Dental Caries Flashcards | Quizlet 18/08/2017, 10:19 PM Dental Caries Flashcards | Quizlet 18/08/2017, 10:19 PM

specifically initiate
caries:

Stages of the Caries -acquired pellicle formation

Process: -bacterial adhesion
-plaque formation
Dental Caries 52 terms Erika_Tracy
-plaque metabolism
-enamel demineralizes at a PH of between 5.0 and 5.5
-if demineralization is greater than remineralization,
cavitation occurs

Dental Caries * an infectious microbiologic disease of the teeth that Acquired Pellicle a cellular, nonmineralized, layer that forms on teeth

results in localized dissolution and destruction of the Formation from salivary glycoproteins immediately after teeth are

calcified tissues. cleaned

*a destructive process causing delcalification of the Purpose of the performs a protective function for the tooth enamel,
tooth enamel and leading to continued destruction of acquired pellicle acting as a barrier to acids and a matrix for
enamel and dentin, and cavitation of the tooth. formation: remineralization.... but also serves as the initial site of

caries is a multi- *dietary sucrose attachment for cariogenic bacteria, specifically, S

factorial disease, *susceptible host mutans

consisting of 3 *carogene ? bacteria Bacterial Adhesion the adhesion process requires specific bacterial
components: receptors (that only MS has) capable of binding to the

Dietary Sucrose -dietary sugars & starches increase the risk of tooth salivary proteins of the acquired pellicle.

decay.
-the type of carbohydrate and the timing of ingestion Once attached, S mutans proliferates and spreads

are more important than the amount. laterally to form a matlike covering over the tooth

-sticky foods are more harmful than non-sticky foods surface

b/c they remain on the surface of the teeth.

-frequent snacking increases the time that acids are in This resulting mixed streptococcal mat allows the

contact with the surface of the tooth adherence of other organisms, such as filamentous and
spiral bacteria
Susceptible Host -teeth present in mouth
-areas for plaque to accumulate and stagnant Plaque Formation cellular, non mineralized, adherent, highly organized

-poor restoration margins mass of bacterial colonies in a gel-like matrix that

-calculus covers the tooth surface

-low availability of fluoride What causes the -high frequency sucrose exposure may be the single

Susceptible Host- -immature enamel is found on teeth immediately after

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Dental Caries Flashcards | Quizlet 18/08/2017, 10:19 PM Dental Caries Flashcards | Quizlet 18/08/2017, 10:19 PM

Susceptible Host- -immature enamel is found on teeth immediately after

plaque to become most important factor in producing a cariogenic
con't eruption. These teeth have reduced mineral content
cariogenic? plaque
and become completely mineralized over time by
-frequent sucrose ingestion begins a series of changes
saliva and F1-
in the tooth environment that promotes the growth of
*the longer a tooth is in the mouth, the less permeable
highly acidogenic bacteria
it becomes, therefore the less susceptible it becomes
-in contrast, when sucrose is absent, plaque growth
to caries
doesn't lead to caries
Low Salivary -physical cleaning properties
Caries Formation 1. Demin>Remin
Functions/Review of -provides calcium and phosphate for mineralization
2. white spot lesion aka incipient
salivas beneficial -carries topical fluoride around the mouth for
early lesion aka demineralized decalcified lesion
actions: remineralization
3.cavitated caries lesion aka cavity
-neutralizes the organic acids produced by plaque
-discourages the growth of bacteria through several Demineralization -a tooth loss of minerals, such as calcium in
enzymes and immune system immunoglobulins hydroxyapatite from the tooth matrix, caused by acidic
-contributes to the enamel maturation process exposure
-bacteria metabolize sugars to produce acid
Cariogenic organisms that cause caries
-acids diffuse into the enamel and dentin of the tooth
200-300 species of bacteria, yeast, and protozoa are
to minerals ? the tooths minerals (calcium and
indigenous to mouth
phosphate)
2 bacterial groups mutans streptococci
Remineralization -natural process in which a tooth's minerals are
associated with dental lactobacilli
restored or replaced
caries:
-remineralization reverses the process of decay caused
characteristics of the acidogenic from demineralization
2 groups that enables aciduric -depends on saliva
them to survive in the -neutralizes acids produced by plaque
oral cavity and -provides calcium and phosphate for remineralization
promote dental
White Spot Lesion ~a demineralized area of enamel that usually has an
caries:
intact surface remaining over the body of the
acidogenic produce acid (lactic acid) from sugar demineralized early carious lesion
-May be reversed by remineralization
aciduric can survive in an acidic environment
Clinical 1. when dried becomes chalky white opacities
Characteristics of MS -the ability to adhere to tooth surfaces
Characteristics of 2. when hydrated not detectable clinically
alone which makes it -ability to create a reserve source of energy for
white spot lesions: 3.undetectable by tactile examination with an explorer
cariogenic, and periods of famine
Cavitation -occurs when the subsurface demineralization is so
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Cavitation -occurs when the subsurface demineralization is so

inactive lesions -white
extensive that the tooth structure surface collapses
-shiny
-not reversible
-smooth
-the progression time from incipient caries to clinical
-hard
caries is estimated to be 12-24 months
-radiation induced xerostomia can lead to clinical Where do most -Mandibular 1st and 2nd molars
caries development in as little as 3 months from the carious lesions occur -Maxillary 1st and 2nd molars
onset of radiation {tooth type} -Mandibular 2nd Premolars, Maxillary 1st and 2nd
Premolars, Maxillary Incisors
Lesion progression once surface becomes cavitated, a more retentive
-Maxillary Canines, Mandibular 1st Premolars
surface area is available to the plaque community,
-Mandibular Incisors, Mandibular Canines
allowing filamentous bacteria that have poor adhesion
abilities, such as lactobacilli, to become established in Where do most -Pit & Fissure areas
the lesion carious lesion occur *occlusal surfaces
{by surface area} *buccal and lingual pits
Lesion progression Once enamel caries penetrates the DEJ, rapid lateral
-Smooth Enamel Surfaces
con't expansion takes place b/c the dentin is much less
*immediately gingival to the proximal contacts
resistant to caries attacks
*in the gingival one third of the facial and lingual
-initial pupal inflammation aka reversible pulpitis
surfaces of the clinical crown
-irreversible pulpitis
-Root Surfaces
-pulp necrosis
Pits & Fissures Etiology: most favorable habitat for S mutans, therefore
Restoration -a carious lesion can serve as a reservoir of MS and
most susceptible area for caries
lactobacilli, which can then establish infections on
Deep recesses shelter bacteria and limit access of
other tooth surfaces
salivary factors for remineralization
-restoration of carious lesions has significant beneficial
clinical effects in addition to the benefit of restoration
Treatment: if a cavitated lesion exists in a pit or fissure,
of the damaged tooth structure and maintenance of
it must be restored (filling)
pupal vitality b/c the restorative process also
effectively removes a nidus of infection
Prevention: if the pit or fissure is not cavitated but at
Caries detection implies finding a sign of the disease, this is the first step risk, then it should be sealed
in the diagnosis process
Smooth Enamel **Immediately gingival to the proximal contacts
caries diagnosis implies determining whether lesions are present, how Surfaces Etiology: size and shape of gingival papillae play a role
severe lesion are, active or arrested, and if they are rough surface caused by caries, poor quality
preventive or restorative treatment restoration, and/or calculus can all create environment
for new caries to occur
Traditional Caries 1. Visual

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Diagnosis 2. Tactile
3. Radiographs Treatment: Class II restoration
Crown/onlay if decay large
Visual: direct clinical 1.clean
examination can be 2.dry
Prevention: Flossing and Fluoride Treatments
done well only if the 3.illumintaed w/good light
teeth are: 4.changes in translucency, luster,stain, and shade may Smooth Enamel **in the gingival one third of the facial and lingual
indicate caries Surfaces con't surfaces
5. tooth color- NOT RELIABLE
Etiology: this area is not rubbed by bolus of food and
Tactile -Use light pressure probing with an explorer to assess
commonly not cleaned by the toothbrush, so plaque
surface hardness and smoothness
accumulates here
-High pressure probing with a sharp explorer is usually
Low salivary flow is contributing factor to this type of
contraindicated
lesion
*may cause cavitation in an incipient lesion
*may cause transfer of bacteria to a previously
Treatment: Class V restoration
uninfected site

Radiographs -bitewing radiographs used primarily to diagnose Prevention: Good brushing technique and saliva
caries for posterior teeth stimulants
-periapical radiographs used primarily to diagnose
Root Surfaces Etiology: Root surfaces exposed to oral environment,
caries for anterior teeth
usually b/c of gingival recession
what are the signs of -white spots on teeth when dry More common in older patients
incipient (early) -dull, flat, opaque, or etched appearance of enamel,
lesions? but it feels smooth to the explorer Treatment:Class V filling? Crown? Extraction?

what are signs of -gray discoloration

cavitation? -opaque area seen during transillumination Prevention: Excellent oral hygiene

-color of carious dentin is yellowish brown to dark More frequent dental visits for:

brown *elderly patients with poor motor coordination

-break in the enamel resulting in an actual hole *patients w/gingival recession

{cavitation} Dental Caries You Rampant Caries

active lesions: -white May Come Across Arrested

-chalky Recurrent

-rough Rampant Caries a rapidly progressive decay process that requires

-porous urgent intervention

inactive lesions -white

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the lesions are numerous and may be large the affected tooth. this makes the tooth's surface very
decayed dentin is soft and moist rough, and the defects often stand out b/c they are
early childhood caries, or ECC, is an example of this brown or yellow in color
-typically caused by malnutrition, illness, infection, or
Early Childhood **aka nursing caries, nursing bottle syndrome, or baby
fever during tooth formation
Caries bottle caries
-some medications can also affect the teeth that were
results from infants' and young children's prolonged
developing at the time of dosage
use of the baby bottle filled with sweetened juices or
-environmental factors can interfere with tooth
milk
formation as well, such as being exposed to toxic
commonly affects maxillary anterior teeth, particularly
chemicals at a very young age
facial surfaces
-the cause of this disease is undetermined
mandibular teeth can be protected by the tongue
-most cases occur before the age of 3
associated with high levels of S mutans {presumably
transmitted by the mother} Prevention -oral hygiene is the primary prevention against dental
caries
Arrested Caries dental decay is not a continuous demineralization
-this consists of personal proper care brushing at least
process
twice a day and flossing daily and professional regular
demineralized lesions may recalcify as a result of an
care dental examination and cleaning, at least once a
improved oral environment, especially in the presence
year
of frequent use of .05% sodium fluoride mouth rinses
-diet: often high in carbs
this recalcified lesion resulting from the
-artificial saliva: helps wash away debris
remineralization process is known as arrested caries
-good oral hygiene: lowers acid potential
characterized by their light brown or brown color, and
-topical fluroide: strengthens tooth structure
firm and glasslike surface when explored

Recurrent Caries ** May also be known as secondary decay

the new decay that occurs at the margin of existing
restorations
pose a threat b/c they may go undetected and invade
the tissue beneath for the restoration
Look for:
*open margins on crowns/fillings
*lost fillings
*amalgam fractures
*darkened margins of resins
*be suspicious of areas where plaque accumulation os
significant

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Radiation Caries radiation caries, a rapidly developing and highly

destructive form of tooth decay, is a well-known dental
consequence of radiotherapy of malignant tumors in
the head and neck region
caries of the cervical regions of the teeth, incisal
edges, and cusp tips secondary to xerostomoia
induced by radiation therapy to the head and neck

Dental Fluorosis Etiology: caused by a child receiving too much

fluoride during tooth development {between 1 and 4
years old}

Treatment: Dental fluorosis can be cosmetically

treated. depending on the severity, tooth bleaching
may be used; composite restorations or porcelain
veneers may be needed for more severe cases

Prevention: In November 2006, the ADA began

recommending that infants from 0-12 mo. use fluoride-
free or very low fluoride water with their formula
make sure children are not eating or swallowing
fluoridated toothpastes; parents need to monitor
brushing

Characteristics: In its mild form, which is the most

common, appears as tiny, white streaks or specks that
are often unnoticeable
In its most severe form, which is also called motting of
dental enamel, it is characterized by black and brown
stains, as well as cracking and pitting of teeth
Fluorosis cannot occur once the tooth has erupted

Enamel Hypoplasia -a tooth enamel defect that results in teeth having less
than normal amounts of enamel
-the missing enamel is usually localized, which results
in small dents, grooves or pits on the outer surface of

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