Week 12 Cariology

Question 1

what is the recipe for caries

Answer 1

tooth, biofilm and food source

Question 2

what are the bacteria types that cause caries

Answer 2

-strep mutans
- strep sanguis
- strep mitis
-bacteroides melaninogenicus
- lactobacillus

Question 3

when does lactobacillus appear

Answer 3

as environment becomes more anaerobic

Question 4

what bacteria is considered normal oral flora and slows the growth of strep mutans

Answer 4

strep mitis

Question 5

describe bacteroides melaninogenicus

Answer 5

obligate anaerobe
-associated with periodontal disease

Question 6

describe dental plaque

Answer 6

• gelatinous mass of bacteria adhering to tooth surface
  -biofilm

Question 7

describe cariogenic bacteria metabolism

Answer 7

bacteria consume sugars and the waste product is acid

Question 8

what pH does enamel deminerlize at? dentin?

Answer 8

enamel- 5.5
dentin 6.2

Question 9

how long does pH remain below 5.5 for after each sugar exposure

Answer 9

20-60 minutes

Question 10

what is the food source for caries

Answer 10

fermentable carbohydrates

Question 11

what is preferred carb source for strep mutans

Answer 11

sucrose

Question 12

what is the epidemiology for caries

Answer 12

-younger children (2-8) have had minor decrease in caries prevalence
- carier prevalence has remained constant for older children
- minority youth still at highest risk
- lower income youth still at most risk

Question 13

what are some things that have been introducted to decrease caries rates

Answer 13

fluoride toothphaste
electric toothbrushes
water picks
- fluoridated water
education

Question 14

why have caries not decreased significantly over the last 30 years

Answer 14

bad diet and drugs

Question 15

what are the sites for caries initiation

Answer 15

-pits and fissures
- smooth surfaces: interproximal contacts (class 2 and 3) and near gingiva (class 5)
- root surfaces

Question 16

where are pit and fissure caries found and what class is this

Answer 16

-class 1
- occlusal surfaces of posterior teeth
-buccal surface of posterior molars: buccal pit
- lingual surface of lateral incisors

Question 17

what is the most prevalent location for caries and how can they be prevented

Answer 17

pit and fissure. prevent with sealants

Question 18

how do you detect pit and fissure caries

Answer 18

• not a stick- use explorer to drag along surface to check for softness
  -clinical visualization- shadowing
• radiographs

Question 19

how long does it take for caries to form in pit and fissures

Answer 19

presence of high concentrations of strep mutans in pits and fissures is followed by caries in 6-24 months

Question 20

when is it important to place sealants

Answer 20

shortly after eruption of teeth

Question 21

how do you diagnose buccal and lingual caries

Answer 21

visually

Question 22

how do you diagnose interproximal caries

Answer 22

with bitewings not PAs

Question 23

what are smooth surface caries associated with

Answer 23

high sugar intake
- soda sippers

Question 24

describe root surface caries

Answer 24

• comparatively rapid succession
• often asymptomatic
  -closer to pulp
  -more difficult to restore

Question 25

what are recurrent/secondary caries

Answer 25

caries developed at margin of a restoration

Question 26

how do you visually diagnose caries

Answer 26

color: dark means probably arrested -matte vs shiny: matte is lots of caries, shiny is a little bit of caries

Question 27

how do you feel for caries

Answer 27

if soft and leathery its a cavity

Question 28

what factors should be considered in managing caries

Answer 28

-general health - xerostomia: radiation and chemotherapy, medical conditions, medications -fluoride exposure

Question 29

going towards caries management and moving away from:

Answer 29

caries prevention and caries treatment

Question 30

how do we prevent caries

Answer 30

- oral hygiene instructions: plaque free surfaces dont decay - dietary counseling: identify sources and reduce frequency and ingestion - sealants

Question 31

what are sealants

Answer 31

- thin resin coating placed on chewing surfaced os teeth with or without enameloplasty

Question 32

how do you arrest caries

Answer 32

- fluoride - oral hygiene environment: reduce biofilms - dietary changes - professional cleanings - address xerostomia

Question 33

what is the intermediate option to managing caries

Answer 33

resin infiltration

Question 34

what is E2

Answer 34

inner surface of enamel close to dentin

Question 35

what is D1

Answer 35

outer surface of dentin

Question 36

when can you use resin infiltration

Answer 36

up to D1

Question 37

when is silver diamine fluoride used

Answer 37

in kids

Question 38

what are the terms for classifying and determining mangament of carie

Answer 38

-sound tooth structure -initial caries - moderate caries -advanced caries

Question 39

define sound tooth structure

Answer 39

no clinically detectabl elesion. dental hard tissue appears normal in color, translucency, and gloss

Question 40

define initial caries and what tooth layers are affected

Answer 40

- E1, E2 or D1 -earliest detectable lesion compatible with mild demineralization. -lesion limited to enamel or to shallow demineralization of cementum/dentin. -mildest forms are detectable only after drying. - when established and active lesions may be white or brown and enamel has lost normal gloss

Question 41

define moderate caries and what tooth layers are affected

Answer 41

-D2 visible signs of enamel breakdown or signs the dentin is moderately demineralized

Question 42

define advanced caries and what tooth layers are affected

Answer 42

- D3 - enamel is fully cavitated and dentin is exposed. dentin lesion is deeply or severely demineralized