
Fluorapatite
Chlorapatite

Question 24

Non surgical periodontal therapy

Answer 24

Deep cleaning with scaling and root planning to eliminate plaque and tartar from perio pockets