Clinical Correlation Lecture: caries (guest lecture)

Question 1

what is the definition of early childhood caries

Answer 1

the presence of one or more decayed. missing, or filled tooth surface in any primary tooth in a child under the age of 6

Question 2

what are the consequences of ECC

Answer 2

-a higher risk of new carious lesions
-hospitalizations and ER visist
- high treatment costs
-loss of school days
-diminished oral health related quality of life

Question 3

how common is ECC

Answer 3

-5 times more common than asthma
- 30-50% of low income children have ECC
-

Question 4

how can a child get ECC

Answer 4

-microbes
- transmitted from caregiver to child through salivary contact
- childrens’ mothers with high stre mutans

Question 5

what is AAPD statement #1

Answer 5

avoid frequent consumption of liquids or solid foods containing sugar such as
-sugar beverages
- breast feeding
- fruit juice

Question 6

what is AAPD statement #2

Answer 6

implement oral hygiene no later than first eruption
- fluoridated toothpaste

Question 7

what is AAPD statement #3

Answer 7

apply fluoride varnish

Question 8

what is AAPD statement #4

Answer 8

establish a dental home within 6 months of eruption of the first tooh

Question 9

what is AAPD statement #5

Answer 9

work with medical providers to ensure infants and toddlers have access to dental screenings and preventative measures

Question 10

what is AAPD statement #6

Answer 10

educating legislators, policy makers and third party payers of strategies for ECC

Question 11

what pH does enamel demineralize

Answer 11

5.5

Question 12

what is a recurrent lesion

Answer 12

occurs around margins of restoration

Question 13

what are residual caries

Answer 13

caries left behind before filling is placed

Question 14

what are initial caries

Answer 14

earliest clinically detectable lesion with mild demineralization. limited to enamel or shallow demineralization of dentin

Question 15

what are moderate caries

Answer 15

visible signs of enamel breakdown or signs the dentin is moderately demineralized

Question 16

what re advanced caries

Answer 16

enamel is fully cavitated and dentin is exposed, dentin lesion is deeply and severely demineralized

Question 17

what are the primary microbes in caries

Answer 17

strep mutans, lactoabcillus, actinomyces

Question 18

what are the requirements for caries

Answer 18

susceptible host, bacteria, food source, time

Question 19

what does saliva do in remineralization

Answer 19

raises pH to non-demineralizing levels, flushes away floating microbes, antibacterial properties, calcium and phosphate ions to enter tooth

Question 20

what are the common concerns of fluoride

Answer 20

lowers IQ, poison added to water supply, fluorosis

Question 21

what is the enamel made of

Answer 21

96% calcium hydroxyapatite crystals and 4% organic materials and water

Question 22

what is amelogenesis

Answer 22

enamel formation

Question 23

what is dentin made of

Answer 23

45% hydroxyapatite crystals, 33% organic material, 22% water

Question 24

can enamel be produced postnatally? dentin?

Answer 24

dentin can, enamel cant

Question 25

how does the dissolution of dentin occur

Answer 25

requires collagenase and proteases to breakdown collagenous matrix and acid to dissolve the mineral crystals present

Question 26

what happens in amelogenesis

Answer 26

reciprocal induction of ameloblasts and odontoblasts form enamel in layers

Question 27

what do tomes processes do

Answer 27

form enamel rods

Question 28

what is PTS or PEP group translocation

Answer 28

method used by bacteria for sugar uptake which uses phosphoenolpyruvate as an energy and phophate source -involves enzymes of the plasma membrane and cytoplasm

Question 29

what are the sources of bacterial lactic acid

Answer 29

-fructose (from sucrose) -salivary amylase -and other bacteria

Question 30

how does saliva effect caries susceptibility

Answer 30

saliva flow over the teeth and its bicarbonate content rinse and neutralize ions that cause caries

Question 31

what nervous system portion stimulates saliva secretion

Answer 31

parasympathetic

Question 32

what catalyzes the production of bicarbonate from CO2

Answer 32

carbonic anhydrase enzyme

Question 33

what is the most abundant enzyme in human saliva

Answer 33

amylase

Question 34

how does amylase promote and prevent caries?

Answer 34

promote: aids in breakdown of carbohydrates -> acid prevent: aids in clearing carbohydrates from tooth surfaces

Question 35

what does fluoride do for the teeth

Answer 35

replaces hydroxide ions in hydroxyapatite of enamel

Question 36

what pH does hydroxyapatite in enamel demineralize

Answer 36

5.5

Question 37

what pH does fluroide demineralize

Answer 37

4.5

Question 38

what pH does dentil demineralize

Answer 38

6.5

Question 39

what are the 3 mechanisms flouride uses to protect against caries

Answer 39

-inhibit demineralization -enhance remineralization -inhibit bacterial enolase activity inhibiting lactase production from carbohydrates