Caries

Question 1

What tissues does caries affect?

Answer 1

hard tissues of the teeth (enamel, cementum, dentine)

Question 2

Definition of lesion

Answer 2

any structural change in a body part resulting from injury or disease

Question 3

What forms a lesion?

Answer 3

demineralisation of hard tissues

Question 4

Cause of caries

Answer 4

dietary sugars that are broken down by microorganisms in biofilm on a tooth surface, producing acids that demineralise tooth enamel over time

Question 5

Definition of caries

Answer 5

Dynamic process. Chemical dissolution caused by metabolic activity in biofilm on a tooth surface

Question 6

What are the different ways caries can be classified?

Answer 6

Site, activity, stage, relationship to existing restorations

Question 7

How can caries be classified by site?

Answer 7

Coronal (e.g. pit/fissure/interproximal/occlusal) or Root

Question 8

How can caries be classified by activity?

Answer 8

active or inactive (arrested)

Question 9

How can caries be classified by stage?

Answer 9

initial, moderate or extensive

Question 10

How can caried be classified by relationship to existing restorations?

Answer 10

primary or secondary caries

Question 11

What is primary caries?

Answer 11

caries on unrestored tooth tissue

Question 12

What is secondary caries?

Answer 12

Caries affecting margin of existing restoration

Question 13

Epidemiology definition

Answer 13

study of how often diseases occur in different groups of people and why

Question 14

What is the most common non-communicable disease worldwide?

Answer 14

dental caries (not an infection therefore non-communicable)

Question 15

What data can be used to assess dental caries epidemiology?

Answer 15

mean DMFT (permanent teeth) or dmft (deciduous)

Question 16

What is the most common reason for hospital admissions for children aged 5-9?

Answer 16

dental caries

Question 17

What are the regional variations in enamel?

Answer 17

surface enamel more mineralised and harder than deeper enamel (closer to ADJ), hardness decreases from incisal to cervical region

Question 18

Why is caries considered a dynamic process?

Answer 18

de- and remineralisation is dynamic. Early stages of caries can be reversed until demineralisation exceeds remineralisation and caries progresses into dentine and tooth surface breaks down.

Question 19

Definition of biofilm

Answer 19

thin layer of living organisms (most interested in bacteria, but fungi and viruses also present)

Question 20

Free sugars definition

Answer 20

sugars added by the manufacturer and sugars naturally present in honey, syrups and fruit juices

Question 21

What 4 elements are required for caries?

Answer 21

tooth tissue, free sugars, biofilm (plaque) and time

Question 22

How does demineralisation occur?

Answer 22

sugars are broken down by microorganisms in biofilm to release acid which dissolves hydroxyapatite in enamel/dentine

Question 23

Graph illustrating pH change after sucrose exposure

Answer 23

Stephan Curve

Question 24

What is the predominant cause of tooth loss in all ages?

Answer 24

Caries

Question 25

How is caries diagnosed?

Answer 25

Clinically (looking at it) or radiographically (radiolucency)

Question 26

Appearance of early lesion

Answer 26

Chalky, white appearance (where plaque has collected in sulcus) or stained, dark spot (e.g. in pit)

Question 27

Appearance of moderate lesion

Answer 27

shadow around initial lesion (decay entering deeper layers)

Question 28

How can caries be treated?

Answer 28

non-operative or operative treatment

Question 29

What does non-operative treatment involve?

Answer 29

diet analysis/advice, increase fluoride exposure, OHI

Question 30

Is water fluoridated in Scotland?

Answer 30

No, naturally occurring fluoride is less than 0.1 mg/l