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Questions and Answers
What defines dental caries?
What defines dental caries?
Which of the following factors contributes to the aetiology of dental caries?
Which of the following factors contributes to the aetiology of dental caries?
Which statement correctly summarizes the carious process?
Which statement correctly summarizes the carious process?
What role do bacteria play in dental caries?
What role do bacteria play in dental caries?
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Which of the following correctly describes aetiological factors leading to dental caries?
Which of the following correctly describes aetiological factors leading to dental caries?
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Which of the following statements is FALSE regarding dental caries?
Which of the following statements is FALSE regarding dental caries?
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What is one of the primary ways to combat dental caries?
What is one of the primary ways to combat dental caries?
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Which of the following psychological factors can contribute to poor oral health?
Which of the following psychological factors can contribute to poor oral health?
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What is a common result of untreated dental caries?
What is a common result of untreated dental caries?
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What are the primary agents responsible for the development of caries?
What are the primary agents responsible for the development of caries?
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Which of the following accurately describes the term 'susceptible tooth surface'?
Which of the following accurately describes the term 'susceptible tooth surface'?
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What role do fermentable carbohydrates play in the caries process?
What role do fermentable carbohydrates play in the caries process?
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Which areas of the tooth are commonly considered more susceptible to caries?
Which areas of the tooth are commonly considered more susceptible to caries?
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In the context of caries, what is the main consequence of plaque biofilm accumulation?
In the context of caries, what is the main consequence of plaque biofilm accumulation?
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How does the presence of time factor into the development of caries?
How does the presence of time factor into the development of caries?
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What is the definition of dental caries?
What is the definition of dental caries?
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What is a significant factor influencing the susceptibility of certain tooth areas to caries?
What is a significant factor influencing the susceptibility of certain tooth areas to caries?
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Why are lactic acid and its production significant in the context of caries?
Why are lactic acid and its production significant in the context of caries?
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Which of the following best exemplifies the term 'fermentable carbohydrates' in relation to dental biofilm?
Which of the following best exemplifies the term 'fermentable carbohydrates' in relation to dental biofilm?
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Which type of carbohydrate is most rapidly metabolised to produce extracellular polysaccharides?
Which type of carbohydrate is most rapidly metabolised to produce extracellular polysaccharides?
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Which of the following sugars is classified as an intrinsic sugar?
Which of the following sugars is classified as an intrinsic sugar?
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What is the primary characteristic of extrinsic sugars?
What is the primary characteristic of extrinsic sugars?
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Which carbohydrate is less cariogenic?
Which carbohydrate is less cariogenic?
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What occurs when the pH becomes acidic in relation to tooth structure?
What occurs when the pH becomes acidic in relation to tooth structure?
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Which type of carbohydrate is only slightly broken down by salivary amylase over time?
Which type of carbohydrate is only slightly broken down by salivary amylase over time?
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When bacteria metabolise simple sugars, what is the primary byproduct produced?
When bacteria metabolise simple sugars, what is the primary byproduct produced?
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Which of the following accurately describes the critical pH for tooth enamel?
Which of the following accurately describes the critical pH for tooth enamel?
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Which of the following sugars is an example of an extrinsic sugar?
Which of the following sugars is an example of an extrinsic sugar?
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What is the role of saliva when the pH becomes acidic?
What is the role of saliva when the pH becomes acidic?
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What role do anaerobic bacteria play in the development of caries?
What role do anaerobic bacteria play in the development of caries?
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What is the relationship between sugar consumption frequency and enamel remineralisation?
What is the relationship between sugar consumption frequency and enamel remineralisation?
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Which bacteria are most commonly associated with enamel caries?
Which bacteria are most commonly associated with enamel caries?
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What finding was observed in the Vipeholm study regarding sugar type and frequency?
What finding was observed in the Vipeholm study regarding sugar type and frequency?
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What happens to calcium ions if sugar is consumed more frequently than every 2-3 hours?
What happens to calcium ions if sugar is consumed more frequently than every 2-3 hours?
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What is the result of prolonged sugar consumption on tooth enamel?
What is the result of prolonged sugar consumption on tooth enamel?
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What is the critical pH threshold for enamel?
What is the critical pH threshold for enamel?
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What occurs when the pH is above the critical pH?
What occurs when the pH is above the critical pH?
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How does frequent acid attacks impact the risk of caries?
How does frequent acid attacks impact the risk of caries?
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What was the resting pH of dental plaque according to studies from the 1940s?
What was the resting pH of dental plaque according to studies from the 1940s?
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Which bacteria are favored as pH drops in the presence of fermentable carbohydrates?
Which bacteria are favored as pH drops in the presence of fermentable carbohydrates?
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Why is time an important factor in the carious process?
Why is time an important factor in the carious process?
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What happens during an acidic environment in relation to tooth minerals?
What happens during an acidic environment in relation to tooth minerals?
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What is the important concept regarding the mineral from saliva and pH levels?
What is the important concept regarding the mineral from saliva and pH levels?
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How long does it typically take for pH levels in dental plaque to return to normal after sugar exposure, as per Stephan's curve?
How long does it typically take for pH levels in dental plaque to return to normal after sugar exposure, as per Stephan's curve?
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What is the relationship between biofilm thickness and oxygen levels?
What is the relationship between biofilm thickness and oxygen levels?
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Study Notes
Aetiology of Dental Caries
- Dental caries is a localized, chemical dissolution of tooth surface caused by metabolic activity in a microbial biofilm.
- The process is reversible in its early stages.
- Caries affects all tooth hard tissues (enamel, dentin, and cementum).
Learning Outcomes
- Understand the aetiology and pathogenesis of oral disease.
- Recognize psychological and sociological factors affecting oral health and treatment success.
- Understand the importance of each component in patient assessment.
- Explain the role of dental therapists in tooth restoration.
Intended Learning Outcomes
- Define dental caries.
- Explain the aetiology of dental caries.
- Identify and describe four aetiological factors leading to dental caries.
- List evidence supporting the proposed aetiologies.
Why Teeth Are Lost
- Periodontal disease
- Trauma
- Elective procedures
- Caries
Burden of Dental Caries
- Average cost of a child extraction at hospital: £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
Preventing Dental Caries
- Prevent and treat dental caries by understanding the aetiology.
What Is the Caries Process?
- A localized, chemical dissolution of a tooth surface.
- Resulting from metabolic activity in a microbial deposit (dental biofilm) on the tooth surface.
Main Points
- Involves chemicals
- Involves microbes and their metabolites
- Involves dissolution
- Affects all hard tissues
- Can be reversed
- Involves fermentable carbohydrates
- Often localized
Aetiological Agents for Caries
- Susceptible tooth surface
- Plaque bacteria
- Fermentable carbohydrates
- 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.
True Extent
- Factors Influencing Caries: Education, social class, income, saliva flow rate, diet, microbial frequency, microbial composition, behaviour, attitudes impacting microbial deposit PH, time, saliva composition, buffer capacity, and sugar clearance rate.
Susceptible Tooth Surface
- All dental hard tissues are susceptible to some extent.
- Some areas are more susceptible; pits and fissures, smooth surfaces, and proximal areas with defective margins like ledges or overhangs, are more conducive to plaque accumulation.
Fermentable Carbohydrates
- Bacteria require nutrients to survive.
- Sugars in the diet provide a substrate for oral commensal bacteria.
- The bacteria metabolise the sugars, producing lactic acid.
Types of Sugars
- Intrinsic sugars: naturally occurring sugars (fruit, vegetables).
- Extrinsic sugars: added sugars or sugars from processed foods.
Bacteria + Sugars = Acid
- Bacteria metabolise simple sugars to produce acid in the mouth.
Critical pH
- When pH drops below 5.5, enamel starts demineralization.
- Critical pH value for dentin is approximately 6.0 to 6.5.
- Enamel is more prone to caries in a lower critical pH range.
Time Factor
- Frequent sugar intake means more time to lower the pH level below the critical level.
- This prolonged acid attack leads to more demineralization.
- Infrequent intake allows for remineralization over time.
Plaque Bacteria
- Plaque bacteria need food to survive.
- The composition of the bacteria in the biofilm changes depending on pH levels and oxygen levels.
- Anaerobic bacteria produce more lactic acid, further lowering the pH, and leading to more demineralization.
Summary of Dental Caries
- Caries develops on susceptible tooth surfaces covered by plaque biofilms.
- Sugars in the diet provide the substrate for producing lactic acid which demineralizes the tooth enamel causing calcium ions to pass into the plaque.
- Mutans streptococci are associated with enamel caries.
- Remineralisation/demineralisation processes occur in a delicate balance. Higher frequency of intake is beyond 2-3 hours, remineralization is less likely and caries more likely.
Evidence for Caries
- Experiments with germ-free rats confirmed bacteria are necessary for caries.
- Studies like the Vipeholm Study (1945-1952) demonstrated the cariogenic effects of different dietary compositions and frequencies. Studies involving different populations and their dietary habits confirmed that a high frequency of sugary foods leads to caries.
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Description
Test your understanding of the aetiology and pathogenesis of dental caries. This quiz covers the factors contributing to tooth decay, the impact of psychological and sociological aspects on oral health, and the role of dental therapists. Delve into the complexities of dental caries and its implications on patient care.
