Exam 3 Flashcards
(147 cards)
1
Q
Translucent film composed of glycoproteins from saliva
A
Acquired pellicle
2
Q
How long does it take for acquired pellicle to form after teeth are cleaned with abrasive agent?
A
30-90 minutes
3
Q
How can pellicles be removed?
A
- Brushing with abrasive toothpaste
- Whitening products
- Acidic food & drink
4
Q
What is the first step in soft deposit formation?
A
Acquired pellicle
5
Q
What protects teeth from acids that can cause demineralization of the enamel surface?
A
Soft deposits
6
Q
What are the significants of soft deposits?
A
-Protection
-Lubrication
-Nidus for bacteria
-Provides attachment for biofilm & calculus
7
Q
What pellicle is translucent and may pick up stains?
A
Acquired enamel pellicle
8
Q
Non-mineralized community of microorganisms
A
Dental biofilm (plaque)
9
Q
What will decay faster than an enamel surface?
A
A root surface covered in dentin
10
Q
What is the first step in dental biofilm?
A
Pellicle formation
11
Q
What is the second step in dental biofilm?
A
Initial adhesion; planktonic bacteria attach
12
Q
What is the third step in dental biofilm?
A
Maturation
13
Q
What is the fourth step in dental biofilm?
A
Detachment & dispersion
14
Q
What provides the mechanism for adhesion of bacteria?
A
Glycoproteins from pellicle
15
Q
compounds secreted by microorganisms that form a matrix around microcolonies
A
Extracellular polymetric substance (EPS)
16
Q
Holds bacteria together
A
Co-adhesion
17
Q
What helps with adhesion and attachment of biofilm to teeth?
A
Stickiness
18
Q
What protects biofilm?
A
Antimicrobial enzymes
19
Q
Early colonizing bacteria provide a source of what?
A
nutrients for late colonizing bacteria
20
Q
What is Quorum sensing?
A
cell-to-cell communication
21
Q
What days for Leo’s gingivitis man study is this?
- Early biofilm consists primarily of gram-positive cocci with small accumulations of leukocytes
A
Day 1-2
22
Q
What days for Leo’s gingivitis man study is this?
- The cocci still dominate while increasing numbers of gram-positive filamentous form and slender rods join the surface of the cocci colonies, along with more leukocytes
A
Day 2-4
23
Q
What days for Leo’s gingivitis man study is this?
- Filaments increase in numbers, and a mixed flora appears compromising rods, filamentous forms, and fusobacteria with heavy accumulations of leukocytes
A
Day 5-10
24
Q
In what days is gingivitis clinically evident?
A
Day 10-21
25
Greater variability in architecture than subgingival biofilm; two layers of mainly gram-positive, aerobic bacteria
Supragingival biofilm
26
Basal layer adheres to the tooth
The second layer adheres to the top of the basal layer
Supragingival biofilm
27
Architecture is predominately gram-negative, anaerobic, and motile
Changes in health, gingivitis, and disease
Subgingival biofilm
28
Organic & inorganic solids = what % of biofilm composition?
20%
29
Water = what % of biofilm composition?
80%
30
What are the inorganic elements of biofilm?
Calcium
Phosphorus
Fluoride
31
Polysaccharides metabolized by S. mutans to produce glucans & fructans
Proteins bind with glucans to support biofilm growth
Organic elements of biofilm
32
a shift of healthy species to periodontitis-associated species
Dysbiosis
33
What factors influence biofilm formation?
Location
Character of tooth surface
Malocclusion
Personal hygiene
34
How can you detect plaque?
Direct vision
Explorer
Disclosing solution
35
What is disclosing solution used for?
- Identity biofilm not visible
- Evaluate patient's ability to rinse
36
Spit out
Expectorate
37
o Usually from general neglect
o Loosely adherent mass of bacteria & cellular debris
o Bulky & soft resembles cottage cheese
o Forms over dental biofilm
o Product of living and dead bacteria, leukocytes, salivary proteins and food debris
o Can be removed by rinsing, water spray, or tongue action
Materia alba
38
Where can food debris be found?
- Cervical third
- Embrasure and proximal spaces
- Open contacts
- Orthodontic appliances
- Bridgework
39
biofilm mineralized by crystals of calcium phosphate mineral salts
Calculus
40
What are the parts of calculus composition?
Tarter
Inorganic content
41
What are the major inorganic components of calculus?
Calcium
Phosphorus
Carbonate
Sodium
Magnesium
42
What are the crystals in calculus made from?
Brushite
Hydroxyapatite
Whitlockite
Octocalcium Phosphate
43
What are the organic components of crystals?
- Various microorganisms
- Desquamated epithelial cells
- Leukocytes
- Saliva
44
What calculus is easy to remove?
Acquired pellicle
45
What is a breeding ground for more biofilm?
calculus
46
What does calculus act as a reservoir for?
Bacteria
Endotoxins
47
What is a secondary etiology factor in periodontitis?
Calculus
48
What are clinical characteristics of calculus?
color
shape
consistency & texture
size & quantity
distribution
49
What are the colors of supragingival calculus?
White, creamy, yellow, or gray
50
What is the shape of supragingival calculus?
Amorphous
Bulky
51
What is the consistency & texture of supragingival calculus?
Moderately hard, covered with nonmineralized biofilm
52
What are the colors of subgingival calculus?
Light to dark brown
Dark green
Black
53
What is the shape of subgingival calculus?
Conforms to root surface
54
What is the consistency & texture of subgingival calculus?
Harder & more mineralized, surface covered with biofilm
55
What is the size & quantity of subgingival calculus?
-Personal oral care
-Age
-Bacterial load
-Disease severity
56
What is the size & quantity of supragingival calculus?
-Personal oral care
-Diet
-Salivary flow
-Position of teeth
-Use of tobacco
57
What is the source of minerals for supragingival calculus?
Saliva
58
What is the source of minerals for subgingival calculus?
Gingival sulcular fluid
59
What have high levels of salivary phosphorus and calcium?
Heavy calculus formers
60
What has high levels of pyrophosphate, urea, and zinc which inhibits calcification?
Light calculus formers
61
What is a precursor to calculus?
Nonmineralized biofilm
62
How long does calculus mineralization take?
24-72 hours
63
How long does it take for complete calculus maturation?
12 days
64
How can supragingival calculus be detected?
direct vision & compressed air
65
How can subgingival calculus be detected?
explorer
compressed air
probe
radiographs
66
What are some ways of calculus prevention?
o Biofilm removal
o Oral self-care education
o Regular professional cleanings
67
What may contain Pyrophosphate salts, Zinc citrate/zinc salts, Triclosan, and Sodium hexametaphosphate?
Anticalculus dentifrice
68
An oral condition characterized by noticeable malodorous smell that is emitted during breathing or speaking
Oral malodor
69
What are some causative factors for oral malodor?
Oral conditions
Systemic factors
Certain foods
70
o Used to assess the presence of biofilm on the teeth
o Utilized for education for adults or children
o Apply disclosing agent liquid or chewable tablets
o Examine all tooth surfaces and record on chart
Biofilm control records
71
staining on external surface of the tooth and may be removed
extrinsic
72
within the body of the tooth, cannot be removed
Intrinsic
73
How is stain removed?
Polishing with abrasive agent
Scaler
74
originate from sources outside the tooth
- may be extrinsic or intrinsic
exogenous
75
originates within the body of the tooth
- always intrinsic
endogenous
76
smoker of 40 years, stain is embedded in body of tooth and on outside surface
extrinsic exogenous stain
77
What type of stain is Tetracycline stain from mother?
Fluorosis
Endogenous stain
78
Most frequent on lingual surfaces
May incorporate into calculus
Varies from oral hygiene and amount of smoking
Brown stains – tobacco
79
Brown pellicle
Stannous fluoride
Tea, coffee, & colas
Chlorhexidine
Betel nut
Other brown stains
80
Explain the following for green stain:
Composition
Distribution
Occurence
Why don't we scale?
- Composition: chromogenic bacteria, fungi, and gingival hemorrhage
- Distribution: anterior facials, cervical 1/3
- Occurrence: primarily children
- Enamel may be demineralized under the stain, do not scale
81
Explain the following for black line stain:
Microorganisms
Distribution
Occurence
- Microorganisms: gram + rods in an intermicrobial substance
- Distribution: Lingual & proximals of Max. posterior teeth
- All ages, more common in females
82
What stain is associated with plaque?
Yellow stain
83
Explain the following for orange/red stains:
Location
Distribution
Etiology
- Location: cervical third
- Distribution: Anteriors facial & lingual
- Etiology: chromogenic bacteria
84
Drugs
Iron: black or brown
Manganese: black
Distribution: generalized
Tablet or capsules best or drink through straw
Metallic stain
85
What are the materials and colors for industry metallic stain?
- Copper or brass: green/blue
- Iron: brown
- Nickel: green
- Calcium: yellow or golden brown
86
What are all the extrinsic stains?
Brown stain
Green stain
Black line stain
Yellow stain
Orange/red stain
Metallic stain (industry)
87
Antibiotic
Absorbed by bones and teeth
May cause staining if taken during tooth development or during third trimester of pregnancy
Tetracycline
88
Generalized intrinsic staining post-eruption
Blue-gray stain of permanent teeth
Antibiotic commonly prescribed for acne
Minocycline
89
Hemorrhage of the pulp chamber, root canal therapy (endodontics), necrosis, and decomposition of the pulp
Brown, gray, black, reddish brown
Pulpless teeth
90
- Amleoblastic disturbance
- White spots may be localized affecting a single tooth or generalized
Enamel hypoplasia
91
Brown stain “mottled enamel” – multiple colors
Ingestion of excessive fluoride
Toxic damage to the ameloblasts
Fluorosis
92
What extrinsic stains can become intrinsic?
o Tabacco
o Silver amalgam
o Stannous fluoride applied topically
o Endodontic therapy materials
93
List the noncarious dental lesions.
o Abfraction
o Abrasion
o Attrition
o Decalcification
o Erosion
o Hypoplasia
94
What are some characteristics about caries?
o Biofilm medicated
o Diet modulated
o Multifractional: require a tooth, environment, host
o Noncommunicable
95
The process of losing minerals from tooth enamel, and it's an early sign of tooth decay, or caries
Demineralization
96
A treatment for early caries lesions that involves restoring minerals to tooth structure to reverse or stop the progression of the lesion
Remineralization
97
Loss of tooth structure where tooth and gums come together
Abfraction
98
Loss of tooth structure by mechanical means
Abrasion
99
A dental condition that occurs when tooth enamel lacks enough calcium
-Chalky looking spots
Hypocalcification
100
What are the factors in dental caries process?
o Microorganisms
o Cariogenic diet
o Salivary factors
o Tooth resistance
101
What are the risk factors for caries?
Moderate or high cariogenic bacterial counts
Visible biofilm
Greater than 3 between-meal snacks
Inadequate saliva flow
102
What are the risk indicators for caries?
Socioeconomic and epidemiological factors
Education level
Special needs
103
What microorganisms are associated with the caries process?
Streptococcus mutans & Streptococcus sobrinus
Lactobacillus
Actinomyces
Bifidobacteria
104
What microorganism is associated with childhood caries?
Bifidobacteria
105
What are the acid forming microorganisms that are transmitted from person-to-person?
Formic acid
lactic acid
propionic acid
acetic acid
106
What is Vertical transmission?
Bacteria from person to baby
107
o Amount of plaque/biofilm
o Predominant microflora
o Rate of saliva flow
o Substrate characteristics/fermentable carbohydrates
o Location of plaque
Important features of acid production
108
o Frequency of intake
o Form of simple sugars – retentive or liquid
o Time of ingestion
o Total intake
Cariogenic factors
109
85% mineral, 15% lipids, protein and water
Mature enamel
110
crystalline mineral component of the teeth
Hydroxyapatite
111
fluoride ions replace hydroxyl ions making the apatite less soluble
Fluorapatite
112
The loss of calcium and phosphate from the enamel surfaces of teeth
Demineralization
113
The natural repair process where calcium and phosphate ions use fluoride as a catalyst to rebuild the crystalline structure histologically in the subsurface lesion
Remineralization
114
white spot lesion
Subsurface lesion
115
What is the first clinically evident sign of a cavity?
Subsurface lesion
116
What step is this in demineralization?
- Organic acids dissolve the enamel crystals into calcium & phosphate ions
1st step
117
What step is this in demineralization?
- Diffusion channels between enamel rods render enamel porous. Small molecules and ions such as calcium, phosphate, Fl, & and acids freely flow into and out of the tooth
2nd step
118
What step is this in demineralization?
- Bathing the tooth in acid starts the process of demineralization
3rd step
119
Small molecules and ions enter the tooth moving from an area of higher concentration to an area of lower concentration
Passive diffusion
120
What are the roles of saliva in the caries process?
o Lubricates the tissues of the mouth
o Aids in the clearance of food
o Buffers acid
o Initiates carbohydrate digestion
o Possesses antibacterial properties
o Serves as a reservoir for calcium, phosphate and fluoride
121
o The replacement of minerals back into the tooth
o Saliva is a buffer = neutralizes acid
o Provides calcium and phosphate ions
o Salivary flow increases the speed of oral clearance
Remineralization process
122
o The symbol of hydrogen ion concentration of an aqueous solution
o Number used to indicate the acidity of a solution
o Ranges from 1-14
pH scale
123
What number is pure acid on the pH scale?
0
124
What number is neutral on the pH scale?
7.0
125
What number is pure base on the pH scale?
14
126
How long can the acidic environment last up to in the caries process?
20 minutes
127
What makes acid?
Fermentable carbohydrates
Bacteria + sugar
128
What critical pH level does demineralization of enamel occur?
5.5
129
When the explorer can penetrate into tooth
Cavitated lesion
130
What ways are used to detect caries?
Visual
Tactile
Radiographic
131
What technology is used for identification of dental caries?
- Visual assessment (loupes/intraoral camera)
- Computer and laser technology
132
What cavity involves one tooth surface?
Simple cavity
133
What cavity involves two tooth surfaces?
Compound cavity
134
What cavity involves more than two tooth surfaces?
Complex cavity
135
initial/early lesion
Primary lesion
(Incipient caries)
136
caries beings in a fault in the enamel
Pit & fissures
137
surface where there is no pit
Smooth surface
138
rapidly progressive decay process that affects smooth surfaces of several teeth
Rampant caries (nursing bottle syndrome)
139
slowly progressive decay process
Chronic caries
140
lesion that has been reversed due to remineralization
Arrested caries
141
new decay located around existing restorations
Recurrent or secondary caries
142
What are causes of tooth fractures?
o Accident
o Blow to face
o Contact sport
o Falls
143
Dislocation of tooth
luxation
144
Normal mobility sensitivity to percussion or touch
Concussion
145
Complete displacement of tooth
Avulsion
146
blunt end of instrument used to test sensitivity of pulp
percussion test
147
exaggerated response to pain
pulpitis
