Dental Caries Flashcards

dental caries

an infectious disease of the dental calcified structures (enamel, dentin, and cementum) that is characterized by demineralization of the mineral composition and dissolution of the organic matrix (breakdown of the tooth surfaces)

WHO definition

dental caries as a localized, post-eruptive, pathogenic process of external origin involving softening of the hard tooth tissue and proceeding to the formation of a cavity

Microorganisms, carbohydrates, susceptible tooth surfaces

main factors in development of caries

S. mutans, S. sobrinus, Lactobacillus

microorganisms involved in caries process

critical pH

the pH at which demineralization occurs

4.5-5.5

critical pH for enamel demineralization

6-6.7

critical pH for root surface demineralization

invisible lesion

first stage of acid penetration of enamel

S. mutans, Lactobacillus

____________ is heavily present at the onset and initiation of the lesion and ____________ is more present once the lesion is more advanced.

acid, calcium phosphate

When these bacteria mix with dietary fermentable carbohydrates they produce ______, which then seeps into the tooth surface and dissolves the tooth mineral.It dissolves the __________ __________ mineral in the tooth enamel or dentin.

6.2-7

Prior to eating the pH level ranges from _______, lower in those that are more caries susceptible and higher in the caries resistant.

length, exposure

the amount of demineralization that occurs depends on the ________ of ___________ to the acid.

lowers, pH

the acidity formed from the bacteria and carbohydrate mix immediately ________ the Ph level in the oral cavity. The teeth hence are constantly going through a demineralization and mineralization process as the body fights the ____ level

invisible

The early subsurface infection is __________

bright light

White area lesion is visible with ________ _______

rough

white area appears in a later stage, the outside surface is ________

cavitation

visible, restoration necessary

sharp tip, blunt probe, back

Its important to not take a _______ _____ of an explorer to evaluate the surfaces. Use a _______ ______ or _____ side of explorer to not disrupt or further break down surfaces

phase 1 incipient lesion

subsurface demineralization; white area appears with no breakthrough to enamel surface; with time, area may turn brown from food, beverages, or tobacco use.

phase 2 untreated incipient lesion

Breakdown of enamel over the demineralized area: visible to observation and irregular to the gentle application of the side of an explorer tip or blunt probe.

rods, DEJ, tubules

Dental caries follows the general direction of the enamel _____, spreads at the _____, and then continues along the dentinal ________.

Class I

cavities in pits or fissures

Class II

cavities in proximal surfaces of premolars and molars

Class III

cavities in proximal surfaces of incisors and canines that do not involve the incisal edge

Class IV

cavities in proximal surfaces of incisors and canines that involve the incisal edge

Class V

cavities in the cervical 1/3 of facial or lingual surfaces (not pit or fissure)

Class VI

cavities on incisal edges of anterior teeth and cusp tips of posterior teeth

Pit and fissure caries

caries begins in a minute fault in the enamel. irregularity occurs where three or more lobes of the developing tooth join; closure of the enamel plates is imperfect

smooth surface caries

caries begins in smooth surfaces where there is no pit, groove, or other fault. It occurs in areas where dental biofilm is protected from removal, such as proximal tooth surfaces, protected near a contact area, cervical thirds of teeth, and other difficult-to-clean areas.

recurrent caries

occurs alongside a restoration

baby bottle syndrome

risk factor for early childhood caries, routine use of a nursing bottle (with milk or sweetened beverage) when going to sleep or prolonged at-will breast feeding

maxillary anterior teeth and primary molars

first teeth to be affected in early childhood caries from baby bottle syndrome

6

children need to be seen for an examination no later than ___ months after eruption of the first tooth.

age, age, recession

The incidence of root caries increases with ____, but not because of ____. Gingival __________ is necessary for root caries, which is related to periodontal infections that lead to recession

fluoride

low levels of root caries incidence has been shown to be directly related to the __________ concentration in the drinking water

root caries

Described as soft, leathery or hard, active are soft or leathery, Yellowish to light brown to black ,move laterally often encompassing the whole neck of the tooth and undermining the enamel.

cervical burnout

An apparent radiolucency found just below the CE junction on the root due to an anatomical variation or a gap between the enamel and the alveolar bone

saliva, fluoride

key factors that aid in remineralization

saliva

can balance or reverse the destruction of the tooth. It buffers- neutralizes the acid and supplies calcium and phosphate ions lost from the tooth.It is a source for fluoride transport to the tooth surfaces . It derives its fluoride from many sources.

risk factors

habits, behaviors, lifestyles, or conditions which increase the chance of a disease occurring

caries risk factors

lighting, visual acuity, detection instruments, air to dry surfaces, radiographs

Prerequisites for caries detection:

dry, air, light, vision, visually, blunt, remineralizing

Recognition of carious lesions:Preparation: ____ each tooth or group of teeth with compressed ____; adjust mouth mirror for indirect _____ and ______. Carefully inspect each surface, first _________ and then gently with a ________ explorer as necessary to confirm visual findings. Avoid using a sharp-pointed explorer in a potentially _________________ area.

white, marginal, margins, yellowish-brown, brown, rapidly, slowly

Recognition of carious lesions:Visual examination: characteristic changes in the color and translucency of tooth structure may be observed. Variations in color and translucency include the following: chalky _______ areas of demineralization; grayish-white discoloration of __________ ridges caused by dental caries of the proximal surface underneath; grayish-white color spreading from _________ of restorations. Open carious lesions may vary in color from _________________ to dark _________. Discoloration is generally less severe when dental caries progresses _________ than when it progresses _________.

side, tip, roughness, smoothness, breaks, remineralizing

Exploratory examination: Smooth surface caries. Technique: Adapt the _____ of the ____ of the probe or blunt explorer closely to the tooth surface. Examine for ____________ versus __________ and continuity of tooth surface versus ________ in continuity. Do not use pressure or break the surface when checking an area that may be _________________

discolored, sealant, obvious

Pit and fissure caries. When a pit or fissure is ____________, one may not determine visually whether dental caries is present. When the objective is to distinguish the pit for a _________ and the decision is made to place a it, the explorer can then be used to clean out the pit of debris in preparation for placement. An _________ cavity does not need to be explored.

complete

Neither clinical nor radiographic examination is _________ without the other.

restorative, acidogenic, lower, fluoride, sealants

Obvious lesions- schedule ____________ appointments. Eliminate as many or all of the active areas possible "nidus of infection"The carious areas contain a large number of ____________ bacteria. Well placed restorations with good marginal seals can ________ the bacterial count. There are restorative materials out there that have __________ releasing capabilities. __________ are to be considered to close off potential sites from harboring the bacteria , where they will thrive and multiple.

keep a food diary, reduce pop intake

Dietary: some patients may be high risk without carious lesions due to diet. May make suggestions like:

biofilm, acidogenic

When a cariogenic diet is used, _________ forms and grows more profusely. Patients who were fed sucrose by stomach tube had less ___________ biofilm than did patients who were fed sucrose by mouth

occlusal, incisal, gingival third

the friction of mastication has been shown to affect only the _________ and _________ thirds of the crowns of teeth. Biofilm on the __________ _______ collected in spite of a normal diet that included coarse bread and fresh fruit or chewing raw carrots three times daily as the only methods for personal care.

water bottles, rinses, 1.1

Fluoride use: Fluoridated water. Purchased _______ ________ do not have fluoride unless stated, tooth paste brushing 2-3 x day, OTC _______, RX level ____% fluoride dentifrice or gel to brush on before bed, no further rinsing

Xylitol

Present in some gum and mints. Inhibits streptococci mutans, reduces plaque formation and the attachment of the biofilm and inhibits demineralization.

chlorhexidine rinse .12%

rinse one minute daily one week each month. Good at killing streptococcus mutans and has high substantivity, meaning it last longer then regular rinses. It is an anti bacterial rinse but has had success in reducing caries.

calcium phosphate toothpastes

this toothpaste puts these important minerals back into the teeth

sealant

an organic polymer (resin) that flows into the pits and fissures and bonds to the enamel. Eliminates the environment that streptococcus mutans likes, makes them cleansable.

indications for sealant placement

High risk caries Recently erupted teeth with pits, and deep groovesCleansability issues

contraindications for sealant placement

Pit and fissures coalesced, cleansableRadiographic evidence of proximal cariesInsufficient eruption

enamel hypoplasia

a defect that occurs as a result of a disturbance in the formation of the organic enamel matrix. May be hereditary. May be a single or localized area. Teeth most affected are first molars, incisors, canines Factors that may contribute to this defect during tooth development include severe nutritional deficiency, particularly rickets; fever-producing diseases, such as measles, chickenpox, and scarlet fever; congenital syphilis; hypoparathyroidism; birth injury; prematurity; Rh hemolytic disease; fluorosis. May appear brown.

syphilis

Hutchinson's incisors and mulberry molars are typical crown forms that result from congenital _________.

attrition

the wearing away of a tooth as a result of tooth-to-tooth contact.Appearance: Initial lesion-- Small polished facet on a cusp tip or ridge, or slight flattening of an incisal edge. Advanced-- Gradual reduction in cusp height; flattening of incisal or occlusal plane as seen on the next slide. Staining of exposed dentin. Discoloration may occur; stain usually is brown. Radiographic. The pulp chamber and canals may be narrowed and sometimes obliterated as the result of formation of secondary dentin.

bruxism

etiology of attrition

may be psychological, tension, or occlusal interferences, coarse foods, chewing tobacco, or abrasive dusts associated with certain occupations.

predisposing factors for attrition

erosion

the loss of tooth substance by a chemical process that does not involve known bacterial action.

Chronic vomiting. Acid of chronic vomiting affects lingual surfaces, particularly anterior teeth. Pregnancy. Eating disorder, such as bulimia. Extrinsic. Industrial: workers' teeth can be exposed to atmospheric acids. Dietary: facial surfaces are most frequently affected. Carbonated beverages. Lemons or other citrus fruit sucked frequently. May be idiopathic (unknown).

etiology of erosion

Dental Caries Flashcards ionicons-v5-c

Dental Caries Flashcards