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Flashcards in Chapter 9 Deck (105):
1

How do we get caries?

Teeth demineralize during acid attack.
–Every eating event is an opportunity for bacteria to use sugar to make acid.

2

Teeth will remineralize

in between acid attacks.

3

Calcium and phosphorous in saliva replace

Lost minerals

4

Available fluoride in the oral cavity will reduce .

The affect of acid on teeth

5

Normal oral pH is between

6.8-7.0

6

Critical pH is

5.5

7

What happens at critical pH

This is the point teeth will start to demineralize
-bacteria will metabolize to create acid
-good can also have pH of 5.5

8

1st during demineralization Acid moves through

Dentinal tubules

9

The acid produced by bacteria during demineralization process can cause

Increased solubility of tooth structure (calcium hydroxyapatite)

10

Calcium (during demin)

Leaches from tooth structure

11

Demineralize area first appears as

White spot

12

After food clears from mouth

pH starts to return to basic 7.0 and starts remineralization process

13

During remineralization the minerals in saliva

take the same path as the acid to through tubules to replace those that are lost ---calcium and phosphorus

14

during remineralization fluoride will

incorporate into the crystalline surfaces tht have been partially dissolved

15

hydroxyapatite converts into

fluorapatite which fortifies tooth structure against future acid attack

16

when demineralization time is greater than remineralization time

cavities develop

17

when remineraliation time is greater than demineralization time

you remain caries free

18

enamel is

porus

19

how long does it take for cavitation to progress through enamel for high rick person

19-22 months

20

high caries risk person includes:

high carb diet
poor quality saliva
poor oral hygiene
unavailable fluoride

21

how long does it take for cavitation to progress through enamel for low risk person

5 years

22

person for low caries risk includes

Sucrose consumption in diet limited to 5% to 10% of daily calorie intake
Diet rich in whole unprocessed foods and foods that keep pH around 7
Ample saliva
Daily plaque removal
Use of fluoridated toothpaste

23

6 factors that play a role in caries development

1. Carbohydrates in the diet
2. Presence of specific bacteria
3. Susceptible tooth structure/host resistance
4. Absence of fluoride
5.Salivary gland hypofunction
6.Poor oral hygiene habits

24

Most of what we know about the relationship of carbohydrates and dental caries is a result of

the Vipeholm study

25

Vipeholm study

-1945 to 1953
-436 adult residents at a mental institution in Vipeholm, Sweden
-Study conducted to determine if form and frequency of eating sugar had an effect on dental caries

26

During Vipeholm study the subjects were divided into

3 Groups:
1.) Basal diet with 300 g of additional sugar in solution during meals (sweet beverage)
2.) Basal diet with 50 g of additional sugar with bread during meals
3.)Basal diet with in-between snacks of toffee and candy consisting of a small amount of sugar

27

Results of Vipeholm Study: First highest caries rate found in which group?

Group that had in between meal candy

28

Results of Vipeholm Study: Second highest caries rate found in which group?

Group who ate sweet spread on bread

29

Primary factor in caries ctivity

Frequency of sugar intake

30

what can increase incidence of caries

Form of foods:
-Retentive foods that stay in the oral cavity longer than liquids increased the rate of caries

31

Sugar

Exerts caries-promoting effect locally on tooth surfaces.

32

What has the potential to cause caries

All foods and beverages that contain sugar

33

Ultra processed food that does not taste sweet may contain

High Fructose corn syrup (HFCS) to improve shelf life

34

Plaque bacteria will feed on

carbohydrates and produce acid that demineralizes enamel.

35

Bacteria produce acid for as long as

The carbohydrate remains in the mouth

36

When is there an opportunity to for bacteria to make acid

Every time you eat or take a sip of a drink

37

Eating behaviors that are detrimental to teeth

Sipping and Grazing

38

Goal is to keep oral pH

as close to 7.0 for as long as possible throughout the day

39

Research by Stephan and Miller in 1943 demonstrated that oral pH drops

within 3 minutes of rinsing with sucrose.

40

Categories of foods that play a role in caries

Cariogenic
Acidic
Cariostatic

41

Fermentable carbohydrates

1.) Monosaccharide
2.) Disaccharide
3.) Sweeteners used in manufacturing—juice, honey, HFCS, glucose, and refined starch

42

Average sugar consumption

¼ pound each day which is Equivalent to four cans of soda.

43

Ultra-processed foods contain

about 20% sucrose which accounts for 57% of daily calories

44

Cariostatic foods

1.) Do not contribute to initiation of enamel demineralization
2.) May prevent dental caries
3.) Maintain a more basic oral pH—animal protein, fats, and calcium-rich foods

45

Polyphenols (Plant molecules) inhibit

acid production—cranberries, cocoa, tea, and coffee

46

Cariostatic cheeses

Aged cheddar
Swiss
Blue cheese
Monterey Jack
Mozzarella
Brie
Gouda

47

Cariostatic foods

Cheese
Nuts
Protein
Sugar-free gum
Candy and gum with xylitol

48

Foods containing acid have a

low pH value that will erode enamel:

49

Foods containing acid will usually have one of these on the label

citric, phosphoric, malic, tartaric, lactic, ascorbic, and carbonic acids on food label ingredient panels.

50

Erosive foods will

soften enamel surface
-As the surface continues to soften and erode, the dentin gets closer to the surface.

51

How does a tooth look where it has eroded

Darker

52

examples of acidic food

soda, citrus fruits, yogurt, and grapes.

53

Liquids clear the oral cavity faster than what

solid or sticky food

54

Regular and diet sodas are very acidic and

Most have citric and phosphoric acid as flavor enhancers.
pH levels range from 2.3 to 2.6.

55

Is diet soda better for your teeth than regular soda

NO

56

Drinking acidic soda lowers pH to

below 5.5

57

Are starchy foods cariogenic or cariostatic

Cariogenic

58

starches have retentive factors such as:

bread, rice, and vending snacks.

59

Starch is reduced to fructose and maltose

by salivary enzymes

60

Starches combined with sugar

the combination is more detrimental than either by itself (EX: bread spread with jelly)

61

if you alternate a bite of cariogenic food with a bite of cariostatic food it will

keeps the oral pH higher.

62

Eating crunchy foods with a meal assures

adequate saliva to clear the oral cavity quickly.

63

Drinking sugary beverages with meals will

clear with other food. Drinking between meals provides a separate acid attack.

64

Bacteria that play a role in dental caries must me

Acidogenic
Aciduric

65

Acidogenic

ability to produce acid

66

Aciduric

ability to tolerate and thrive in an acidic environment

67

Acids produced

Lactic
Formic
Propionic
Acetic

68

Which acid is most abundant

Lactic

69

How many bacteria are in the mouth

over 500

70

Bacteria cultivated at site of caries

1.) Streptococcus mutans
2.) Streptococcus sobrinus
3.) Actinomyces
4.) Lactobacillus—predominant in dentinal and root caries
5.) Candida albicans—ECC

71

Shallow grooves are less susceptible to

dental caries

72

Straight teeth are less or more susceptible

Less susceptible
-Affected by pre-eruptive nutrition

73

Fluoride is absorbed by

the mucosal tissue

74

Professional application of fluoride will arrest

developing caries.

75

Salivary fluoride levels will be elevated

up to 3 hours after brushing with fluoridated toothpaste.

76

Fluoride accumulates in

plaque fluid and is held against enamel.

77

True or false?
Daily use of fluoridated toothpaste and mouthwash adds to the reservoir of the mineral available in the oral cavity.

TRUE

78

After fluoride what is the #1 protector of teeth

Saliva

79

Saliva is saturated with

calcium, phosphate, sodium bicarbonate, and proteins.

80

what is pH of Sodium bicarbonate

7.0

81

eating what increases salivary production?

Crunchy foods

82

Clears food from oral cavity and dilutes acid

Saliva

83

which is more effective at rinsing teeth: Viscous or more fluid saliva

More fluid saliva

84

More chewing means that

saliva increases :

85

Saliva flow is stimulated by

Chewing

86

If a person has a lot of saliva

food will clear faster so pH returns to basic faster.

87

Chemical factors in saliva

Sodium bicarbonate, phosphates, protein, and urea in saliva buffer acid.

88

More saliva means more buffering chemicals available and that will

Protect teeth

89

Calcium and phosphorus in the diet can

saturate saliva and assist with remineralization.

90

Mucins in saliva

Trap bacteria and are swallowed with saliva.

91

Proteins in saliva can

Kill bacteria

92

Does Motivation to remove bacterial plaque play a role in keeping teeth caries free?

Yes, a major role

93

Eating carbohydrates will make plaque sticky which can

cause more plaque to accumulate

94

Scrupulous home care will

eliminate bacterial plaque from the caries equation.

95

Early Childhood Caries (ECC)

-Affects mainly maxillary anterior teeth.
-Mandibular anterior teeth are protected by tongue and saliva.
-Sucking on bottle stops during sleep and fluid pools around teeth.

96

ECC can be prevented by

1.) Wean off bottle at an early age
2.) Put child to bed with bottle of water or pacifier

97

Sugar substitutes

Synthetic sweeteners
Sugar alcohols
(Both are noncarogenic)

98

Which sweeteners are noncaloric

ONLY synthetic

99

Aspartame

(Equal or NutraSweet)
180 times sweeter than sucrose
Used by 100 million people worldwide

100

Saccharine

(Sweet ‘N Low or Sugar Twin)
300 times sweeter than sucrose

101

Acesulfame K

(Sweet One)

102

Sucralose

(Splenda)
Made by chlorinating sucrose

103

Sugar alcohols

Sorbitol
Xylitol
Maltitol
Mannitol
Lactitol
Isomalt
Erythritol

104

Xylitol

-Most desirable of all sugar substitutes
-Not metabolized by bacterial plaque
-Reduces salivary Streptococcus mutans in the oral cavity
-Has capability to remineralize incipient decay

105

Include what with each meal for ample saliva and to help clear the oral cavity

One crunchy food