CARIOLOGY

Question 1

biofilm-mediated, diet modulated, multifactorial, non-communicable, dynamic disease resulting in net mineral loss of dental hard tissues

Answer 1

Dental Caries

Question 2

Dental caries is determined by

Answer 2

biological, behavioral, psychosocial, and environmental factors

Question 3

caries lesion (cavity) develops as consequence of

Answer 3

dental caries process

Question 4

the clinical judgment, including detection of and assessment of caries signs (lesions), to determine the presence of disease

Answer 4

Caries Diagnosis

Question 5

The purpose of clinical caries diagnosis is to achieve

Answer 5

best health outcome for your patient

Question 6

The purpose of clinical caries diagnosis is to achieve the best health outcome for your patient - which can be achieved by

Answer 6

selecting: the best management option for each lesion type, to inform the patient, and to monitor the clinical course of the disease

Question 7

concept that reflects the mineral balance, (mineral loss, net mineral gain, or statis over time)

Answer 7

Caries Activity

Question 8

Caries active =
Caries inactive =

Answer 8

caries initiation/progression
caries arrest/regression

Question 9

the likely/expected course of dental caries

Answer 9

Progression of Caries

Question 10

implies there are no detectable signs of dental caries

Answer 10

Caries Free

Question 11

implies there are no detectable cavities in dentine (may have non-cavitated clinically)

Answer 11

Cavity Free

Question 12

actions taken to interfere with the mineral loss at all caries disease stages

Answer 12

Care Care/Management/Control

Question 12

actions taken to interfere with the mineral loss at all caries disease stages

Answer 12

Care Care/Management/Control

Question 13

traditionally referred to the inhibition of caries initiation (primary prevention)

Answer 13

Caries Prevention

Question 14

loss of tooth mineral due to acids. In dental caries, this process is biofilm-mediated

Answer 14

Demineralization

Question 15

net gain of mineral in previously demineralized tissue

Answer 15

Remineralization

Question 16

a “consortium of microorganisms” that stick to the tooth surface - microorganisms are embedded in extracellular polymeric matrix

Answer 16

Dental Biofilm

Question 17

clinical term used commonly when referring to the dental biofilm

Answer 17

Dental Plaque

Question 18

describes the substrates or microorganisms capable of promoting dental caries

Answer 18

Cariogenic

Question 19

describes substances or procedures capable of arresting dental caries

Answer 19

Cariostatic

Question 20

number of teeth/surfaces that have caries lesions, restorations, and/or are missing due to caries, accumulated by an individual up to a designated point in time

Answer 20

Caries Experience

Question 21

the number/proportion of individuals with caries in a given population at a specified threshold, at a certain point in time

Answer 21

Caries Prevalence

Question 22

number/proportion of individuals with new or progressing caries at a specified threshold in a given population, detected at a given period of time

Answer 22

Caries Incidence

Question 23

“ongoing, systematic collection, analysis, and interpretation of caries data, essential to the planning, implementation, and evaluation of public health practice, and the timely dissemination of these data to those who need to know so that action can be taken”

Answer 23

Caries Surveillance

Question 24

probability that the caries lesion will appear/progress if the conditions remain the same within a period of time

Answer 24

Caries Risk

Question 25

environmental, behavioral, or biological factor (confirmed by evidence) that directly increases the probability of caries occurrence

Answer 25

Caries Risk Factor/Determinant

Question 26

risk factor is a determinant that can be modified by intervention for example to reduce the probability of caries

Answer 26

Modifiable Risk Factor

Question 27

characteristic associated with increased probability of caries or increased occurrence of caries - not casually associated with the disease

Answer 27

Caries Risk Indicator/Marker

Question 28

measures taken to reduce the caries risk that the individual or population is subject to

Answer 28

Caries Risk Management

Question 29

clinical signs of caries

Answer 29

caries lesion

Question 30

Caries lesion is clinical signs of caries that can be categorized according to the

Answer 30

1. anatomical location - coronal or root/cementum 2. severity - cavitated versus non-cavitated 3. depth of penetration into tissue - enamel, dentin, pulp 4. activity status - active versus inactive

Question 31

identification of the signs of dental caries, where caries lesions are “identified at various detection thresholds and stages”

Answer 31

Caries Lesion Detection

Question 32

caries lesion detection - stages

Answer 32

non-cavitated, micro-cavitated, cavitated

Question 33

frequently used term for non-cavitated caries lesion

Answer 33

initial caries lesion

Question 34

initial caries lesion refers more to _____ than _____

Answer 34

stage of severity than to the lesion activity

Question 35

popular term for a non-cavitated that was used in the past that refers only to the color

Answer 35

White-spot Lesion

Question 36

"White-spot lesion" may be confused for other pathologies such as

Answer 36

molar incisor hypomineralization (MIH) or dental fluorosis

Question 37

"White-spot lesion" doesn't consider

Answer 37

the lesion activity

Question 38

tooth structure without clinically detectable alteration of the natural translucency, color, or surface

Answer 38

Sound Enamel/Dentin

Question 39

tooth structure without clinically detectable alteration of the natural translucency, color, or surface

Answer 39

Sound Enamel/Dentin

Question 40

caries lesion on previously sound tooth structure

Answer 40

Primary Caries

Question 41

recurrent caries developed adjacent to a restoration (filling)

Answer 41

Secondary Caries

Question 42

demineralized carious tissue left in place before a restoration (filling) is placed

Answer 42

Residual Caries

Question 43

lesion in dentine that is missed on visual exam but caught radiographically or diagnostic aide

Answer 43

“Hidden Caries”

Question 44

historic term to describe multiple caries lesion on same patient (used in association with early childhood caries or radiation caries)

Answer 44

Rampant Caries

Question 45

change in caries lesion severity and/or activity stage in response to changes of lesion environment

Answer 45

Caries Lesion Transition

Question 46

early onset of caries in young children with often fast progression, likely result in complete destruction of primary dentition

Answer 46

Early Childhood Caries (ECC)

Question 47

Early Childhood Caries is defined as the presence of

Answer 47

one or more decayed (non-cavitated or cavitated lesion), missing (due to caries), or filled surfaces in any primary tooth of a child under the age of 6

Question 48

any sign of smooth-surface caries in a child younger than three years of age, and from ages three through five, one or more cavitated, missing (due to caries), or filled smooth surfaces in primary maxillary anterior teeth or a decayed, missing, or filled score of greater than or equal to four (age 3), greater than or equal to five (age 4), or greater than or equal to six (age 5)

Answer 48

Severe Early Caries

Question 49

one or more decayed (non-cavitated or cavitated lesion), missing (due to caries), or filled surfaces in any primary tooth of a child under the age of 6

Answer 49

Early Childhood Caries (ECC)

Question 50

identification of the presence of caries lesion visually

Answer 50

Visual Detection of Caries

Question 50

identification of the presence of caries lesion visually

Answer 50

Visual Detection of Caries

Question 51

Atraumatic tactile evaluation of tooth surface integrity and texture of the caries lesion using a dental instrument.

Answer 51

Tactile Assessment

Question 52

use of radiographs to detect radiolucencies (darkening on x-rays) that is interpreted as caries lesion

Answer 52

Radiographic Detection

Question 53

episodic assessment of the effect of an intervention or natural behavior on clinical and/or radiographic status of caries lesion

Answer 53

Caries Lesion Monitoring

Question 54

Non-surgical measures interfering with initiation of new caries lesion and rate of caries lesion progression

Answer 54

Non-Operative Caries Treatment/Management/Control/Care

Question 55

Non-Operative Caries Treatment/Management/Control/Care aims to

Answer 55

keep the caries process at subclinical level and/or arrest caries lesion progression at the clinical/radiographic

Question 56

Non-Operative Caries Treatment/Management/Control/Care key elements include

Answer 56

brushing with fluoride toothpaste, other fluoride treatments, dietary modification, oral hygiene measures, etc.

Question 57

surgical intervention to place a restoration (filling) to control caries, to aid biofilm control, and typically to restore form and function

Answer 57

Operative (Restorative) Caries Treatment (Care

Question 58

approach to make cavitated caries lesions accessible to tooth cleaning by removal of overhanding enamel margins

Answer 58

Non-Restorative/Non-Operative Cavity Treatment

Question 59

fluorides that are applied locally, applied directly to the teeth

Answer 59

Topical Fluorides

Question 60

fluoride that is ingested into the body

Answer 60

Systemic Fluorides

Question 61

holistic caries management philosophy focusing on caries lesion control/minimal operative intervention to preserve tissue

Answer 61

Minimal Intervention Dentistry

Question 62

Minimal Intervention Dentistry includes

Answer 62

early caries detection, non-operative treatment, combined with minimally invasive restorative approaches

Question 63

Enamel

Answer 63

highly mineralized epithelial tissue with approx. 85% volume occupied by hydroxyapatite crystals of large size and high crystallinity

Question 64

Enamel Rods

Answer 64

elongated “crystalline” structures

Question 65

Tightly packed ________ form enamel

Answer 65

hydroxyapatite crystals

Question 66

Composition of enamel

Answer 66

Not pure hydroxyapatite crystals – enamel contains inorganic ions with inclusion calcium, phosphate or hydroxyl ions

Question 67

Unit Cell of Hydroxyapatite

Answer 67

Ca10 (PO4)6 (OH)2

Question 68

hardest substance in human body

Answer 68

enamel

Question 69

Enamel formation =

Answer 69

amelogenesis

Question 70

Enamel is made up of tightly bunched _____ crystals

Answer 70

oblong

Question 71

Acquired Pellicle

Answer 71

acellular film that forms on tooth surfaces when exposed to oral environment

Question 72

Acquired pellicle is mostly made up of

Answer 72

Mostly salivary proteins, also carbohydrates and lipids

Question 73

Acquired pellicle maintains oral health by providing

Answer 73

lubrication, de/remineralization, influences composition early microbial flora that colonizes tooth surface

Question 74

Newborns (oral microbiome) are colonized within ______ of birth - what are these microorganisms called?

Answer 74

5 min - pioneer microorganisms

Question 75

5 key domains of determinants of health for influences on children's oral health

Answer 75

1. Genetic and biological factors 2. Social environment 3. Physical environment 4. Health behaviors 5. Dental and medical care

Question 76

3 hypothesis for etiology of caries

Answer 76

specific plaque, non-specific plaque, ecological plaque

Question 77

Specific Plaque Hypothesis

Answer 77

only certain bacteria species are involved in caries process; preventative measures include targeting specific bacteria (immunization)

Question 78

Non-specific Plaque Hypothesis

Answer 78

assumes all plaque/bacteria pathogen/causes caries; preventative measures aimed at all plaque (toothbrushing)

Question 79

Ecological Plaque Hypothesis

Answer 79

suggest shift in pH of biofilm cause shift toward cariogenic bacteria (e.g., S. mutans) in oral environment, resulting in disease

Question 80

Repeated low pH conditions following sugar intake will favor ___________ species - what hypothesis for etiology of caries is this associated with?

Answer 80

acidogenic and aciduric species - Ecological Plaque Hypothesis

Question 81

Caries ecological hypothesis: Dental biofilms metabolize/ferment ______ resulting in

Answer 81

carbohydrates (e.g. Lactobacilli, mutans streptococci) - resulting in acid production that result in caries

Question 82

3 reversible stages in caries process - according to extending caries ecological hypothesis

Answer 82

Dynamic stability stage, Acidogenic stage, Aciduric stage

Question 83

Acidogenic

Answer 83

acid producers

Question 84

Aciduric

Answer 84

Survive in acid environment

Question 85

Does increasing the number of Acidogenic and aciduric bacteria result in caries?

Answer 85

no

Question 86

Increasing the frequency of what results in more acid production?

Answer 86

Increasing frequency of fermentable carbohydrate results in lowered pH, resulting in proliferation of aciduric bacteria, resulting in more acid production

Question 87

At what pH are oral fluids supersaturated (with respect to hydroxyapatite and fluroapatite)

Answer 87

7.4

Question 88

When biofilm pH decreases the solubility of apatite ___________

Answer 88

increases

Question 89

When pH is lowered, supersaturation (with respect to hydroxyapatite) is

Answer 89

reduced

Question 90

At what pH will enamel dissolve?

Answer 90

5.5

Question 91

What is an essential dietary factor to caries development?

Answer 91

free sugars

Question 92

dental caries is the most common ________ disease worldwide

Answer 92

noncommunicable

Question 93

G.V. Black experiment - enamel changes after dental plaque allowed to accumulate undisturbed for 1 week:

Answer 93

no macroscopic changes; distinct signs of direct dissolution of outer enamel at the ultrastructural level (scanning electron); histologically shows slight increase in enamel porosity

Question 94

G.V. Black experiment - enamel changes after dental plaque allowed to accumulate undisturbed 14 days:

Answer 94

a whitish, opaque changes are visible: increased porosity with mineral removal deep to outer surface with start of a subsurface lesion