Caries Formation Flashcards
1
Q
What are the primary factors of caries? (4)
A
Host
Microbial flora
Substrate
Time
2
Q
According to the modified keyes diagram what are the factors?
A
Primary modifying - oral environment
Secondary modifying - environmental factors
3
Q
This is a layer that contains microorgranisms
A
Biofilm
4
Q
What is an acquired pellicle?
A
if the plaque has no microorgranisms within them.
5
Q
Biofilm is composed of? (4)
A
Bacteria
By-products
Extracellular matrix
Water
6
Q
The microorganisms found in plaque are foreign. T or F
A
False, they are found in the normal oral flora
7
Q
Streptococcus mutans are usually very adherent to the tooth structures especially in the _______ and __________
A
pits and fissure
mesial surface of the molars
8
Q
Streptococcus mutans causes the biofilm to increase in _______, __________, _________, and _________
A
Carbon dioxide
Lactate
Acetate
Peroxide
9
Q
The presence of streptococcus mutans causes the environment of the biofilm to become__________?
A
Anaerobic
10
Q
Rapid _________ metabolism in the presence of ______________ forms acids
A
Anaerobic
suitable substrates
11
Q
What is an important factor in mature biofilm?
A
Time
12
Q
______________ byproducts causes the pH to drop
A
Metabolic
13
Q
What are the critical pH of enamel and dentin respectively?
A
5.5 and 6.2
14
Q
Low pH = _______
A
Demineralization
15
Q
What are the indispensable factors of caries? (4)
A
Tooth
Substrate
Time
Biofilm
16
Q
Which would dissolve faster in the presence of acids, Enamel or Dentin? Why?
A
Dentin, they only have 60-64% of HA crystals
17
Q
What areas of the teeth are considered Caries Suceptible?
A
Pits and fissure
Proximal surfaces
CEJ
Lingual pits of lateral incisors
18
Q
What areas of the teeth are considered Caries resistant?
A
Facial surfaces of the anterior teeth
Incisal edges of the anterior teeth
Cuspal tips of posterior teeth
19
Q
Which are more susceptible to caries, Anteriors or Proximals? why?
A
Proximals because they are more exposed when we chew our food
20
Q
These are shelters of the microorgranisms
A
Faults such as Pits and fissures
21
Q
What is the composition of saliva?
A
Calcium and Phosphate ions
22
Q
It is important to have a lot of saliva because?
A
Saliva aids in the mechanical washing of the tooth surfaces
23
Q
The saliva should have what kind of viscosity?
A
Watery
24
Q
This is when the calcium and phosphate ions leaves the tooth
A
Demineralization
25
This is when calcium and phosphate ions diffuses into the tooth
Remineralization
26
what does IAP stand for?
Ion activity product
27
KSP stands for?
Solubility Product Constant
28
SI stands for?
Saturation index
29
if SI is negative it means _________
there is demineralization occurring
30
ISP < KSP = SI is __________-
Negative
31
ISP > KSP = SI is ___________
what does the above mean?
SI is positive meaning there is no demineralization
32
What is the pH level of stimulated saliva?
7.4-7.8 pH
33
50% of stimulated saliva comes from __________ gland?
Parotid
34
There are _______ ions and ______ bicarbonates in stimulated saliva
More
35
What are the ions found in saliva?
Sodium
Chloride
Bicarbonate ions
36
Stimulated saliva is less ________ than unstimulated saliva
Hypotonic
37
What is the main buffer system?
Bicarbonates
38
what is the pH level of unstimulated saliva?
6.8-7.2 pH
39
The minor salivary glands produces _____ of the total saliva in the mouth?
10%
40
what is another gland that aids produces the unstimulated saliva other than the minor salivary glands?
Submandibular glands
41
Unstimulated saliva is more _________ than plasma
Hypotonic
42
A decrease in ions and an increase in potassium and phosphate indicates a _______ flow rate
low
43
There is an increase in ____,____, & ____ and a decrease in ____ and _____ in high flow rates of saliva
Na, Cl, HCO3
| K and PO4
44
Which is more efficient in mechanical cleansing of the tooth surfaces, low flow rate or high flow rate?
High flow rate
45
Organic composition of saliva (6)
Digestive enzyme
Proteins with lubricating function
Ca binding proteins
Carbon dioxide hydration
Antimicrobial proteins
Growth factors
DPC CAG
46
The thicker the saliva the more prone the tooth is to _______________
Caries formation
47
Increase in buffer capacity, ________ caries formation
Less
48
This is the rate at which a substance is removed or cleared from the mouth or reduced to a very low concentration
Oral clearance rate
49
Oral clearance rate is dependent on?
Saliva flow rate
| Volume of saliva before and after swallowing
50
What is the normal threshold of swallowing?
1.1 mL
51
What is the normal pH of the buffer capacity of saliva?
6 - 7.5 pH
52
Buffer capacity is determined by the lab through ___________
titration of saliva
53
Stimulated flow is the most _________
alkaline
54
What are the antimicrobial enzymes of saliva?
Lysozyme
Lactoperoxidase
Lactoferrin
Salivary peroxidase and thiocyanate
Immunoglobulins
Amylase
LLL SIA
55
These are also found in our tears
Lysozyme
56
These increases availability of oligosaccharides and substrates
Amylase
57
This suppresses biofilm formation on tooth surfaces
Lactoperoxidase
58
This inhibits the growth of some iron dependent microorganisms
Lactoferrin
59
This is the most common caries when it comes to anatomical sites
Pit and fissure caries
60
Pit and fissure caries usually occur in? (5)
Occlusal surfaces of the molars and pre molars
Lingual pit of maxillary incisors specifically lateral incisors
Buccal pit of molars
Buccal / lingual grooves of molars
Facial surfaces of teeth with pits or fissures
61
Which premolar is more prone to caries formation and why?
Maxillary 2nd premolar because it has a lot of grooves and has a wrinkled appearance.
62
What is the distinguishing characteristic of the maxillary 1st molar?
Cusp of carabelli
63
You don't usually find caries in the facial surfaces due to? (2)
Mechanical washing by the lips
| Anatomy of the teeth
64
What is the appearance of pit and fissure caries?
Triangular configuration with the apex on the external surface and the base towards the pulp
65
Once the caries reaches the DEJ what happens?
There will be rapid lateral progression due to the lateral dichotomous branching of the dentinal tubules. The apex is now at the pulp and the base is at the DEJ
66
What is the enamel rod configuration in pit and fissure caries?
tent like
67
What is the most caries resistant?
Lower lingual surfaces of the anteriors
68
What is the appearance of smooth surface caries?
Apex is on the pulp side
| Base is on the eternal tooth surface
69
What does relatively caries resistant mean?
it means they can still be affected by caries
70
Proximal caries begins where?
Just below the contact points
71
What is the first sign of caries formation?
opacity
72
what is an opacity?
areas of decalcification
73
if it is smooth it is caries. t or f
false, it has to be rough
74
During the early stage of caries, what does the caries look like?
Faint white opacity of the enamel without apparent loss of continuity of the enamel surface
75
What are the other names of greatest convexity?
Crest of curvature
| Greatest bulge of the tooth
76
Describe acute dental caries (6)
```
Has pain
Lighter in color
Soft
Yellowish
Cheesy
Leathery
```
77
These are caries that occur in areas that are usually caries resistant
Rampant caries
78
Why are children more prone to caries?
Greater permeability of the enamel
More organic content
Wider dentinal tubules
79
Where do nursing milk caries occur?
Upper anterior teeth
80
Is meth mouth an example of rampant caries?
yes
81
Describe chronic dental caries?
Asymptomatic
darker in color
hard surface
brown or black
82
Which is more common in adults, chronic or acute caries?
Chronic
83
This is caries that has become static and does not show any tendency for further progression
Arrested caries
84
Describe the appearance of arrested caries
```
Large open cavity
Lack of food retention
Superficially softened and decalcified dentin
Brown stained
Polished appearance
Hard
```
85
What does eburnation of dentin mean?
Dentin is smooth and looks polished
86
another name of primary caries
virgin caries
87
Another name for secondary caries (3)
Recurrent caries
Marginal caries
center caries
88
Secondary caries is caries along the __________ or even in the perimeters of __________.
Restorations
| Crown
89
What is the definition of recurrent caries?
Caries that occurs on a tooth with existing restoration or condition
90
Earliest sign of caries formation in the enamel
Opacities which are usually whiter than the rest of the enamel
91
Earliest sign of caries in the dentin
Caries on the DEJ
92
Rapid lateral progression of caries occurs due to the?
Dichotomous branching of the dentinal tubules
93
Explain incipient caries
Caries that is less than halfway through the enamel, not reaching the DEJ
94
Explain moderate caries
Caries is more than halfway through the enamel but does not reach the DEJ
95
Explain advanced caries
Caries that reach half of the dentin
96
Explain severe caries
Caries that involves the enamel and more than half of the dentin and more than half the distance toward the pulp
97
G.V. black class 1
Occlusal areas or Buccal areas or Lingual pits on the tooth surfaces
98
G.V. Black classification class 2
Proximal areas of the posteriors
99
G.V. Black classification class 3
Caries on the proximal areas of the anterior teeth not including the incisal angle
100
G.V. black classification class 4
Caries on the proximal areas of anterior teeth including the incisal angles
101
G.V. black classification Class 5
Caries on the gingival third of the crown on facial or lingual surfaces of the tooth
102
G.V. black classification class 6
Caries on the cuspal tips or any smooth surface areas except the lateral incisors
103
ICDAS stands for?
International caries detection and assessment system
104
before classifying in ICDAS, you should do the following: (3)
Clean and dry the tooth
Remove plaque
use a ball ended explorer
105
Code 0 in ICDAS
Sound tooth surface after 5 seconds of drying
106
Code 1 in ICDAS
There is visual change in enamel after prolonged drying.
107
Code 2 in ICDAS
Distinct visual change in enamel even without prolonged air drying
108
Code 3 in ICDAS
Localized enamel breakdown is seen but no dentinal involvement
109
Code 4 in ICDAS
Underlying dark shadow from the dentin
110
Code 5 in ICDAS
Distinct cavity with visible dentin. Less than half of the tooth surface is involved
111
Code 6 in ICDAS
Extensive distinct cavity with visible dentin. More than half of the tooth surface is involved
112
What are developmental defects that are considered sound: (6)
```
Enamel hypoplasia
Fluorosis
Tooth wear - Attrition
Tooth wear - Abrasion
Tooth wear - Erosion
Stains
```
113
What is Attrition?
Physiologic wearing of the tooth structure. usually seen in the lower anteriors
114
What is abrasion?
Wearing of the cervical portion of the teeth due to incorrect brushing
115
What is erosion?
Chemical wearing of the tooth structure due to acids
116
What is the ICDAS 2 digit coding method?
Restoration and the caries code
117
What is the restoration code 1?
Partial sealant
118
What is the restoration code 2?
Full sealant
119
What is the restoration code 3?
Tooth colored restoration / composite
120
What is the restoration code 4?
Amalgam restoration
121
What is the restoration code 5?
Stainless steel crown
122
What is the restoration code 6?
PFM crown, veneer or gold crown
123
What is the restoration code 7?
Lost or broken restoration
124
What is the restoration code 8?
Temporary restoration
125
What is the restoration code 96?
Tooth surface cannot be examined
126
What is the restoration code 97?
Tooth is missing due to caries
127
What is the restoration code 98?
Tooth is missing due reasons other than caries
128
What is the restoration code 99?
Unerupted
129
What does the code 46 mean?
Amalgam restoration, Extensive cavity with visible dentin, more than half of the tooth surface is involved.
130
What does code E mean in ICDAS?
Root surface cannot be visualized due to calculus thus it cannot be classified.
131
Difference of code 1 and 2 in ICDAS root caries codes
Code 1 - loss of anatomical contour is less than 0.5 mm
| Code 2 - loss of anatomical contour is 0.5 mm or more than 0.5 mm
132
ICDAS code 1 and 2 is ICCMS classification?
Initial
133
Moderate classification in ICCMS is codes ______ and _____ in ICDAS
3 and 4
134
Severe classification in ICCMS is codes ___ and _____ in ICDAS
5 and 6
135
What are the classifications according to ADA
Sound
Initial
Moderate
AAdvanced
136
What are the classifications according to ICCMS
Sound
Initial
Moderate
Extensive
