Lecture 1 (Part 2 - Caries Etiology, Pathogenesis and Modifying Factors of Dental Caries)

Question 1

Pellicle formation

Answer 1

Stage 1

Question 2

Formation of an acellular layer

Answer 2

Stage 1

Question 3

early colonization

Answer 3

Stage 2

Question 4

Initial attachment

Answer 4

Stage 2

Question 5

Irreversible attachment

Answer 5

Stage 3

Question 6

Early maturation

Answer 6

Stage 4

Question 7

Bacterial complexity increases creating anaerobic zones, food chains are established and an increased range of receptor sites for bacterial attachments.

Answer 7

Stage 4

Question 8

Cell division and recruitment of new bacteria also allows the bacterial population to increase

Answer 8

Stage 4

Question 9

also called maturation II

Answer 9

Stage 5

Question 10

Mosaic microenvironments develop, particularly areas of different pH, oxygen concentrations and secondary metabolite accumulations around microcolonies.

Answer 10

Stage 5

Question 11

The plaque microbial ecology reaches a pseudo-steady state climax community where there is constant turnover of cells but the overall composition remains the same.

Answer 11

Stage 5

Question 12

Biogeography of a human oral microbiome at the micron scale

Answer 12

Mature Dental Biofilm

Question 13

Dispersion

Answer 13

Stage 6

Question 14

Enzymes that degrade the biofilm (such as dispersin B) allow some bacteria to detach themselves from the biofilm (sometimes in response to a deleterious environmental condition) in order to spread and colonize new surfaces in the oral cavity.

Answer 14

Stage 6

Question 15

Classical microbiological techniques have estimated that plaque contains ____ distinct oral species

Answer 15

800

Question 16

Classical microbiological techniques have estimated that plaque contains 800 distinct oral species and a healthy individual possesses ____ different species at any one time.

Answer 16

50-100

Question 17

a new powerful molecular technique analyzing ribosomal RNA

Answer 17

Pyrosequencing

Question 18

Pyrosequencing has estimated at least ____ phylotypes.

Answer 18

19,000

Question 19

Microorganisms and host are in a symbiotic relationship.

Answer 19

pH is Neutral

Question 20

There is a natural balance between the dental plaque and the tooth surface (and oral fluids)

Answer 20

pH is Neutral

Question 21

Various species live in a co-operative, physiological equilibrium in biofilm through a complex interaction of synergism and antagonism

Answer 21

pH is Neutral

Question 22

Acid-sensitive microorganisms like S, sanguinis are thriving. They keep acid production low and increase remineralization.

Answer 22

pH is Neutral

Question 23

The small amount of acid produced is buffered by bicarbonates and phosphates in the oral fluids.

Answer 23

pH is Neutral

Question 24

The small amount of acid produced is buffered by ____ and ____ in the oral fluids.

Answer 24

bicarbonates and phosphates

Question 25

A dynamic equilibrium exists between the mineral contents of the tooth and the oral fluid* with the mineral content in the HA crystal being equal to that of the oral fluid

Answer 25

pH is Neutral

Question 26

The HA crystals dissolve minimally and releases calcium (Ca2+), phosphate (PO43-), and hydroxyl ions (OH-)

Answer 26

pH is Neutral

Question 27

is metabolized by bacteria

Answer 27

sugar

Question 28

main energy generating pathway in all bacteria

Answer 28

by glycolysis

Question 29

The by-product of glycolysis is

Answer 29

lactic acid

Question 30

KEY FEATURES OF DENTAL CARIES:

Answer 30

- Multifactorial etiology - Site-specific disease - Time-dependent dynamic disease process modified by protective factors

Question 31

is a highly localized and complex process which occurs in areas of stagnation where plaque can accumulate undisturbed.

Answer 31

Dental caries

Question 32

Each tooth site represents a unique environment that influences plaque:

Answer 32

- composition - metabolic status - thickness

Question 32

The early stages of dental caries can be prevented, reversed or arrested, primarily through the elimination or modification of etiological factors and/or by enhancing protective factors. TRUE OR FALSE

Answer 32

TRUE

Question 33

Give Etiological Factors:

Answer 33

- dietary - microbial

Question 34

Give Protective Factors:

Answer 34

- Fluoride - Sealants - Salivary Stimulation

Question 35

What are Low Concentration:

Answer 35

- Decrease rate of enamel demineralization - Increased rate of enamel remineralization - Inhibition of microbial enzyme systems

Question 36

What are High Concentration:

Answer 36

- Formation of CaF2 - Concentrates in incipient lesions - Bactericidal effects

Question 37

Decrease rate of enamel demineralization

Answer 37

Low Concentration

Question 38

Increased rate of enamel remineralization

Answer 38

Low Concentration

Question 39

Inhibition of microbial enzyme systems

Answer 39

Low Concentration

Question 40

Formation of CaF2

Answer 40

High Concentration

Question 41

Concentrates in incipient lesions

Answer 41

High Concentration

Question 42

Bactericidal effects

Answer 42

High Concentration

Question 42

Provides the driving force to penetrate the dental biofilm adjacent to the tooth surface

Answer 42

High Concentration

Question 43

What are the Main Etiological Factors:

Answer 43

- Tooth location and morphology - Dental biofilm microorganisms with acidogenic and aciduric properties - Frequent dietary exposure to fermentable carbohydrates - Salivary flow rate

Question 44

Caries as an infectious disease vs caries is a

Answer 44

lifestyle disease

Question 45

is a complex, multifactorial disease

Answer 45

Caries

Question 46

It cannot be controlled simply by eliminating one type of microorganism or a matter of improving host resistance

Answer 46

Caries

Question 47

caries are formed

Answer 47

Demineralization

Question 48

No caries

Answer 48

Remineralization

Question 49

Predominance of cariogenic bacteria in biofilm. what factor?

Answer 49

Pathological Factors

Question 50

Sub-normal saliva flow and or function. what factor?

Answer 50

Pathological Factors

Question 51

Frequent eating/drinking of fermentable carbohydrates what factor?

Answer 51

Pathological Factors

Question 52

Poor oral hygiene what factor?

Answer 52

Pathological Factors

Question 53

Predominance of non-cariogenic bacteria. what factor?

Answer 53

Protective Factors

Question 54

Increased saliva flow and composition. what factor?

Answer 54

Protective Factors

Question 55

Frequent exposure to fluoride. what factor?

Answer 55

Protective Factors

Question 56

Good oral hygiene what factor?

Answer 56

Protective Factors

Question 57

Give "Limit Substrate"

Answer 57

- Substantially reduce sucrose from diet - Eliminate sucrose from between meal snacks

Question 58

Modify Microflora:

Answer 58

- Bactericidal mouthrinses (chlorhexidine) - Topical fluoride treatments - Antibiotic treatment (vancomycin, tetracycline, polymyxin)

Question 59

What is chlorhexidine?

Answer 59

Bactericidal mouthrinses

Question 60

vancomycin, tetracycline, polymyxin are ____

Answer 60

Antibiotic treatment

Question 61

PLAQUE DISRUPTION/REMOVAL:

Answer 61

- Brushing - Flossing - Other oral hygiene aids (water piks, interdental brushes)

Question 62

MODIFY TOOTH SURFACES:

Answer 62

- Systemic Fluoride - Topical Fluoride application - PRR - Enameloplasty - Prophylactic Odontotomy

Question 62

STIMULATE SALIVARY FLOW:

Answer 62

Sugarless chewing gums (Xylitol)

Question 63

RESTORE TOOTH SURFACES:

Answer 63

- Restore all cavitated lesions - Seal pit and fissures at caries risk - Correct all defects (marginal crevices, cervical overhangs

Question 64

ECOLOGICAL APPROACHES TO CARIES PREVENTION

Answer 64

- Antimicrobial Peptides (AMPs) - Probiotics - Prebiotics - Sugar Polyols - Quorum-sensing Targets - Natural Products - Replacement Therapy with "Designer" Bacteria

Question 65

OTHER ECOLOGICAL APPROACHES TO CARIES PREVENTION:

Answer 65

- Nanoparticles - Graphene oxide - Ceramic water