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Oral biology > Oral environment > Flashcards

Oral environment Flashcards

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1
Q

What do oral fluids contain

A

Saliva​
-Major and minor salivary glands​

Gingival crevicular fluid​

Oral bacteria​

Food debris​

Epithelial cells

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2
Q

What are the functions of the oral fluids

A

Protective​
-Cleansing​
-Mucosal protection​
-Buffering​
-Remineralisation​
-Antimicrobial​

Digestive​
-Taste​
-Digestive enzymes​
-Lubricates bolus for chewing, swallowing​

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3
Q

How do the oral fluids provide mucosal protection

A

A dry mucosal surface is at a greater risk of infection

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4
Q

What is a symptom for patients with salivary gland disease

A

Xerostomia (dry mouth) lack of various protective components

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5
Q

What issues arise with reduced salivary flow

A

Increased incidences of dental caries

Caries present on buccal and labial surfaces

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6
Q

What type of glands are salivary glands

A

Exocrine

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7
Q

What are the major salivary glands

A

Parotid
Submandibular
Sublingual

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8
Q

Where can minor salivary glands be found

A

Buccal (mucous)
Labial (mucous)
Lingual (serous & mucous NOT MIXED)
Palatal (mucous)

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9
Q

What is the gingival crevicular (sulcular) fluid

A

Fluid from the epithelium lining the gingival crevice (sulcus)

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10
Q

What is the function of the Gingival Crevicular fluid

A

No ‘function’ as such but possibly acts as an Inflammatory exudate

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11
Q

When is GCF produced

A

There is little production from healthy gingivae, but flow increase with inflammation (gingivitis)

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12
Q

What is the daily salivary flow

A

Averages 500-700 ml

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13
Q

What glands contribute to the production of saliva

A

Parotid
Submandibular
Sublingual
Minor glands

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14
Q

When sleeping what is the percentage makeup of saliva by the different glands

A

Parotid - 0
Submandibular - 70%
Sublingual - 15%
Minor glands - 15%

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15
Q

What is the difference between the makeup of saliva from glands when resting and stimulated

A

Parotid - 20% , 50%
Submandibular - 72%, 40%
Sublingual - 4%, 2%
Minor glands - 4%, 8%

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16
Q

What factors affect unstimulated salivary flow rate

A

State of hydration
Previous stimulation
Circadian rhythms
Circannual rhythms
Medications
Salivary gland disease

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17
Q

What is saliva composed of

A

Inorganic:
Water (99.5%)
Ions (0.2%)

Organic:
Mainly proteins (0.3%)
Little carbohydrate or lipid

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18
Q

When does greater bicarbonate ion conc of saliva occur

A

At greater flow rates as it is important for buffering plaque acids

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19
Q

What is the function of Fluoride in saliva

A

Antibacterial
Forms fluorapatite
Promotes remineralisation

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20
Q

Why is thiocyanate present in saliva

A

Antibacterial agent

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21
Q

What purpose do bicarbonate and phosphates play in saliva

A

Buffering properties to limit acidic attack

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22
Q

What can calcium and phosphate be used for within saliva

A

Remineralisation

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23
Q

What buffers are present within saliva

A

Bicarbonate: effective at high flow rates, when [HCO3] is highest ​

Phosphates: important ‘at rest’ ​

Proteins: limited effect, as main buffering action occurs at pH <5 ​

Bacterial NH3 : some role in buffering plaque acid​

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24
Q

What are the balanced equations of the buffers within saliva
Bicarbonate
Phosphate
Ammonia

A

H20+CO2<–>H2CO3<–>H+ +HCO3-

H2PO4- <–> H+ + HPO4 (2-)

Urea ———-> CO2 + NH3
NH3 + H+ ——> NH4+

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25
When is mucous secretion greatest
When sleeping (30%)
26
When is DNA most susceptible to radiation
When separated for translation and transcription to produce proteins
27
What is an example of previous stimulation
Chewing gum, eating etc
28
What natural body secretion can protect against radiation
Saliva
29
What are the main salivary proteins
Amylase​ Cystatin​ Gustin​ Histatin​ Immunoglobins​ Lactoferrin​ Lactoperoxidase​ Lipase​ Lysozyme​ Mucoproteins​ ‘Plasma proteins’​ Proline-rich proteins​ Statherins​ ​
30
Where could amylase be found
Mucosal gland secretions Saliva
31
What is the function of lysozyme
Attacks bonds in bacterial cell walls, causing lysis Involved in antibacterial and immune functions found in body secretions
32
What property does lactoperoxidase have and why
Antimicrobial effect due to oxidation of thiocyanate
33
What do cystatins do
Inhibit cysteine proteases, especially in bacteria Antimicrobial function
34
What drug will impact the effects of Gustin
Erectile disfunction drug Impacts taste
35
What are histatins
Histidine rich proteins Inhibit CaPO4 precipitation Antimicrobial Inhibits: -candida albicans -streptococcus mutans
36
What are immunoglobins
Antibodies
37
What protein binds Fe3+ and possesses antimicrobial properties (especially against bacteria that require Fe)
Lactoferrin
38
What secretes lipase
Von Ebner glands on tongue
39
What does lipase do
Hydrolyses triglycerides (may assist in digestion of milk)
40
What is the purpose of mucoproteins
Bind to tooth and epithelial surfaces: -protective role -lubrication -component of primary pellicle Affects bacterial adhesion Promotes bacterial aggregation - easier clearance from mouth
41
What proteins resist acid attack decrease mineral loss regulate bacterial attachment
Proline-rich proteins
42
What protein has anticalculus action
Statherins
43
What are plasma-derived substances
Proteins e.g. albumins Blood group substances Immunoglobins Hormones Drugs
44
Which salivary constituents have these functions: (a) Antimicrobial​ (b) Buffering​ (c) Digestive​ (d) Lubrication​ (e) (Re)mineralising​
(a)Histatins, amylase?, Lysozyme, Lactoperoxidase, cystatins (b)Bicarbonate (c)Lipase (d)Lubrication (e)Proline rich proteins
45
What are the mechanical and chemical unconditioned salivary stimuli
Mechanical -pressure on PDL/oral mucosa Chemical -gustation -olfaction -common chemical sense
46
How does mechanical stimuli work
Pressure on PDL (chewing) causes an increase in flow from ipsilateral glands
47
What receptors and action brings about a gustation stimuli
Receptors on taste buds: -tongue dorsum, palate and epiglottis Different potencies (flavours) -acid > umami > sweet > bitter **adaption to constant stimulus
48
What is stimulated during olfaction stimuli
Receptors in olfactory epithelium Produces very weak stimulus in humans
49
What is conditioned salivary stimuli
Learned responses to: Psychic stimuli Visual stimuli Auditory stimuli Requires regular enforcement to maintain responses
50
How does the PSNS respond to salivation
Increased secretions, increases blood flow via vasodilation
51
Where do the primary salivary secretions occur
Acinus
52
What does primary secretion depend on
Acetylcholine
53
Salivary secretion is a 2-stage mechanism what does the second stage involve
Reabsorption of sodium chloride Secretion of potassium and bicarbonate
54
Is saliva hypotonic
yes
55
What volume of saliva is in the mouth
1.1ml (0.5-2.1ml)
56
Where is film flow of saliva highest
Lower lingual region
57
Where is saliva secretion slowest
Labial and buccal region
58
Where are cariogenic sugars retained longest
In regions when flow is lowest
59
What is clearance
The rate at which substances are removed from the mouth
60
Where are caries less frequent
Lingual region due to greater saliva retention/flow
61
What are important oral health aspects of clearance
Removal or 'harmful' materials Retention of 'beneficial' materials
62
What are the steps in clearance
Stimulus Salivary flow Accumulation in mouth Swallow trigger Residual volume
63
What are some beneficial substances retained by slow clearance
Fluoride Chlorhexidine
64
How is sucrose removed from the mouth
Rapid clearance, increased by high salivary flow
65
Why should fluoride preparations be tasteless and tablets should be sucked not chewed
Ensure slow clearance to retain more fluoride within the oral cavity increasing possibility of fluorapatite forming
66
What is a stephan curve
A graph of the plaque pH change over time
67
How does increased salivary flow neutralise plaque acid
Increased bicarbonate content of saliva
68
How does dilution of plague acid affect the oral cavity
Very little effect within plaque
69
What is the effect of chewing gum on saliva
Large initial increase in salivary flow rate Flow subsides to just above normal flow pH rises by 0.5 pH unit which persists for a long time
70
When is there a much larger increase in salivary pH when chewing gum
When the gum contains bicarbonate
71
Are the 'sugar free gum aids oral health' claims valid
Gum chewing does not remove plaque, but will increase salivary flow rate, although the increase is quite small​ The salivary pH is increased​ The stimulated saliva may promote remineralisation​
72
What occurs below a pH of roughly 5.5
Demineralisation
73
Why are alternative 'sugar free' sweeteners better for oral health
Can not be metabolised to acids by plaque bacteria
74
What are examples of Bulk (cariogenic) sweeteners
Sucrose Fructose Glucose Lactose
75
What are low caloric sweeteners
Mannitol Sorbitol Xylitol
76
What are some Non-caloric/high intensity sweeteners
Aspartame Cyclamates Saccharin Sucralose
77
When will patients complain of Xerostomia
When salivary flow rates fall below 50% of normal levels
78
When will a reduction in flow to below 50% occur
As a result of loss of function of more than one major salivary gland
79
What are causes of decreased salivary flow
Side effect of drugs Radiotherapy Diseases: -Specific salivary gland disease -Systemic diseases that also affect salivary glands (Sjogren's syndrome) -General conditions e.g. fluid/ electrolyte loss
80
How many drugs have decreased salivary flow as a side effect
>400
81
Which caries are associated with reduced salivary flow
Smooth surface caries (anterior teeth)
82
What are the consequences of decreased salivary flow
Increased dental caries Increase oral disease (stomatitis) Dysesthesia Impaired oral function Diminished taste perception
83
What is Dysaesthesia
'Burning' mouth
84
Why are there consequences of decreased salivary flow
Decreased clearance leading to a loss of protective components such as: -Antimicrobial agents -Buffering -Less remineralisation -Mucins and other proteins -Gustin -Consumption of cariogenic confectionery in attempts to increase salivation
85
Questions to determine a diagnosis of Sjogren's disease
'Does your mouth feel dry when eating a meal' 'Do you have difficulty swallowing any foods' 'Do you sip liquids to help you to swallow dry foods' 'Does the amount of saliva in your mouth seem too little'
86
What salivary substitutes can be used when no functioning gland tissue is present
Mucin based, cellulose based (water alone is not very effective)
87
What drug can increase/stimulate salivary flow
Sialogogues - drug that promotes secretion of saliva

Oral biology (14 decks)

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