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Flashcards in FINAL EXAM Deck (33)
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1

describe dental caries lesions

  • lesions that occur due to activity within plaque that covers a tooth
  • considered signs and symptoms of metabolisms within plaque
  • can occur on enamel, dentin, or cementum

2

in the formation of dental caries lesions, the ___ is left undisturbed for a period of time on any tooth surface, causing the potential for a ___ to form

  • biofilm (plaque)
  • caries lesion

3

what is the best definition of dental caries lesions?

a multifactorial process of demineralization and concurrent remineralization, and is often reversible

4

describe dental plaque

  • a biofilm (a natural, physiological process)
  • an active community of microorganisms that work together
  • if left on a tooth too long, it will make a white, chalky lesion on the tooth

5

what is the multifactorial model of the caries process?

6

what are the host factors that contribute to caries lesions

  • tooth anatomy, texture of surface, protected surfaces
  • salivary flow rates
  • salivary quality and buffering capacity
  • systemic disease

7

what are the environmental factors that contribute to caries lesions

  • diet: including fermentable carbohydrates, frequency of meals, acidity of meals
  • oral hygiene and compliance
  • fluoride exposure

8

what are the bacterial factors that contribute to caries lesions?

  • streptococcus: mutans ans sobrinus
  • lactobacilli
  • other non-cariogenic bacteria can become cariogenic for short periods of time under certain conditions

9

describe strep mutans

  • gram positive organism
    • peptidoglycan layer in cell wall
  • primary causative agent in the formation of dental cavities
  • metabolizes sucrose to lactic acid

10

describe enamel after eruption

  • once erupted, enamel is in dynamic transformation
  • teeth slowly erupt, therefore enamel undergoes subclinical changes, due to exposure to oral microbes, and salivary minerals
  • once fully erupted into occlusion, enamel is also subjected to mechanical modifications

11

what is the origin of dentin?

mesodermal

12

what is the composition of dentin?

  • 75% inorganic
  • 20% organic
  • 5% water

13

dentin has ___ mechanisms and works in concert with ___

  • reparative (odontoblasts)
  • pulp (dentino-pulpal organ)

14

what is the composition of enamel?

  • 95% mineral
  • 5% water

15

what is dentin?

  • living tissue made up of tubules, each of which contain an odontoblast
  • is a series of tubules extending from pulp to the DEJ, which are widest at the pulp and hardest at the DEJ
    • 1/5 as hard as enamel

16

how are caries lesions classified?

  • according to their anatomical site
    • pit and fissure (common on occlusal), smooth surface (enamel caries, root caries)
  • cavitated vs. non-cavitated
  • activity level 
    • active vs. inactive
  • primary (lesions on natural, intact tooth surfaces) vs. secondary (recurrent, adjacent to a filling/restoration - same etiology as primary caries) vs. residual (demineralized tissue that has been left behind before a filling is placed)

17

compare treatment of active vs. inactive lesions 

  • inactive lesions do not require any restorative action because the caries process has been arrested
  • if active, steps should be taken to influence the metabolic activities and possibly the ecological balance in the biofilm in favor of arrest rather than further demineralization

18

what are the disease causing factors of the caries balance?

BAD disease-causing factors include the following:

  • Bad bacteria - acid-producing bad bacteria
  • Absence of saliva 
  • Dietary habits (poor) - frequent sugars and acids lead to demineralization and a low pH, allowing bad bacteria to thrive, starting the decay process

19

what are the protective factors of the caries balance?

SAFE protective factors include the following:

  • Saliva and sealants - saliva neutralizes acid, encouraging good bacteria to thrive and aids remineralization.  sealants seal the chewing surfaces of the teeth most susceptible to decay.
  • Antimicrobials - helping rid the bad bacteria and establish health-promoting bacteria
  • Fluoride - strengthening the tooth surfaces against demineralization, promoting remineralization
  • Effective (healthy) diet 

20

what are the functions of saliva relative to the teeth?

21

what are the functions of saliva relative to food?

22

what are the functions of saliva relative to microbes?

23

describe how dental biofilms are formed

  1. pellicle formation - minutes to hours
  2. attachment of a single bacterial cell - 0-24 hours
  3. growth of attached bacteria leading to the formation of distinct microcolonies - 4-24 hours
  4. microbial succession (and coadhesion) - leads to increased species diversity and continued growth of microcolonies
  5. climax community/mature biofilm - >/= 1 week

24

describe the ADA classification of a sound tooth

25

describe the ADA caries classification of initial caries

26

describe the ADA caries classification of moderate caries

27

describe the ADA caries classification of advanced caries

28

for a low risk patient, describe the frequency of radiographs, frequency of caries recall exams, antibacterials/chlorhexidine/xylitol, and fluoride recommendations

  • frequency of radiographs - BWX every 24-36mo
  • frequency of caries recall exams - every 6-12mo
  • antibacterials/chlorhexidine/xylitol - per saliva test if done
  • fluoride - OTC fluoride-containing toothpaste twice daily; optional: NaF varnish if excessive root exposure or sensitivity

29

for a moderate risk patient, describe the frequency of radiographs, frequency of caries recall exams, antibacterials/chlorhexidine/xylitol, and fluoride recommendations

  • frequency of radiographs - BWX every 18-24mo
  • frequency of caries recall exams - every 4-6mo
  • antibacterials/chlorhexidine/xylitol - per saliva test if done; xylitol 6-10g/day 
  • fluoride - OTC fluoride-containing toothpaste twice daily plus 0.05% NaF rinse daily; initially 1-2 app NaF varnish, then 1 app at 4-6mo recall

30

for a high risk patient, describe the frequency of radiographs, frequency of caries recall exams, antibacterials/chlorhexidine/xylitol, and fluoride recommendations

  • frequency of radiographs - BWX every 6-18mo or until no cavitated lesions are evident
  • frequency of caries recall exams - every 3-4mo
  • antibacterials/chlorhexidine/xylitol - chlorhexidine gluconate 0.12% (10ml rinse for 1min daily for 1wk each month), xylitol (6-10g/day)
  • fluoride - 1.1% NaF toothpaste 2x daily; optional 0.2% NaF rinse daily then OTC 0.05% rinse 2x daily; initially 1-3 app NaF varnish, then apply at each 3-4mo recall