Aetiology of Dental Caries medium
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Questions and Answers

What characterizes intrinsic sugars?

  • They are present in natural form and packaged intracellularly. (correct)
  • They have no effect on dental caries.
  • They are readily available for immediate metabolism by bacteria.
  • They are often found in processed foods.
  • Which statement about extrinsic sugars is correct?

  • They are more complex carbohydrates that take longer to metabolize.
  • They are always found in natural foods.
  • They require a breakdown process before bacteria can use them.
  • They are readily available and highly cariogenic. (correct)
  • Why are complex carbohydrates like starch considered less cariogenic?

  • They metabolize quickly to produce acid.
  • They do not contribute to energy production.
  • They require a breakdown process before sugars are released. (correct)
  • They are fully digested in the mouth.
  • Which of the following sugars is an example of an extrinsic sugar?

    <p>Glucose (B)</p> Signup and view all the answers

    What happens to intrinsic sugars once they are released from their cellular structure?

    <p>They are metabolized quickly to produce energy. (D)</p> Signup and view all the answers

    Which food item would most likely contain extrinsic sugars?

    <p>Honey (C)</p> Signup and view all the answers

    What defines the cariogenic potential of a carbohydrate?

    <p>The speed at which it can be metabolized by bacteria. (A)</p> Signup and view all the answers

    What is the primary product of bacterial metabolism of sugar in the mouth?

    <p>Acid (A)</p> Signup and view all the answers

    What happens to tooth enamel when the pH drops below the critical level?

    <p>It starts to demineralize (B)</p> Signup and view all the answers

    At what pH does the demineralization of enamel typically begin?

    <p>5.5 (B)</p> Signup and view all the answers

    Why is dentine more susceptible to caries compared to enamel?

    <p>It requires a lower pH to dissolve (C)</p> Signup and view all the answers

    What is the critical pH range for dentine?

    <p>6.0-6.5 (D)</p> Signup and view all the answers

    What is the role of saliva in relation to acid produced by bacteria?

    <p>Saliva draws out ions from hydroxyapatite (D)</p> Signup and view all the answers

    What process can occur if mineral loss from a demineralized tooth is not irreversible?

    <p>Remineralization (C)</p> Signup and view all the answers

    What happens to phosphates and hydroxides in saliva when the environment becomes acidic?

    <p>They become supersaturated (D)</p> Signup and view all the answers

    What is the primary cause of dental caries?

    <p>Bacterial activity in dental biofilm (B)</p> Signup and view all the answers

    Which of the following best describes dental caries?

    <p>A progressive disease caused by metabolic events in a dental biofilm (B)</p> Signup and view all the answers

    What component is essential for preventing dental caries, according to the learning outcomes?

    <p>Understanding the mechanisms behind dental caries (B)</p> Signup and view all the answers

    Which of these factors does not contribute to poor oral health?

    <p>Good dietary choices (A)</p> Signup and view all the answers

    At what stage is dental caries considered reversible?

    <p>At the earliest stages (C)</p> Signup and view all the answers

    What role do fermentable carbohydrates play in the carious process?

    <p>They serve as a food source for bacteria (B)</p> Signup and view all the answers

    Which of the following is NOT part of the patient assessment process in relation to dental health?

    <p>Providing dental treatments immediately (A)</p> Signup and view all the answers

    What is a significant outcome of understanding dental caries as a dental professional?

    <p>Preventing and treating dental caries effectively (C)</p> Signup and view all the answers

    Which of the following best summarizes pathogenic factors of dental caries?

    <p>A combination of bacteria, carbohydrates, and poor oral hygiene (B)</p> Signup and view all the answers

    What is considered a major psychological factor influencing oral health?

    <p>Stress and anxiety about dental visits (A)</p> Signup and view all the answers

    Which type of surfaces are more likely to attract food debris and plaque biofilm?

    <p>Grooved surfaces (A), Proximal ledges/overhangs (B)</p> Signup and view all the answers

    Which carbohydrate is considered most cariogenic due to its rapid metabolism by bacteria?

    <p>Sucrose (C)</p> Signup and view all the answers

    What is a secondary local factor that can lead to increased plaque biofilm accumulation?

    <p>Proximal ledges/overhangs (A)</p> Signup and view all the answers

    Why are complex carbohydrates like starch less cariogenic than simple sugars?

    <p>They are tough for bacteria to metabolize. (B)</p> Signup and view all the answers

    What are intrinsic sugars primarily found in?

    <p>Fruits and vegetables (D)</p> Signup and view all the answers

    Which of the following is NOT a characteristic of bacteria in plaque biofilm?

    <p>They require complex proteins to survive. (C)</p> Signup and view all the answers

    What is the primary food source for bacteria in plaque biofilm?

    <p>Fermentable carbohydrates (B)</p> Signup and view all the answers

    What characteristic makes smooth surfaces less prone to plaque biofilm accumulation compared to grooved surfaces?

    <p>Smoother texture (C)</p> Signup and view all the answers

    In terms of cariogenic potential, which statement is true of fermentable carbohydrates?

    <p>Some carbohydrates are more cariogenic than others. (A)</p> Signup and view all the answers

    What typically happens to sugars like sucrose when metabolized by mouth bacteria?

    <p>They generate lactic acid. (C)</p> Signup and view all the answers

    What is required for dental caries to occur?

    <p>Susceptible tooth surface, plaque bacteria, time, and fermentable carbohydrates (D)</p> Signup and view all the answers

    What is the role of microbes in chemical dissolution related to dental caries?

    <p>Their metabolites contribute to the dissolution of hard tissue (A)</p> Signup and view all the answers

    Which statement best describes the process of caries formation?

    <p>It requires a combination of time along with other factors for development (A)</p> Signup and view all the answers

    What is the primary composition of dental biofilm?

    <p>Microbial deposits including bacteria and their metabolites (D)</p> Signup and view all the answers

    What factor is NOT a contributor to the risk of dental caries?

    <p>The absence of plaque bacteria (C)</p> Signup and view all the answers

    How can the process of caries be described in detail?

    <p>It is a localized chemical dissolution caused by microbial activity (B)</p> Signup and view all the answers

    What aspect makes certain areas of the tooth more susceptible to caries?

    <p>The ability of plaque biofilm to accumulate in those areas (B)</p> Signup and view all the answers

    What are the defining characteristics of fermentable carbohydrates in relation to caries?

    <p>They promote the growth of plaque bacteria and acid production (B)</p> Signup and view all the answers

    Which definition encompasses all the necessary components of caries formation?

    <p>A localized, chemical dissolving of a susceptible tooth surface over time (D)</p> Signup and view all the answers

    What time frame is critical in the formation of dental caries?

    <p>Over a sustained period involving exposure to fermentable carbohydrates (B)</p> Signup and view all the answers

    Flashcards

    Fermentable Carbohydrates

    Sugars that bacteria can use to produce acid, leading to tooth decay (caries).

    Critical pH

    The acidity level at which tooth enamel and dentin start to lose minerals.

    Dental Caries

    Tooth decay caused by bacteria metabolizing fermentable carbohydrates to produce acids.

    Demineralization

    The loss of minerals from tooth enamel and dentin caused by acid.

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    Enamel Critical pH

    The pH level (around 5.5) at which enamel begins to demineralize.

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    Dentin Critical pH

    The pH level (around 6.5) at which dentin begins to demineralize.

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    Bacteria + Sugar

    A reaction that creates acid, which causes the tooth surface to dissolve.

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    Remineralization

    The process where teeth can regain lost minerals, stopping the dissolving process.

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    Dental Caries Definition

    A localized chemical breakdown of tooth surface caused by bacteria metabolizing sugars in plaque.

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    Dental Caries Aetiology

    The study of the causes of dental caries.

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    4 Aetiological Factors

    Factors leading to dental caries: Bacteria, Fermentable Carbohydrates, Tooth Surface, Host Factors.

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    Bacterial Plaque

    A sticky film of bacteria living on teeth.

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    Fermentable Carbohydrates

    Sugars that bacteria in plaque easily metabolize.

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    Tooth Surface

    The exterior part of a tooth, including enamel, dentin, and cementum.

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    Host Factors

    Personal factors like saliva quality and immune system that affect caries risk.

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    Carious Process

    The progressive breakdown of tooth structure by bacteria.

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    Reversible Caries

    Dental caries that can be repaired or halted in its early stages.

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    Progressive Caries

    Dental caries that worsen over time, eventually causing more issues.

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    Chemical Dissolution

    The process where chemicals, often involving microbes and their metabolic byproducts, break down hard dental tissues.

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    Dental Caries Aetiology

    The cause of dental caries, involving susceptible tooth surface, plaque bacteria, time, and fermentable carbohydrates.

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    Susceptible Tooth Surface

    Areas of the tooth more prone to dental caries due to factors like plaque accumulation.

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    Plaque Bacteria

    The bacteria that contribute to the chemical process of tooth decay.

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    Fermentable Carbohydrates

    Sugars that bacteria use to produce acids, leading to tooth decay.

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    Intrinsic Sugars

    Sugars present naturally in fruits and vegetables, packaged inside cells.

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    Extrinsic Sugars

    Free sugars not enclosed in cells, readily available for bacteria.

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    Localized Chemical Dissolution

    The breakdown of teeth that happens in specific areas, often caused by bacteria and their products.

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    Cariogenicity (Sugars)

    Potential to cause tooth decay.

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    Dental Biofilm

    A sticky layer of bacteria that accumulates on teeth, providing a breeding ground for decay-causing bacteria.

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    Extrinsic Sugar Example

    Table sugar, glucose, and fructose are examples.

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    Caries

    Cavities or tooth decay, caused by the interaction of specific factors.

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    Tooth Surface Susceptibility

    Variations in the tooth's ability to resist decay, related to plaque build-up.

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    Intrinsic Sugar Example

    Sugars in fruit, vegetables locked within the cells

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    Caries Risk - Intrinsic

    Less likely to cause cavities than extrinsic sugars because process of being released and available to metabolise takes time.

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    All-encompassing Definition of Caries

    A specific type of chemical erosion of tooth enamel caused by bacteria's metabolic activity on fermentable sugars, over time, in a vulnerable spot.

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    Caries Risk - Extrinsic

    Highly cariogenic because they are immediately available to bacteria which metabolize to produce acid.

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    Defective margins

    Areas on teeth where the restoration (filling) is not properly sealed, creating spaces for food and bacteria to accumulate.

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    Pits and fissures

    Small grooves or pits in the tooth surface.

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    Grooved surfaces

    Areas on the tooth surface with grooves attracting food and plaque.

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    Fermentable Carbohydrates

    Sugars that bacteria use to produce acids, leading to tooth decay.

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    Plaque Biofilm

    A sticky film of bacteria that forms on teeth.

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    Sugars

    Types of carbohydrates that oral bacteria use to produce acid.

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    Sucrose

    A type of sugar that bacteria readily metabolize, forming plaque acids faster than other sugars.

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    Complex carbohydrates

    Carbohydrates (like starch) that are not easily broken down by bacteria in the mouth.

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    Intrinsic sugars

    Sugars naturally occurring in foods.

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    Extrinsic sugars

    Added sugars in processed foods.

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    Study Notes

    Aetiology of Dental Caries

    • Dental caries is a localized chemical dissolution of tooth surfaces.
    • It's caused by metabolic activity within a microbial deposit (biofilm) on tooth surfaces.
    • The process is highly dependent on the presence of fermentable carbohydrates.

    Learning Outcomes

    • Understand the aetiology (cause) and pathogenesis (development) of oral diseases.
    • Recognize psychological and sociological factors affecting oral health.
    • Discuss components of patient assessment processes.
    • Explain the role of dental therapists in tooth restoration.
    • Define dental caries.
    • Explain the aetiology of dental caries.
    • List and describe four aetiological factors causing dental caries.
    • List evidence supporting the proposed aetiologies.

    Why do we lose teeth?

    • Periodontal disease
    • Trauma
    • Elective removal
    • Dental caries

    Burden of Dental Caries

    • Average cost of a tooth extraction for a child under 5 is £836.
    • £50.5 million was spent on tooth extractions for those under 19 between 2015 and 2016.
    • £7.8 million was spent on tooth extractions for those under 5 during this time.

    So What?

    • Understanding dental caries is crucial for prevention and treatment.
    • This impacts the quality of life and healthcare costs.

    The Caries Process

    • The process involves localized chemical dissolution of tooth tissues.
    • It is a progressive disease (in its early stages it is reversible) of tooth hard tissues (enamel, dentin, cementum).
    • Bacteria metabolize fermentable carbohydrates to produce acids

    Main Points

    • Caries is often localized.
    • Involves chemical dissolution.
    • Involves microbes and their metabolites.
    • Affects all hard tissues.
    • Involves fermentable carbohydrates.
    • Can be reversible.

    Aetiological Agents for Caries

    • Susceptible tooth surface
    • Plaque bacteria
    • Fermentable carbohydrates
    • Time

    All-Encompassing Definition of Caries

    • A localized chemical dissolution of a susceptible tooth surface, over time, caused by metabolic activity associated with fermentable carbohydrates and a microbial deposit (biofilm).

    True Extent of Caries

    • Factors like social class, education, income, diet, saliva composition, microbial frequency, behaviour & attitudes influence the development of dental caries

    1. Susceptible Tooth Surface

    • All dental hard tissues are susceptible to some degree of caries.
    • Some areas are more susceptible due to factors like pits and fissures, smooth surfaces, proximals and defective margins.
    • These areas are more prone to biofilm accumulation.

    Which Areas of the Tooth are Susceptible?

    • Pits and fissures
    • Smooth surfaces
    • Proximal surfaces
    • Defective margins/ledges/overhangs

    2. Fermentable Carbohydrates

    • Bacteria need food to survive, and sugars in diets provide the substrate needed for their metabolism.
    • This results in lactic acid production
    • Not all sugars are equally cariogenic.
    • Sucrose is the most rapidly metabolized.
    • Intrinsic sugars are naturally occurring (e.g., fruit sugars).
    • Extrinsic sugars are added to foods (e.g., table sugar).
    • Complex carbohydrates (e.g., starch) are less cariogenic because these are not easily broken down within the mouth, which means that the time for acid production is increased and more difficult.

    Bacteria and Simple Sugars

    • Bacteria, in the presence of simple sugars, produce acids that can demineralize tooth surfaces.

    What Does 'Critical' pH Mean?

    • Critical pH is the point below which tooth tissues start demineralizing.

    Critical pH Values

    • Critical pH for enamel is approximately 5.5.
    • Critical pH for dentin is approximately 6.5

    3. Time

    • Time is a crucial factor in the development of caries.
    • For caries to develop, there needs to be a period of time where all the factors are present.
    • The frequency of sugar intake is important-frequent intakes provide opportunity for more de-mineralization.
    • Grazing, snacking, suckling increase instances of acid attacks within the mouth.
    • Aim to reduce frequency of sugar intake and monitor

    4. Plaque Bacteria

    • Plaque bacteria are needed for caries to develop.
    • The composition of the biofilm changes with time and pH fluctuations.
    • Shifting bacterial populations influence the production of acids that demineralize enamel and dentin tissues.

    Summary

    • Caries develops in susceptible areas of the tooth, influenced by microbial activity, fermentable sugars and prolonged exposure.
    • Frequent sugar intake increases the risk of acid production and demineralization.
    • The see-saw of remineralization and demineralization is key and can be influenced by the frequency of sugar intake impacting the rate of demineralization influencing the likelihood of damage within the enamel.

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    Description

    This quiz delves into the causes and development of dental caries, exploring essential factors that contribute to tooth decay. It covers the microbial biofilm, the influence of dietary carbohydrates, and broader implications for oral health. Participate to consolidate your understanding of dental caries and related oral diseases.

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