Flashcards in Midterm Deck (25):
What is classified by activity?
white spot, brown spot , initial, incipient, and active caries lesion (progressive)
noncavitated caries/carious lesion, with enough mineral loss to change the appearance of enamel (loss of translucency). Not all white spot lesions are incipient, some may have been there for a long time and could involve the enamel and dentin
active caries lesion
progressive develops fast, will not cause recession
arrested or inactive lesion
lesion not undergoing net mineral loss
noncavitated caries/carious lesion where net mineral loss and acquisition of pigments lead to loss of translucency and a brown discoloration
How do you classify an active caries lesion?
visual appearance, tactile feeling, and potential for plaque accumulation:
likely active if enamel is whitish/yellowish opaque and chalky (with loss of luster); feels rough when the tip of the probe is moved gently across the surface; lesion is in a plaque stagnation area. In dentin, lesion is likely active when the dentin is soft or leathery on gently probing.
How do you evaluate a carious lesion?
Three Step Evaluation Process:
1. In a plaque stagnation area?
2. Visual appearance?
3. Gentle Tactile feeling with ball ended probe
more predictors indicating activity then lesion is active
multiple active carious lesions in the same patient; may also involve unusual teeth surfaces, ex. mandibular incisors
sometimes classified by their causality
early childhood caries
the presence of one or more decayed (non-cavitated or cavitated lesions), missing (due to caries) or filled tooth surfaces in any primary tooth in a preschool-age child between birth and 71 months of age
Bottle caries or nursing caries
caused by the frequent and long-term exposure of a child's teeth to liquids containing sugars
What are the 3 different plaque hypothesis?
1. specific plaque hypothesis
2. non-specific plaque hypothesis
3. ecological plaque hypothesis
Specific plaque hypothesis
proposed that only a few organisms out of the diverse collection in the plaque flora were actively involved in the disease. Preventive measures targeting specific bacteria (e.g. immunization) would be a logical consequence of this hypothesis.
considered the carious process to be caused by the overall activity of the total plaque microflora. A consequence of this approach is that all plaque should be disturbed by mechanical plaque control (toothbrushing).
ecological plaque hypothesis
proposes that the organisms associated with disease may be present at sound sites. Demineralization will result from a shift in the balance of these resident microflora driven by a change in the local environment. Frequent sugar intake (or decreased sugar clearance if salivary secretion is low) encourages the growth of acidogenic and aciduric species, thus predisposing a site to caries. The consequence of this hypothesis is that both mechanical cleaning and some restriction of sugar intake are important in controlling caries progression.
Includes those measures that prevent the development of the clinical signs of caries in the absence of disease, that is, prevent the initiation of the disease.
Centers on the prompt and efficacious treatment of disease at an early stage and includes measures that arrest and/or reverse the caries process after initiation of clinical signs.
Involves measures that remove irreversibly damaged tooth tissue and replace it in such a way as to prevent further progress of the caries process. (Note: some secondary and tertiary preventive options involve a ‘‘hybrid’’ interaction
of nonoperative and operative procedures).
too much fluoride
can be dietary, occupational, intrinsic;
physical result of a pathologic, chronic, localized, loss of dental hard tissue chemically etched away from the tooth surface by acid and/or chelation without bacterial involvement.
dental erosion (simple term)
acid hits tooth, gets rid of enamel
loss of tooth due to a foreign element, brushing too hard, piercing
wearing away of tooth substance during food chewing , influenced by abrasiveness of individual food
loss of tooth due to opposing teeth
loss of tooth structure due to occlusion due to bite