Cariology Flashcards
(165 cards)
1
Q
__________should not be given to people with milk allergy & Lactose Intolerance
A
CPP-ACP
2
Q
Chemical plaque control should be given to people with_______
A
high caries risk
3
Q
What are the different types of flouride toothpaste
A
NaF, Na MFP, Stannous & Amine Fluoride
4
Q
Concentration of fluoride recommended for different ages:
- 18 months - 5 y.o.:________ppm
> 5 y.o.:________ppm
A
- 400-500ish
-1000
5
Q
Is NaF/MFP toothpaste more effective ?
A
NaF slightly more effective
6
Q
- What is the minimum age for fluoride rinse
A
6 y.o.
7
Q
Fluoride rinse concentrations:
- weekly/fortnightly rinse= _______ppm
- daily rinses = _______ppm
A
- ~ 900ppm (0.2%)
- ~ 220ppm (0.05%)
8
Q
Fluoride mouth rinse should be used at the time of a given day when_______
A
toothpaste is not being used
9
Q
Anything with Fluoride conc. above______ppm is prescription ONLY
A
5000
10
Q
Fluoride gel is more effective in_______dentition ?
A
Permanent
11
Q
What is the typical conc. of fluoride gel ?
A
9000-12,300 ppm
12
Q
- What is the minimum age for fluoride gels
A
- 10 y.o.
13
Q
When applying fluoride gels, it is important to advice patients_______
A
NOT to swallow
14
Q
In what stage of dental caries does white spot lesion occur but the enamel is still intact ?
A
Acidogenic
15
Q
In acidogenic stage, the damage is_______
A
reversible w/ fluoride
16
Q
Degradation of the organic matrix & collagen occur in______stage ?
A
Proteolytic stage
17
Q
_________ contributes to the break down of collagen & other ECM proteins in dentin degradation
A
Matrix Metalloproteinase (MMP)
18
Q
Wt is the percentage of space around rods/prisms in enamel?
A
10%
19
Q
________is the most accurate predictor for future caries
A
Past caries experience
20
Q
What does stephen curve indicate the measure of changes in___________
A
plaque pH following a glucose drink
21
Q
Acquired pellicle is acellular homogenous organic film that forms on enamel by___________
A
selective absorption of salivary protein
22
Q
dental caries or dental lesion is not a disease ?
A
dental lesion
23
Q
There are about_______species of bacteria in the mouth ?
A
500
24
Q
What is stagnation area in dental ?
A
Ares where bacteria thrive & debris not adequately cleaned
25
Plaque BY ITSELF (is/is not) sufficient to cause dental caries ?
is not
26
The acid produced by fermentation is trapped against the tooth surface by_________
plaque biofilm
27
Which plaque hypothesis is used now ?
Ecological plaque hypothesis
28
What does ecological plaque hypothesis state ?
Caries organisms......
Caries organisms may present at the sound site but shift balance by the change of a local enviornment (i.e. sugar)
29
The first clinical sign of dental caries is a_________which is revealed when____________
white spot lesion, thick plaque removed by toothbrush
30
- Radiolucency provide evidence for_________
- Tooth mineral lost only
31
The demineralised enamel will breakdown to form______if________
Cavity, sugar exposure remains high & not disturbed
32
Cavity progression is faster in dentine because___________
it is less mineralised & has higher protein content
33
lesion arrest and natural repair occur if plaque is removed before_________starts
CAVITY development (breakdown of demineralised enamel)
34
T/F, daily cycle of demineralization & reminerlization occur
T
35
- Floride conc. of water in HK is_____ppm
- Optimal fluoride level in Australia is___ppm
- 0.5
- ~0.6-1.1
36
Fluorapatite is (less/more) resistant to future acid attack ?
more
37
teeth of individuals living in areas w/ proper floridated water develope________thru daily cycles of de & remineralization ?
Veneer of Fluorapatite
38
What are the 3 most common sites for plaque buildup ?
along gingival margins, interproximal area, groove & fissures
39
T/F, dental caries is mainly is social disease ?
T, also lifetyle related disease
40
Arrested lesion is a________that feels________when probing
Remaining scar after prev. tx, Hard
41
What are the 4 risk factors for dental caries ?
1. Dental plaque
2. dietary sucrose
3. insufficient fluoride
4. insufficient saliva
42
Cariogenic bacteria contain 6 species of Streptococcus and 2 other what species ?
Lactobacillus spp, Actinomyces spp
43
Initial white spot lesion takes______to turn into a CAVITY
~ 4 years
44
White spot lesion is the sign that the enamel is________
dissolving
45
Plaque Index:
- Score 0=
- Score 1=
- Score 2=
- Score 3=
- No plaque
- No Plaque visible even w/ drying, but can be picked up w/ probe
- Visible plaque (no need probing), formed 24 hrs after careful brushing
- THICK visible plaque, been present for days/weeks
46
What tooth surfaces are scored in Plaque index ?
Buccal & Lingual. Buccal first
47
In white spot lesions, there are more which specie of bacteria than health enamel ?
Strep MUTAN
48
in CAVITATED lesions,__________ make up about 30 % of total flora ?
Strep MUTAN
49
in MUSHY CAVITATED lesions, which 3 species are more prevalent ?
Lactobacilli, Prevotellae, BifidoBacterium
50
Oral pH rise in which 3 circumstances
1. Inc salivary flow due to chewing
2. Sugar free gum chewed
3. Cheese consumed
51
Saliva has buffering function by_________
Neutralizing acids formed by bacteria fermentation
52
T/F, saliva contains Ca & Phosphate ions to reminerlize
T
53
The critical pH is derived from the theoretical solubility of________
Enamel in saliva NOT plaque
54
Plaque pH return to resting pH much quicker on_________than teeth w/ carious lesions
Cavity free
55
Plaque in (upper/lower) jaw is more acidogenic
Upper
56
In Vipeholm study, does sugar in solution @ mealtime INC caries incidence ?
NO
57
In vipeholm study, Sugar in______form @ what time INC caries incidence the MOST ?
Sticky form BETWEEN meals
58
In vipeholm study, when sugar is decreased in all forms as much as possible, no one dvlp caries ?
F, a few subjects still dvlp caries
59
_________studies states that the relative cariogenicity of fructose to sucrose remains inconclusive ?
Turku Sugar studies
60
What is the greatest indicator of future caries risk ?
Past caries experience
61
Ppl w_____or more DMFS @ baseline is 7 times more likely to dvlp future caries lesions
4
62
Optimal fluoride lv in community depends on___________
how much water ppl drink
63
On avg, water fluroidation reduce caries risk by____% in perm. teeth & _____% in primary teeth
60, 50
64
_____color of disclosing agent indicate acid pdtion and pH < 4.5
light blue
65
Blue/purple color of disclosing agent indicates plaque biofilm has been around for >_____hours ?
>48
66
_____color of disclosing agent indicates thin layer of plaque biofilm ?
Pink/Red
67
No fluoridated toothpaste should be recommended to individuals <_________
< 18 months
68
Brush (before/after) breakfast
After
69
- Chlorhexidine is effective against which 3 types of microbes ?
- gram +., gram -, yeasts
70
- Chlorhexidine belongs to chemical group of________
- What are the 3 forms of administration
- What is the minimum age to use Chlorhexidine
- bisbiguanides
- 0.2/0.12% solution, 1% gel, chewing gum
- 6 y.o.
71
T/F, chemical plaque control is given to patients w/ good oral health
F, only to those w/ bad oral health & high caries risk
72
Fortnightly fluoride rinse reduce caries by____%
25
73
________is metabolised by bacteria into a side product which neutralize plaque acids ?
Arginine
74
SnF2 is used @____% for children &_____% for adults in solutions
8, 10
75
- What are the 4 fxns of Stannous Fluoride (SnF2)
- It has been shown to be effective @________
- Does it stop & reverse dental lesions ?
- Prevention of gingivitis, infection, caries & relieve dental hypersensitivity
- Stopping & reversing dental lesions
- YES
76
SnF2 containing (dentifrices/solution or gel) has higher risk of staining ?
solution or gel
77
Deficiency in which 2 vitamins can disrupt salivary flow & protective qualities of saliva ?
A,D
78
Foods containing phytic acid can dec. the absorption of__________, which contribute to_________
Fe Zn Mg Ca, demineralization
79
If there is no water fluoridation, what toothpaste should be given to a person that is 12 months old ?
400-500ppm fluoride toothpaste
80
Saliva is alkaline & super-saturated w/_______________
Ca & PO4
81
In areas where water fluoride conc. is ~ 1ppm or higher, caries experience is on avg. _________%lower
40-60
82
What teeth are score in the Plaque Index
16, 11, 26
46, 41, 36
83
What are the 6 clin. presentations of dental caries
1. White spot lesion
2. Loss of enamel (pitting/cavitation)
3. Hole dvlps (enamel lost, dentine goes soft, brown & mushy)
4. Hole gets bigger
5. Tooth breakdown (loss of tooth structure & height)
6. Exodontia/tooth death
84
Salivary amylase break down______to______
starch to smaller sugars
85
What antibody is found in saliva
IgA
86
Does sticky form of sugar AT MEAL time inc. caries incidence
Yes
87
Does solution form of sugar AT MEAL time inc. caries incidence
No
88
What is the caution when using SnF2 on cavities
Not to use on deep cavities > can cause local necrosis & moderate pulp inflammation
89
According to Daily Reference Value, the maximum of sugar intake is______g/day, which = approx.______%of daily energy intake
60g, 10%
90
The use of fluoride toothpaste lead to____% caries prevalence reduction in dvlped countries
25
91
What are the four indications for fluoride rinses
1. undergoing ortho tx
2. post-irradiation hyposalvation
3. unable to perform adequate toothbrushing
4. high caries risk
92
What are the 3 types of fluoride gels
APF gel (12,300ppm), natural NaF gel (2%), Stannous fluoride gel (0.4%)
93
- What are the indications of Fluoride VARNISH
- 1. EVEN HIGHER risk of caries,
2. patients w/ removable ortho appliances/partial dentures,
3. children over 6 y.o/adults exposed to greater cariogenic challenge,
4. local application to INITIAL carious lesions to minimize progression
94
- What is the ppm of fluoride VARNISH
- What is the minimum age to use it ?
- 22,600ppm
- 6 y.o.
95
What are the 4 contraindications of fluoride varnish
1. ULCERATIVE gingivitis & stomatits
2. known allergies
3. ppl w/ low caries risk who consume optimally fluoridated water
4. home use of fluoride varnish
96
CPP-ACPf
- _______ppm fluoride
- age_______
- 1000ppm
- older than 6 y.o.
97
When is CPP-ACP applied
after brushing & flossing
98
What is the mechanism of silver fluorides ?
cause bacterial cell wall lysis > lose ability to reproduce on surviving bacteria
99
The probable toxic dose of fluoride is________mg/kg of body weight
32-60
100
What are the 2 tx options to remove fluoride from body for fluoride poisoning
1. give the patients a drink of milk
2. oral administration of 5% calcium gluconate/calcium lactate/ milk of magnesia
101
what is the difference in mechanism between sclerosed dentine & reactionary dentine
- Sclerosed dentine: dentine tubules become occluded w/ mineral crystals > Reduced permeability to protect pulp
- Reactionary dentine: Laid down by odontoblast > add THICKNESS to protect pulp
102
Radiolucency restricted to enamel (is certain/unlikely/may or may not) indicate a cavity
unlikely
103
Radiolucency extending to outer half of dentine (is certain/unlikely/may or may not) indicate a cavity
may or may not
104
- In acidogenic stage: bacteria______________
- In aciduric stage: bacteria_____________
- produce acids from metabolizing fermentable carbs (sugars)
- tolerate & thrive in low pH (pH < 5.5)
105
Electrical Conductance Exam detects ________caries
Dentine ONLY
106
Fiber optics method detects what caries
Proximal caries in adults
107
DIAGOdent is used widely for diagnosis of what caries
initial occlusal carious lesion
108
Is teeth cleaning required b4 using DIAGOcam
NO
109
Tactile may only detect_____%of dental caries
24
110
Caries is usually (unilateral/bilateral)
bilateral
111
Which tooth is the LEAST susceptible to dental caries
canines
112
(Anterior/posterior) sextants are more prone to caries
Post
113
____or more new active carious lesions in one year usually indicates a person is high risk
2
114
In a 6 y.o. child, caries in (primary/first perm. molar) is a better indicator of caries risk
primary
115
The new system to assess caries risk focus on_____________
identifying the principal factors contributing to a person's current caries status
116
The normal unstimulated flow of saliva=______mL/min
0.3
117
The normal stimulated flow of saliva=______mL/min
1-2
118
Chlorhexidine is mainly advised for patients under which 5 circumstances
1. Physically/Mentally handicapped patients
2. Acute Periodontal Inflamation
3. Reduced salivary flow
4. Bad Breath (Halitosis)
5. High caries risk ?
119
Chlorhexidine has +ve effect on________ but inconclusive role in___________
gingivitis, dental caries
120
What are the 5 mechanisms of fluoride ?
1. Reducing demineralization
2. Promotes mineralization
3. Formation of fluroapatite > More resistant to future acid challenge
4. Antimicrobial (topical)
5. Inhibit bacterial sugar metabolism
121
(Chlorhexidine/Fluoride rinse) is more effective for ppl w/ high caries risk
Fluoride rinse
122
- White spot after drying corresponds to ICDAS code____
- White spot when wet corresponds to ICDAS code____
- 1
- 2 or 3?
123
- Enamel breakdown after drying corresponds to ICDAS code____
3
124
- Shadow from dentine corresponds to ICDAS code____
4
125
- Cavity into dentine corresponds to ICDAS code____
5
126
ICDAS codes ranges from_____to_____
0 to 6
127
Total score of plaque index is______
36
128
T/F, ICDAS codes 0-6 are recorded on the patient form
F, only codes 2-6 are recorded
129
- According to ICDAS, what is the treatment for codes 3 & 4
- What is the treatment for code 2
- Sealant
- Home care + fluoride
130
List the 5 major events of Caries Management Sys. ?
Patient assessment > Clin. assessment > Analysis > Risk management > Monitoring
131
What is the "MOST" vulnerable site for plaque build up & caries
Grooves (pit & fissure sys.)
132
(white flour/wholemeal flour) is less cariogenic because____________
wholemeal flour, it is unrefined carbs
133
- Which 4 sugar substitutes are NON-nutritive
- Saccharin, Acesulfame-K, Aspartame, Thaumatin
134
- Which 4 sugar substitutes are Nutritive
- Xylitol, Sorbitol, Mannitol, Maltitol
135
- Government definition of high sugar drinks=______
- Mid sugar drinks=______
- > 8g/100mL
- 5-8g/100mL
136
Dropping below critical pH promotes____________
demineralization
137
In a study, the drinking of red bull containing 11g sugar/100g cause a salivary pH decrease to______
3.336
138
How to convert from ppm to mg F/g paste
Divide ppm by 1000
139
Resting flow rate for visual hydration examination of saliva flow (Step 1 of saliva testing) :
- LOW: >_____seconds
- NORMAL: _____seconds
- HIGH: <_____seconds
- > 60
- 30-60
- < 30
140
What does step 2 of saliva testing examine ?
Saliva viscosity
141
What does step 3 of saliva testing examine ?
pH
142
Testing the quantity of saliva (Step 4 of saliva testing)
- VERY LOW: <_____mL
- LOW: ______mL
- NORMAL: >______mL
- <3.5
- 3.5-5.0
- >5.0
143
- Parotid gland contribute to____% saliva
- Submand. + subling. glands contribute to____% saliva
- 30
- 70
144
most of the money is spent in (1/2/3/4) prevention
2
145
List 3 limitations of bitewing radiograph when it comes to diagnosis ?
1. Cannot detect early occlusal lesions
2. Cannot distinguish active vs arrested lesions
3. Underestimate lesion size coz of 2D nature
146
Dosage for fluoride varnish:
- Prim. dentition: _____mg F
- Mixed dentition:_____mg F
- Perm. dentition_____mg Fq
- 6 (0.25mL)
- 9 (0.40mL)
- 17 (0.75mL)
147
high caries risk patient require recall appt. every_____months
3 (for monitoring, application of F-varnish)
148
In KaVo DIAGNOcam, enamel appears_____-like, carious lesions absorb more______& appears_______
glass, light, dark
149
- Which caries diag. methoud use infrered light
- Which caries diag. method use blue light fluorescence
- DIAGNOcam
- DIAGNOdent
150
List 5 questions to ask in dental history
1. Freq. of visits
2. past dental tx
3. ongoing dental tx
4. lv of anxiety
5. previous bad experience ?
151
- List the 5 questions to ask in diet history
- When to use the 24 hr diet questionnaire ?
- snacks between meals, soft drinks between meals, whether they add sugar in tea/coffee, sport drinks, acidic food
- If score > 2 in the diet history questions
152
Caries Diagnosis methods:
- ________shows greater sensitivity
- ________shows greater specificity
- DIAGNOdent
- ICDAS
153
10 steps of caries management sys.:
1. Diet assessment
2. ___________
3. Clinical & bitewing radiographic survey
4. Diagnosis & caries risk management
5. ___________
6. ___________
7. Oral hygiene coaching
8. ___________
9. Monitor
10. __________
1. Diet assessment
2. Plaque assessment
3. Clinical & bitewing radiographic survey
4. Diagnosis & caries risk management
5. Preparation of tx plan
6. Case presentation
7. Oral Hygiene coaching
8. Topical fluoride application (professional/home)
9. Monitor
10. Recall program tailored to patient risk
154
Buffering Ability test (step 5 of saliva testing)
- VERY LOW ability= score________
- LOW ability= score_________
- NORMAL ability= score_________
- 0-5
- 6-9
- 10-12
155
Does radiolucency itself indicate cavity
No
156
List two of the three 100% effective prevention in HIGH RISK patients
1. prof. topical app. w/APF gel (12,300ppm F) ONCE A WEEK FOR 4 WEEKS + DAILY mouthrinsing w/ 0.05% NaF solution
2. DAILY mouthrinsing w/0.05% NaF/0.2% Chlorhexidine solutions
157
What does step 5 of saliva testing examine ?
Buffering
158
A radiolucency on x ray indicates________ONLY
Loss of tooth mineral
159
Bitewing radiolucency extending to inner half of dentine (is certain/unlikely/may or may not) indicate a cavity
is certain
160
Silver diamine fluoride sol'n @_____% is effective in arresting active dentine caries
38
161
What are the indications of stannous fluoride gel (0.4%)
Remineralization of white spot lesion & hypomineralized enamel, root caries
162
(APF/NaF gel) should NOT be used in tooth-colored RESTORATIONS
APF
163
What are the 4 indications of NaF gel
hypomineralization, enamel erosion, exposed dentine, carious dentine
164
What are the 3 compounds recommended for fluoridating drinking water in australia
H2SiF6, Na2SiF6, NaF
165
Fiber help clean teeth by_____________
promoting saliva pdtion & mechanical scrubbing action
