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150 Cards in this Set
- Front
- Back
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What is one of the most common diseases in humans? |
Dental caries |
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What does dental caries cause? |
pain and disability |
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What do caries lead to? |
infection, tooth loss, and edentulism at any age |
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What is one of the oldest theories about caries? |
a tooth worm lived in the center of the tooth. |
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What was a theory about caries in the 1700s? |
caused by erosion that would be smoothed by a file |
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What was a theory about caries in 1881? |
caused by organisms |
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Who published the chemicoparisitic theory of caries? |
W.D. Miller |
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Who is G.V. Black? |
founder of modern dentistry |
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What did Dr. Black add to the belief about caries? |
microbic plaque was the source of the acids |
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Why have disease patterns changed? |
fluoride has been introduced |
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What must there be in order for caries to develop? |
a susceptible tooth and host cariogenic microorganisms frequent excessive consumption of refined carbohydrates |
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When must the development of caries process occur? |
over a long period of time |
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How many categories of the disease process need to occur for caries to happen? |
all 4 |
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What is the first step in the development of caries? |
a tooth covered in a film of cariogenic bacteria is exposed to carb and metabolizes it. |
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What is produced from the metabolism of the carb by cariogenic bacteria? |
weak acid byproducts |
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What does the acidogenesis create? |
an environment that demineralizes the tooth enamel and dentin |
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Where are the general areas of the tooth that carious lesions occur? |
pit and fissure smooth surface root surface secondary/recurrent carries |
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Where are secondary/recurrent caries found? |
on tooth surface adjacent to an existing restoration |
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What are the 3 stages of caries? |
Incipient lesion demineralization toward dentinoenamel juction and pulp overt or frank lesion |
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What is an incipient lesion? |
initial stage of tooth decay that hasty penetrated the outer surface of the tooth |
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What does an incipient lesion look like? |
a white spot on enamel |
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What is lost in incipient lesions? |
calcium, phosphorus, ions of enamel |
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What is an overt or frank lesion? |
actual cavitation (loss of enamel integrity) |
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When does rampant decay occur? |
when the development of overt lesions is rapid or extensive and after frequent intake of sucrose and xerostomia |
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What is an example of when rampant decay would occur? |
baby bottle decay |
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How is there a direct connection of the bacterial biofilm to the lesion? |
demineralization remineralization enamel rods |
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What does demineralization create? |
a raged profile |
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What does progression of a lesion depend on? |
pH Saliva flow rate buffering capacity |
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What happens when caries reaches the dentin? |
it spreads to a larger area |
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In what shape does caries develop on the enamel? |
a triangle or arrow |
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What is an effective means of preventing caries in children? |
reduce the number of MS in parents and siblings mouths before a child's birth |
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What are two main bacteria species that cause caries? |
mutans streptococcus lactobacillus |
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What is the main bacteria species that causes caries? |
mutans streptococcus |
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How many species of bacteria in plaque? |
300 |
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Where and when does mutans streptococci form? |
immediately over developing smooth surface lesions |
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What does mutans streptococci produce? |
extracellular glucans and acids |
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How does mutans streptococci cause damage? |
through lactic acid and other acids |
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At what pH does enamel get damaged? |
5.5 or lower |
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What are lactobacilli? |
cariogenic acidogenic aciduric |
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Are lactobacilli required for caries development? |
no |
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When are lactobacilli common? |
after irradiation therapy for head and neck cancer |
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What are the sources of acid? |
dietary bacterial environmental intrinsic (bulimia) |
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How long does it take to neutralize the pH from solid/sticky sugars?
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40 minutes
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How long does it take to neutralize the pH from liquid sugars? |
20 minutes |
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What are the most susceptible teeth to caries? |
1st and 2nd molars on mandible and maxilla mandibular premolars |
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What teeth have a lower incidence rate of caries? |
anterior teeth |
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Why do anterior teeth have a lower incidence rate of caries? |
they are smooth saliva |
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What teeth are the least susceptible to caries? |
lower anterior |
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What are the major salivary glands? |
parotid submandibular sublingual |
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What role does saliva play with caries? |
helps prevent caries |
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How does saliva help prevent caries? |
repaires damage by neutralizing acids and replacing lost minerals |
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Which gland secretes sodium bicarbonate and initiates carbohydrate digestion? |
parotid |
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What is sodium bicarbonate? |
baking soda
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What is the function of saliva? |
lubrication clearance of food buffers pH antibacterial remineralizes with its contents |
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What contents of saliva help with remineralization? |
calcium phosphates fluoride saturation |
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What ph does coronal dental caries start? |
5.5 and lower |
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What pH does root caries start? |
6 and lower |
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What does enamel protect? |
underlying dentin |
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What does dentin protect? |
pulp |
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What features on coronal caries give in to caries? |
pits and fissures interproximal smooth surface |
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What exposes root to caries? |
gingival recession |
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what can create xerostomia? |
medication, cancer and age |
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What are the risk factors that lead to caries? |
age gender fluoride exposure illness oral hygiene diet |
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What are secondary or recurrent caries due to? |
imperfection in or around restoration |
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How can secondary or recurrent caries be lessened? |
by preventing the imperfections applying fluoride materials to bone the tissue |
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What is the Stephan Curve? |
the immediate drop in pH when sugary snacks are eaten, followed by a longer recovery period when other foods are eaten. |
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What is another name for the Stephan Curve? |
drop and recovery curve |
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What is demineralization caused by? |
plaque acid that dissolves the tooth minerals |
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What does remineralization require? |
ions with fluoride with a catalyst |
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What are the minerals that make up the tooth? |
calcium, phosphate, and hydroxyl crystals |
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What does continued exposure to low concentrations of fluoride result in? |
gradual incorporation of fluoride into existing hydroxyapatite crystals |
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what does fluoride and hydroxyapatite crystals create? |
fluorohydroxyapatite |
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What is special about fluorohydroxyapatite? |
its more resistant to acid damage |
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What is successful in stimulating surface remineralization? |
topical procedures such as gels, dentifrices and varnish |
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What do some researchers believe? |
that remineralization is a reasonable objective for caries that reach the dentin |
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What are some protective measures against caries? |
daily oral hygiene diet fluoride sugarfree gum or mints antibacterial rinse |
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What helps with dry mouth? |
saliva substitute products bakingsoda xylitol gum/mints sip on water throughout day |
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What helps with caries management? |
risk assessment early detection fluoride/antibacterial therapy minimally invasive restorations |
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What is CAMBRA? |
validated evidence-based approach to preventing, reversing, and treating caries |
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what does CAMBRA emphasize? |
whole disease process |
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how long does caries take to form? |
months to years |
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How do you diagnose caries? |
drying tooth visually transillumination radiographs lasers |
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What is dental calculus? |
hard calcified dental plaque |
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where does dental calculus occur? |
teeth implants dentures appliances |
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What is calculus always covered with? |
plaque |
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Where doesn't calculus grow? |
gingiva |
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What is found in calculus? |
things found in plaque and calcifying salts |
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Does calculus by itself initiate periodontal disease or caries? |
no |
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What are some physical characteristics of calculus? |
porous attracts and harbors plaque |
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how does calculus perpetuate periodontal disease? |
by being physically and chemically irritating |
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What is the first step in non-surgical periodontal therapy? |
removal of calculus to eliminate gingival inflammation |
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Is there pain associated with calculus? |
no |
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How is calculus classified? |
by its location on the tooth surface related to the gingival margin |
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what is supragingival calculus? |
above the gingival margin |
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what are other names for supragingival ?
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supramarginal
extragingival |
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what is the source of minerals for supra gingival
calculus? |
saliva |
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Where is supra gingival calculus most abundant? |
near openings of major salivary glands buccal side of maxillary molars lingual of mandibular anteriors |
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What is the recurrence like after removal of supra gingival calculus? |
may be rapid |
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what is the texture and color of supra gingival calculus? |
hard covered in plaque white,yellow |
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how is supra gingival calculus recognized? |
clinical inspection by drying the tooth to see a chalky appearance |
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Where is subgingival calculus? |
under the gingival margin |
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What are other names for subgingival calculus? |
submarginal serumal |
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Where does subgingival calculus get its minerals? |
the serum in blood |
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Where is subgingival calculus commonly found? |
interproximal proximal and lingual surfaces |
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Which is harder to remove supra gingival or subgingival calculus? |
subgingival |
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What is the consistency, texture, and color of subgingival calculus? |
brittle harder and denser light to dark brown or black |
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which type of calculus has a wider distribution? |
subgingival calculus |
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How is subgingival calculus detected? |
tactile visual (color change or blowing air) radiographs periscopy |
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what are the structures of subgingival calculus?
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spicules ledge ring veneer |
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What is calculus made of? |
inorganic and organic componants and water |
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Is it made of mainly organic or inorganic componants? What percent?
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inorganic 70-90% |
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What are the inorganic componants? |
calcium phosphorus carbonate sodium magnesium potassium |
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Is there flouride in calculus? |
yes, but it varies on amount of fluoride from H2O, topical Fl, toothpaste and rinses
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What is 2/3 of the inorganic matter? |
crystals |
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is calculus alive or dead? |
dead |
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how long does mineralization of calculus take? |
3-4days to week |
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how does calculus appear on a radiograph? |
radioopaque, in interproximals |
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What forms in 12 hours? |
mineral elements from plaque |
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what forms in 3-4 days? |
heavy calculus more calcium and phosphate |
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what is the average time it takes for calculus to mineralize? |
12 days |
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Why is there an increase in calculus for people on dialysis and tube feeding?
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they aren't chewing to produce saliva |
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what color is swimmers calculus? |
yellow to brown |
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What is the mineralization theory? |
saliva is super saturated because of the sales and is able to support crystal growth but can't be used because of the pellicle |
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What is the carbon dioxide theory? |
saliva leaving the duct has CO2 tension... but not accepted |
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What is the ammonia theory? |
ammonia breaks down from urea that results in pH increase in plaque.... but not accepted |
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what is the initial layer of crystal formation? |
brushite paralel to tooth |
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what does brushite calcify into? |
whitlockite |
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What happens to the older layers of whitlockite? |
become hard to remove |
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What do crystals contain? |
ions |
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How does calculus form? |
in layers |
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how long does calculus form in heavy formers? |
3-4 days |
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Where does mineralization begin? |
intercellular plaque matrix |
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What are the modes of calculus attachment? |
acquired pellicle irregularities on tooth surfaces direct contact (braces) |
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Which mode of attachment is most common? |
irregularities on tooth surfaces |
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where does calculus form? |
areas closest to salivary ducts areas hard to clean |
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What type of calculus do kids have? |
supra |
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Why should calculus be removed? |
to prevent inflammation of periodontal tissue |
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What does the tenacity of calculus depend on? |
the length of time present attachment mechanism supra vs sub the individual |
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What are the means of attachment of calculus?
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acquire pellicle mechanical locking direct contact |
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Which attachment is easiest to remove?
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pellicle |
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which attachment is hardest to remove? |
mechanical locking |
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what is direct contact attachment? |
between calculus and exposed roots and strongly attached to cementum |
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how do you prevent calculus? |
homecare instruction professional supervision |
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What does the professional removal of calculus benefit? |
makes environment conducive to healing easier maintenance |
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what is the significance of radiographs for calculus? |
aids in detection guides during scaling patient education |
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What is the objective of anticalculus dentifrices and mouthrinses? |
inhibits calculus growth |
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what should the patient be taught about calculus? |
person oral hygiene how it forms what it is effects on peridontium |
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how long does it take for supra gingival calculus to form? |
3-20 days |
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how early can mineralization of subgingival calculus begin? |
24 - 48 hours |
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what do anti calculus agents have that prevents calculus?
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pyrophosphates
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