Aetiology of Dental Caries
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Questions and Answers

Which sugar is most rapidly metabolized to produce extracellular polysaccharides?

  • Glucose
  • Lactose
  • Sucrose (correct)
  • Fructose
  • What distinguishes extrinsic sugars from intrinsic sugars?

  • Extrinsic sugars are found in unprocessed foods.
  • Extrinsic sugars are intracellularly packaged.
  • Extrinsic sugars include lactose and fructose.
  • Extrinsic sugars are not bound within a cellular structure. (correct)
  • What is a consequence of simple sugars being metabolized by bacteria?

  • Reduction in plaque formation
  • Increased enamel mineralization
  • Production of acid (correct)
  • Enhanced saliva flow
  • Which carbohydrates are considered less cariogenic due to their digestion?

    <p>Starch and complex carbohydrates (A)</p> Signup and view all the answers

    What does a critical pH level indicate regarding tooth enamel?

    <p>Tooth tissue starts to lose minerals below critical pH. (B)</p> Signup and view all the answers

    Which of the following foods contain intrinsic sugars?

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

    What process occurs when saliva becomes supersaturated with ions in acidic environments?

    <p>Demineralization of enamel (B)</p> Signup and view all the answers

    Which carbohydrate listed is only slightly broken down by salivary amylase?

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

    What is the definition of dental caries?

    <p>A reversible disease involving chemical dissolution of tooth surfaces (B)</p> Signup and view all the answers

    Which factor is NOT associated with the aetiology of dental caries?

    <p>Genetic predisposition to tooth enamel strength (C)</p> Signup and view all the answers

    Which of the following best describes the aetiological agents for caries?

    <p>Susceptible tooth surface and time (C)</p> Signup and view all the answers

    What is the role of biofilm in the carious process?

    <p>It harbors bacteria that lead to chemical dissolution of teeth (D)</p> Signup and view all the answers

    Which component is essential for preventing dental caries?

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

    What does the term ‘fermentable carbohydrates’ refer to in the context of caries?

    <p>Sugars that bacteria can metabolize to produce acids (A)</p> Signup and view all the answers

    Which of the following structures is considered a susceptible area for caries development?

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

    Which of the following statements best describes the carious process?

    <p>It leads to the gradual loss of hard tissue due to metabolic activity of bacteria (B)</p> Signup and view all the answers

    What is a primary method to treat dental caries?

    <p>Fluoride application and restorative procedures (A)</p> Signup and view all the answers

    What metabolic activity is primarily responsible for the dissolution of tooth surfaces in caries?

    <p>Glucose fermentation by plaque bacteria (C)</p> Signup and view all the answers

    Which of the following does not contribute to poor oral health?

    <p>Regular dental check-ups (B)</p> Signup and view all the answers

    Which statement accurately represents the all-encompassing definition of caries?

    <p>A localized chemical dissolution caused by metabolic activity in a dental biofilm (B)</p> Signup and view all the answers

    What is the significance of understanding the aetiology of dental caries in clinical practice?

    <p>It allows for the application of different treatment protocols (D)</p> Signup and view all the answers

    What is the role of plaque bacteria in the process of caries formation?

    <p>They metabolize fermentable carbohydrates to produce acids (B)</p> Signup and view all the answers

    Which area is NOT typically considered a susceptible site for dental caries?

    <p>Occlusal surface of molars (A)</p> Signup and view all the answers

    In caries development, what factor is critical alongside the presence of a susceptible tooth surface?

    <p>Time for the metabolic processes to occur (B)</p> Signup and view all the answers

    What occurs when the pH of the environment is greater than the critical pH for enamel?

    <p>Remineralisation of enamel (A)</p> Signup and view all the answers

    Which of the following statements about time and frequency of acid attacks is true?

    <p>Regular frequency increases the risk of demineralisation. (B)</p> Signup and view all the answers

    Which bacteria are favored when the pH drops below the critical level?

    <p>Lactobacillus and Streptococcus mutans (A)</p> Signup and view all the answers

    What is the effect of an acidic environment on tooth minerals?

    <p>It dissolves tooth minerals. (C)</p> Signup and view all the answers

    According to Stephan's studies, how long does it typically take for the pH to return to normal after exposure to fermentable sugars?

    <p>Up to 1 hour (C)</p> Signup and view all the answers

    What is the critical pH range for dentine?

    <p>6-6.5 (A)</p> Signup and view all the answers

    What happens to the tooth when there is a neutral environment?

    <p>Reversal of tooth decay begins. (A)</p> Signup and view all the answers

    What effect does a thicker dental biofilm have on bacterial populations?

    <p>Promotes anaerobic conditions (B)</p> Signup and view all the answers

    What is the primary effect of lactic acid produced by anaerobic bacteria on tooth enamel?

    <p>It causes demineralisation of the enamel. (A)</p> Signup and view all the answers

    Which bacteria are primarily associated with enamel caries development?

    <p>Mutans streptococci (D)</p> Signup and view all the answers

    What happens to calcium ions in plaque when sugar is consumed more frequently than every 2-3 hours?

    <p>More calcium ions move into the plaque than are readded. (D)</p> Signup and view all the answers

    In the Vipeholm study, which group of patients showed the most caries development?

    <p>Patients given the most cariogenic food with high frequency. (D)</p> Signup and view all the answers

    How does frequent sugar intake affect the balance of demineralisation and remineralisation?

    <p>It favors demineralisation due to calcium loss. (B)</p> Signup and view all the answers

    What condition can develop if demineralisation continues over time?

    <p>White spot lesions on the enamel. (A)</p> Signup and view all the answers

    Which of the following is true regarding the role of sugars in caries development according to the content provided?

    <p>Sugars provide the substrate for bacteria to produce acid. (B)</p> Signup and view all the answers

    What was highlighted by the Tristan de Cunha case regarding diet and dental health?

    <p>The import of cariogenic foods led to increased caries rates. (D)</p> Signup and view all the answers

    Flashcards

    Fermentable Carbohydrate

    Carbohydrates that can be metabolized by bacteria to produce acids.

    Intrinsic Sugars

    Naturally occurring sugars found in unprocessed foods, packaged intracellularly.

    Extrinsic Sugars

    Sugars not bound within a cellular structure, often found in processed foods.

    Cariogenic

    Substances that promote tooth decay by producing acid when metabolized by bacteria.

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    Critical pH

    The acidic pH level where tooth minerals begin to dissolve from saliva or plaque.

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    Simple Sugars

    Sugars like glucose, fructose, and sucrose that are quickly metabolized by bacteria.

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    Complex Carbohydrates

    Carbohydrates such as starch that are not completely digested in the mouth.

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    Demineralization

    The process of losing minerals like hydroxyapatite from tooth enamel due to acidic pH.

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    Dental Caries

    A localised chemical dissolution of tooth surface due to bacteria.

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    Aetiology of Dental Caries

    Factors that cause and contribute to dental caries development.

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    Four Aetiological Factors

    Four key contributors leading to dental caries: bacteria, diet, time, and teeth.

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    Microbial Deposits

    Biofilm on teeth consisting of bacteria that cause caries.

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    Reversible Caries

    Early stages of caries that can potentially be reversed.

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    Dental Plaque

    A sticky film of bacteria that forms on teeth surface.

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    Prevention of Dental Caries

    Methods to avoid the onset of dental caries.

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    Treatment of Dental Caries

    Approaches to address and restore carious teeth.

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    Critical pH for enamel

    The pH range (5-5.5) where tooth enamel begins to dissolve.

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    Stephan Curve

    A graph showing the change in plaque pH after exposure to fermentable sugars.

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    Frequency of Acid Attacks

    How often acid-producing bacteria are exposed to fermentable carbohydrates.

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    Caries-causing Bacteria

    Bacteria such as Lactobacillus and Streptococcus mutans that thrive in low pH environments.

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    Anaerobic Bacteria

    Bacteria that grow in environments with low oxygen, typical in thicker biofilms.

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    Plaque Biofilm

    A complex microbial community on tooth surfaces that causes caries.

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    Lactic Acid Production

    Anaerobic bacteria metabolize sugars, producing lactic acid.

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    Mutans Streptococci

    Bacteria primarily responsible for enamel caries development.

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    Caries Frequency Rule

    Frequent sugar intake (more than every 2-3 hours) increases caries risk.

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    Vipeholm Study

    Research showing sugar type and frequency impacts caries development.

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    Calcium Ion Movement

    Calcium ions transfer between plaque and tooth enamel during sugar consumption.

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    Caries Aetiology

    The causes of dental caries involve susceptible tooth surfaces, plaque bacteria, time, and fermentable carbohydrates.

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    Susceptible Tooth Surface

    Areas of a tooth that are more prone to decay due to structural defects or accumulation of plaque biofilm.

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    Plaque Bacteria

    Microorganisms that form dental biofilm and metabolize carbohydrates to produce acids causing tooth decay.

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    Localized Chemical Dissolution

    The process whereby a susceptible tooth surface breaks down chemically due to acid produced by bacteria.

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    Dental Biofilm

    A structured community of bacteria living on tooth surfaces, essential for the development of caries.

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    Susceptible Areas

    Specific locations on the tooth more likely to develop caries, such as pits, fissures, and proximal surfaces.

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    Metabolic Activity

    The biochemical processes by which bacteria convert fermentable carbohydrates into acids, affecting tooth health.

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    Study Notes

    Aetiology of Dental Caries

    • Dental caries is a localized, chemical dissolution of a tooth surface, caused by metabolic activity in plaque biofilm.
    • Dental caries is a progressive disease of the hard tissues (enamel, dentine, and cementum) and is reversible in the early stages.
    • Key factors contributing to dental caries are: susceptible tooth surface, fermentable carbohydrates, and plaque bacteria.

    Learning Outcomes

    • Understand the aetiology (cause) and pathogenesis (development) of oral diseases.
    • Recognize psychological and sociological factors impacting poor oral health and treatment success.
    • Explain the significance of each stage in the patient assessment process.
    • Explain the role of a dental therapist in tooth restoration.
    • Define what dental caries is.
    • Explain the aetiology of dental caries.
    • List and describe 4 aetiological factors leading to dental caries.
    • List the evidence supporting identified aetiologies.

    Reasons for Tooth Loss

    • Periodontal disease
    • Trauma
    • Elective procedures
    • Caries

    Burden of Dental Caries

    • Average cost of a tooth extraction in hospital for a child under 5 is £836.
    • £50.5 million was spent on tooth extractions for those under 19 in 2015-2016.
    • £7.8 million was spent on tooth extractions for those under 5 in the same period.

    Preventing Dental Caries and Treating It

    • Preventative and treatment strategies for reducing caries are dependent on understanding the process.

    What is the Caries Process?

    • A localized, chemical dissolution of a tooth surface brought about by metabolic activity within a microbial deposit (a biofilm) covering the affected surface area.
    • Dental caries are described in terms of their signs and symptoms, and a localized chemical dissolution of tooth surfaces by metabolic events happening within the biofilm (dental plaque).
    • The process is caused by the actions of bacteria on fermentable carbohydrates.

    Main Points

    • Involves chemicals.
    • Involves microbes and their metabolites.
    • Involves dissolution.
    • Affects all hard tissue.
    • Often localized.
    • Can be reversible.
    • Involves fermentable carbohydrates.

    Etiological Agents for Caries

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

    All Encompassing Definition

    • A localized, chemical dissolution of a susceptible tooth surface over time brought about by metabolic activity on fermentable carbohydrates in a microbial deposit (a dental biofilm) covering the tooth surface.

    True Extent

    • Factors influencing caries development include social class (saliva flow rate), education, diet (composition and frequency), microbial species, behavior and attitudes.
    • Saliva flow rate and its effect on the acid environment and mineral dissolution and remineralisation are important in the caries development process.

    Susceptible Tooth Surface

    • All dental hard tissues are susceptible to some degree of caries.
    • Some areas are more susceptible than others, including pits and fissures, smooth surfaces, and proximal surfaces.
    • Susceptible areas often have factors that increase their ability to accumulate plaque biofilm.

    Fermentable Carbohydrate

    • Bacteria need food to survive, and sugars present in the diet provide a substrate for oral commensal bacteria to metabolize and produce lactic acid.
    • Simple sugars (glucose, fructose, sucrose) are rapidly metabolized and produce acid, they are considered cariogenic.
    • Complex carbohydrates are not completely digested in the mouth and are less cariogenic.
    • Intrinsic sugars are naturally occurring sugars found in whole foods, like fruit and vegetables
    • Extrinsic sugars are not bound within a cellular structure, some are glucose, sucrose, lactose, fructose.

    Bacteria + Simple Sugars = Acid

    • Bacteria metabolizing simple sugars produce acid.
    • Critical pH is the point below which tooth tissue starts losing mineral to saliva or plaque.

    Critical pH

    • Critical pH of enamel is 5.5.
    • Critical pH of dentine is 6.5.

    Time

    • Time is a significant factor in caries development.
    • Frequent exposure to fermentable carbohydrates leads to more time below the critical pH, increasing demineralization risk.
    • Infrequent intake allows for remineralization to happen, lowering caries risk.

    Evidence for the Caries Process

    • Experiments with germ-free animals and those fed a sugar-free diet demonstrated the necessity of bacteria and fermentable carbohydrates for caries to develop.
    • The Vipeholm study (1945–1952) showed a correlation between cariogenic food frequency, quantity, and the development of caries.
    • Further studies on populations with limited access to cariogenic foods and beverages have also confirmed the role of the other factors in developing caries.

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    Aetiology Of Dental Caries PDF

    Description

    This quiz explores the causes and development of dental caries, a prevalent oral disease. Participants will learn about the contributing factors, the significance of patient assessment, and the role of dental therapists. Improve your understanding of the pathological aspects of dental health.

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