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Flashcards in Cariology Deck (87):
1

What are the 4 things necessary to create dental caries?

1.TIME 2.Micro-Organisms 3.Substrate 4.Host & Teeth

2

What are three things that TODAY's view of what causes caries incorporates?

1.Education 2.Income 3.Social Class

3

Dental caries is a _______ disease process.

multi-factorial

4

What are the two types of lesions that can occur with enamel exposure to acid?

1.Carious lesion 2.erosion

5

In remineralization: Partially demineralized apatite crystals can grow to their _______. Especially in the presence of ______!

ORIGINAL SIZE!....Fluoride

6

Caries: A ______ disease that progresses very ______ in most individuals.

chronic....SLOWLY

7

In erupting teeth, the outermost surface layer is _____ and ____ in fluoride

porous...low

8

If fluoride is present in the oral fluids, the gradual increase in the surface enamel is called "_______ maturation"

Secondary Maturation

9

Is there a VISUAL sign of caries after 1 week of undisturbed plaque? Is there a HISTOLOGICAL sign?

NO...Histo: yes, increase in enamel porosity

10

How long does it take for White Spot Lesions to appear with Undisturbed Plaque?

2 weeks

11

What is the technique that needs to be used when checking for White Spot Lesions?

Air-drying

12

Histologically, how long does it take for a surface lesion to form with undisturbed plaque?

2 weeks

13

How long does it take to see a White Spot lesion with a chalky surface (no air drying necessary!)? (w/o undisturbed plaque)

4 weeks

14

After 4 weeks of undisturbed plaque, what do you see Histologically?

Enlarged inter-crystalline spaces

15

What are the 4 indications of HIGH risk caries in CAMBRA?

1.Visible Cavites Present 2. Restorations in the last 3 Years 3. Interproximal caries lesions/radiolucencies 4.White Spots on enamel surfaces

16

What is CAMBRA short for?

CArries Management By Risk Assessment

17

If you have a have a W.S.L. that you have been letting plaque grow on for a while, THEN you take the plaque off... how long does it take for the chalky appearance to diminish?

1 week

18

If you have a have a W.S.L. that you have been letting plaque grow on for a while, THEN you take the plaque off... How long does it take to see a normal shiny appearance of normal enamel?

2 weeks

19

When thinking about our Caries Classification Pyramid (D1-D4)... Where on the pyramid will I find "Sub-clinical lesions in a dynamic state of progression/regression"??

The Base of the Pyramid

20

When thinking about our Caries Classification Pyramid (D1-D4)...Where on the pyramid will I find "lesions detectable only with additional diagnostic aids"?

The second rung from the bottom

21

When thinking about our Caries Classification Pyramid (D1-D4)...Which classification level is this, "Clinically detectable enamel lesion with intact surfaces"?

D1

22

When thinking about our Caries Classification Pyramid (D1-D4)... Which classification level is this, "Clinically detectable cavitation limited to enamel"?

D2

23

When thinking about our Caries Classification Pyramid (D1-D4)...Which class am I: "Clinically detectable lesions in dentin"?

D3

24

When thinking about our Caries Classification Pyramid (D1-D4)... Which classification am I: "Lesions into pulp"?

D4...yikes.

25

When thinking about our Caries Classification Pyramid (D1-D4)... WHERE IS THE LINE DRAWN between CAVITATED and NON-CAVITATED lesions????

In D3

26

When thinking about our Caries Classification Pyramid (D1-D4)... When do we switch treatment form chemo-theraputics to drill and fill?

When the lesion becomes caveated in D3 (some schools teach drill and fill all cavities to the dentin/all D3)

27

What are 2 positives of having resident flora?

1.Assist wil nutrient absorption 2. Barrier to colonization by transient bugs

28

Can you "catch" decay?

YES! you can give your strep mutans to people!

29

WHEN is the "WINDOW of INFECTIVITY"? (when most children become inoculated with S.Mutans)...

18-36 months

30

When is the earliest a child can become inoculated with S.Mutans (like before the Window of Infectivity)?

3 months (or earlier!)

31

About ___% of children get MS from MOM, significantly associated with her ______ levels of bacteria referred to as “_______ transmission”

70%...mom...salivary...“vertical transmission”

32

What was the main point of the Sweedish and Japanese studies of transmission of S.Mutans?

that 45-58% of transmission can be HORIZONTAL transmission

33

______ the acquisition of S.Mutans reduces caries experience in both the primary and permanent dentition!!!

DELAYING

34

How do we DELAY transmission of S. Mutans?

Reducing Maternal Bacterial Load!!

35

When looking at the impact of Delayed Transmission: if a child has S.Mutans at age 2 (window of infetivity) WHAT is the % of CARIES in that child at age 4????

89%!!!! BOOM

36

When looking at the impact of Delayed Transmission: If a child has NO S. Mutans at age 2, what % of them have caries at age 4??

25%

37

When looking at the impact of Delayed Transmission: how much of an increase in Decay & Fill Services at age 4 do we see for a child who did not have S.Mutans at age 2 compared to a child WITH S.Mutans at age 2???

5 fold increase in fillings!!!

38

What are the 4 risk factors for Early Transmission?

1. high MATERNAL levels of S.Mutans 2.Sweetend fluids in bed 3.Sugar/Snacks 4.Sharing food with adults

39

HOLY CRAP! In the Common Childhood Diseases graph CARIES was NUMERO UNO....What % of Children have Caries?????

44 FREGGIN %!!!

40

Is the Caries rate in Permanent Teeth of 6-17 year olds increase or decrease from 1971 to 1994?

Decreased!

41

From 1994 to 2002, which age groups saw an INCREASE in caries free teeth?

ALL age groups! (but as you get older, you have less and less caries free teeth)

42

WHY has there been a DECLINE in Caries?? (2 main reasons)

1.Increased Fluoride Exposure (toothpastes and water) 2.improved preventative behaviors/services (better O.Hygiene and Sealants)

43

(Aside) Does brushing decrease the decay rate?

NO! No correlation between brushing and decay!

44

HUGE CONCEPT: What is the most common surface for Caries??? WHAT % of caries occur here?

1.OCCLUSAL surface- 55%

45

HUGE CONCEPT: What is the second most common surface for Caries? What % of caries occur here??

2.Buccal and Lingual Caries!- 34%

46

HUGE CONCEPT: What is the 3 most common surface for caries? What % of caries occur here?

3.Smooth Surfaces (interproximals!)- 11% (CRAZY, interproximal decay is the LEAST common location!!)

47

What are the 3 groups of people/children with the HIGHEST Caries rates???? ___% of underserved children experience 80% of the decay!!!

1.Low Income Children 2.Racial & Ethnic Minorities 3. Children with Special health care needs....20%

48

In general what % of children have HIGH caries?

20%

49

In general what % of children have low caries?

24%

50

In general what % of children have caries (add low and high)?

44%

51

In general what % of children do not have Caries?

56%

52

In the Children (age 3-5) of the American Indian community, what happened to the prevalence and severity of dmfs between 1991 and 1999??

It increased!

53

What has happened to the prevalence of Edentualism in adults 65 years and older from 1957 to 2004??

Decreased (about 3 fold!!)

54

Who is the NEW "AT-RISK" population? Why? (1)

Older individuals, edentualism is decreasing!

55

What are 2 caries factors for the new "at-risk" older population?

1.Xerostomia 2.Previous Restorative Work

56

Interesting....Caries, not _________, is the PRIMARY cause of tooth loss in adults!

periodontal disease

57

What type of Caries is MOST COMMON in older adults? (he asked this again in class!!!)

ROOT caries

58

_______ is increasing prevalence corresponding with decline in caries.

Dental Fluorosis

59

What age group is most affected by dental fluorosis?

12-15 years old

60

What are the 4 factors for dental fluorosis?

1.[F-] 2.Duration/Time of exposure 3.age 4.weight

61

What are the current fluoridation levels in the water? (in ppm, please)...

1.0 ppm

62

2011 USA commission looking to _____ levels of water fluoridation. (INTERESTING!)

reduce

63

Progression of caries: Permanent Teeth: Progression is a ____ process in most individuals (there are exceptions), It takes an average of about ___ years for a lesion to progress through the enamel of permanent teeth

slow..4 years

64

Is caries progression FASTER or SLOWER in primary teeth compared to permanent teeth?

FASTER in primary teeth

65

WHAT are the 5 guiding principles for Caries Mgmt?? NEW SCHOOL DENTISTRY YO!

1.Asses Risk Status 2.Diagnose EARLY 3.Treat (remineralize/control the infection) 4.avoid operative 5.restore Active disease only

66

Guiding Principle #1: Asses Caries Risk- Race/ethnicity, Socioeconomic status, Previous history of caries, Inherited risks, Salivary composition...these are all factors I _____ change.

can't... i hate that word but ok

67

Guiding Principle #1: Asses Caries Risk- Levels of cariogenic bacteria Fluoride exposure, Diet, Oral hygiene, Salivary flow. These are all factors I ___ change.

CAN! Wooo!

68

Guiding Principle #1: Asses Caries Risk- Impact of Race. What ethnic group has the highest caries rate in 2-4 year olds?

American Indians..by far

69

Guiding Principle #1: Asses Caries Risk- Impact of SocioEconomic Status--is there a relationship between income and caries?

YES

70

Guiding Principle #1: Asses Caries Risk- Impact of Previous history of Caries.....Children with caries in primary teeth are ___ times more likely to have caries in their permanent teeth!!!!

3x!!!

71

Guiding Principle #1: Asses Caries Risk- Impact of Inherited risks....________ (______) twins have similar caries patterns but _______ twins don’t.

Monozygotic (identical)....dizygotic

72

Guiding Principle #1: Asses Caries Risk- Impact of Inherited risks....What are 4 genetic differences between us humans?

1.Sructure of our Enamel 2. Immune response to S. Mutans 3.Salivary Gland activity/Composition of Saliva 4.Sugar Metabolism

73

Guiding Principle #1: Asses Caries Risk- Si Se Puede! Levels of Cariogenic bacteria...[S. Mutans] is DIRECTLY related to ______.

Caries Risk

74

Guiding Principle #1: Asses Caries Risk- Si Se Puede! Fluoride Exposure...Regular exposure to ______ fluorides significantly reduces caries risk. (water, toothpaste, varnish)

TOPICAL

75

Guiding Principle #1: Asses Caries Risk- Si Se Puede! Diet..Eat less ______ carbs, eat more _____.

Less FERMENTABLE carbs, more Calcium

76

Guiding Principle #1: Asses Caries Risk- Si Se Puede! Diet.... Sugar intake drops oral ____, which leads to: ________ and altered plaque ecology-->Which Favors _____ bacteria such as streptococci, and lastly their impact is dependent on presence of ______!

pH....Demineralization...aciduric.. flouride

77

Guiding Principle #1: Asses Caries Risk- Si Se Puede! Diet.... What is the double whammy of Acid in the mouth?

1.Demineralization of enamel 2.Promotino of S.Mutans growth

78

Guiding Principle #1: Asses Caries Risk- Si Se Puede! Diet.... What costs more? Milk or soda?

milk, by a lot.

79

Guiding Principle #1: Asses Caries Risk- Si Se Puede! Diet.... When eating Sugar, what are the two main issues to consider?

1. the Form of sugar and 2. Frequency of consumption

80

Guiding Principle #1: Asses Caries Risk- Si Se Puede! Diet.... They SAY stickiness of the sugar is the only thing but matters, BUT you know that ______ is even more important...

FREQUENCY of sugar ingested

81

Guiding Principle #1: Asses Caries Risk- Si Se Puede! Diet....It’s not how much sugar you eat, its ______ you eat it that is important.

HOW OFTEN

82

Guiding Principle #1: Asses Caries Risk- Si Se Puede! Diet..BIG BOY recommendation time!!! Limit the total amount of ADDED sugars to ___ g/day in NON-Fluoridated areas.

40 g/day (54g in a green monster)

83

Guiding Principle #1: Asses Caries Risk- Si Se Puede! Diet..BIG BOY recommendation time!!! Limit the total amount of ADDED sugars to ___ g/day in NON-Fluoridated areas.

55 g/day (54g in a green monster)

84

Guiding Principle #1: Asses Caries Risk- Si Se Puede! Diet..BIG BOY recommendation time!!! The total amount of added sugars should be __-__% of your energy intake.

6-10%

85

Guiding Principle #1: Asses Caries Risk- Si Se Puede! Diet..BIG BOY recommendation time!!! Limit SUGAR intake to __x/day. Preferably at _____.

4x/day..meals

86

Guiding Principle #1: Asses Caries Risk- Si Se Puede! Diet....Sugar and Babies-> Encourages colonization by ______ bacteria like 1. _______ 2. ________.. Also it discourages ________ by noncariogenic bacteria :(

aciduric...1.Strep Mutans 2.LactoBacilli...colonization

87

Guiding Principle #1: Asses Caries Risk- Si Se Puede! Diet....Infants & toddlers with high sugar intake have _____ colonization by S. Mutans and _____ caries rates

Earlier.....higher