Aetiology of Dental Caries Quiz
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Questions and Answers

What defines dental caries?

  • A localized, chemical dissolution of tooth surfaces due to microbial activity (correct)
  • A reversible process affecting only the gums
  • A physical fracture of the tooth caused by trauma
  • An inflammatory condition affecting all oral soft tissues

Which of the following factors contributes to the aetiology of dental caries?

  • Exposure to excessive light during dental procedures
  • High fluoride levels in drinking water
  • The presence of fermentable carbohydrates in the biofilm (correct)
  • Regular use of mouthwashes with alcohol content

Which statement correctly summarizes the carious process?

  • It involves the local chemical destruction of tooth due to plaque activity. (correct)
  • It is an irreversible condition affecting all teeth equally.
  • It leads to the immediate death of dental tissue.
  • It is solely caused by poor brushing habits.

What role do bacteria play in dental caries?

<p>Bacteria produce acids that dissolve tooth minerals. (B)</p> Signup and view all the answers

Which of the following correctly describes aetiological factors leading to dental caries?

<p>Certain bacteria and fermentable carbs must coexist. (D)</p> Signup and view all the answers

Which of the following statements is FALSE regarding dental caries?

<p>Dental caries exclusively affect molar teeth. (B)</p> Signup and view all the answers

What is one of the primary ways to combat dental caries?

<p>Understanding and preventing the carious process (B)</p> Signup and view all the answers

Which of the following psychological factors can contribute to poor oral health?

<p>Anxiety leading to avoidance of dental visits (D)</p> Signup and view all the answers

What is a common result of untreated dental caries?

<p>Potential tooth loss and infection (A)</p> Signup and view all the answers

What are the primary agents responsible for the development of caries?

<p>Fermentable carbohydrates and plaque bacteria (A)</p> Signup and view all the answers

Which of the following accurately describes the term 'susceptible tooth surface'?

<p>Any area of dental hard tissue that can be affected by caries (A)</p> Signup and view all the answers

What role do fermentable carbohydrates play in the caries process?

<p>They provide energy for plaque bacteria, leading to acid production (D)</p> Signup and view all the answers

Which areas of the tooth are commonly considered more susceptible to caries?

<p>Pits and fissures, and proximal areas (C)</p> Signup and view all the answers

In the context of caries, what is the main consequence of plaque biofilm accumulation?

<p>Production of lactic acid leading to tooth decay (A)</p> Signup and view all the answers

How does the presence of time factor into the development of caries?

<p>Caries result from chronic exposure to acid over time (A)</p> Signup and view all the answers

What is the definition of dental caries?

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

What is a significant factor influencing the susceptibility of certain tooth areas to caries?

<p>Ability of plaque biofilm to accumulate in specific areas (C)</p> Signup and view all the answers

Why are lactic acid and its production significant in the context of caries?

<p>It contributes to the demineralization of the tooth surface. (B)</p> Signup and view all the answers

Which of the following best exemplifies the term 'fermentable carbohydrates' in relation to dental biofilm?

<p>Sugars and starches that can be metabolized by bacteria (A)</p> Signup and view all the answers

Which type of carbohydrate is most rapidly metabolised to produce extracellular polysaccharides?

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

Which of the following sugars is classified as an intrinsic sugar?

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

What is the primary characteristic of extrinsic sugars?

<p>They are not bound within a cellular structure. (D)</p> Signup and view all the answers

Which carbohydrate is less cariogenic?

<p>Complex carbohydrates like starch (B)</p> Signup and view all the answers

What occurs when the pH becomes acidic in relation to tooth structure?

<p>Mineral loss from teeth begins. (B)</p> Signup and view all the answers

Which type of carbohydrate is only slightly broken down by salivary amylase over time?

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

When bacteria metabolise simple sugars, what is the primary byproduct produced?

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

Which of the following accurately describes the critical pH for tooth enamel?

<p>It is the point below which enamel begins to demineralise. (B)</p> Signup and view all the answers

Which of the following sugars is an example of an extrinsic sugar?

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

What is the role of saliva when the pH becomes acidic?

<p>It becomes supersaturated with phosphate and hydroxide ions. (A)</p> Signup and view all the answers

What role do anaerobic bacteria play in the development of caries?

<p>They produce lactic acid which decreases pH (C)</p> Signup and view all the answers

What is the relationship between sugar consumption frequency and enamel remineralisation?

<p>Frequent sugar intake causes calcium ions to be lost from the enamel. (C)</p> Signup and view all the answers

Which bacteria are most commonly associated with enamel caries?

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

What finding was observed in the Vipeholm study regarding sugar type and frequency?

<p>Greater sugar frequency led to increased caries development. (A)</p> Signup and view all the answers

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

<p>They move into the plaque and are lost. (B)</p> Signup and view all the answers

What is the result of prolonged sugar consumption on tooth enamel?

<p>Formation of porous enamel and white spot lesions. (D)</p> Signup and view all the answers

What is the critical pH threshold for enamel?

<p>5-5.5 (B)</p> Signup and view all the answers

What occurs when the pH is above the critical pH?

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

How does frequent acid attacks impact the risk of caries?

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

What was the resting pH of dental plaque according to studies from the 1940s?

<p>6.5-7.0 (B)</p> Signup and view all the answers

Which bacteria are favored as pH drops in the presence of fermentable carbohydrates?

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

Why is time an important factor in the carious process?

<p>Infrequent acid attacks increase remineralisation (A)</p> Signup and view all the answers

What happens during an acidic environment in relation to tooth minerals?

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

What is the important concept regarding the mineral from saliva and pH levels?

<p>Mineral can return as long as it hasn't been removed (B)</p> Signup and view all the answers

How long does it typically take for pH levels in dental plaque to return to normal after sugar exposure, as per Stephan's curve?

<p>Up to an hour (A)</p> Signup and view all the answers

What is the relationship between biofilm thickness and oxygen levels?

<p>Thicker biofilms have less oxygen (C)</p> Signup and view all the answers

Flashcards

Dental Caries Definition

A localized chemical breakdown of tooth surfaces caused by bacteria's metabolic activity in dental plaque.

Aetiology of Dental Caries

The cause of tooth decay.

Caries Aetiological Factors

The 4 main factors contributing to tooth decay: bacteria, fermentable carbohydrates, susceptible host, and time.

Dental Plaque (Biofilm)

A sticky film of bacteria that forms on tooth surfaces.

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Fermentable Carbohydrates

Sugars that bacteria use to produce acids.

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Susceptible Host

A person with certain factors like poor saliva flow or mouth issues that make them more prone to decay.

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Time

The length of exposure which enables decay progression.

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Reversible Caries

Early stages of tooth decay that can potentially be reversed.

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Progressive Caries

Tooth decay that continues to progress if left untreated.

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Dental Caries Aetiology

The cause of dental caries, involving microbes, chemicals, and their metabolites affecting hard tissues and often localized dissolution.

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Susceptible Tooth Surface

Areas of the tooth more prone to decay, often due to plaque biofilm accumulation.

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Plaque Bacteria

Oral bacteria that form a biofilm on tooth surfaces.

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Fermentable Carbohydrates

Sugars that bacteria in plaque use as food, producing acid harmful to tooth enamel.

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Chemical Dissolution

The process by which acids produced by bacteria erode tooth enamel and dentin.

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Dental Biofilm

A sticky layer of bacteria on the tooth surface, crucial for caries development.

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Localized Caries

Decay primarily concentrated in specific areas of the tooth.

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Pits and Fissures

Grooves and depressions in the chewing surfaces of teeth, vulnerable to plaque accumulation.

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Proximal Surfaces

Tooth surfaces that touch adjacent teeth; a common site for caries, especially in crowded mouths.

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Defective Margins

Areas of restorations (fillings) that are not sealed properly, thus allowing bacteria access to the tooth.

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Fermentable Carbohydrate

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

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Intrinsic Sugars

Naturally occurring sugars found in whole foods like fruits and vegetables.

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Extrinsic Sugars

Added sugars, not part of the food's original structure.

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Sucrose

A simple sugar (table sugar) that quickly fuels bacteria.

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Complex Carbohydrates

Large molecules like starch, not easily digested in the mouth.

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Cariogenic

Causing tooth decay. Substances associated with tooth decay.

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Critical pH

The pH level below which tooth enamel starts to dissolve.

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Demineralization

The loss of minerals from tooth enamel caused by acid.

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Bacteria + Simple Sugars

The combination that creates acid, which harms teeth.

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Saliva

A fluid in the mouth that helps maintain a neutral pH and plays critical roles in oral health

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Plaque Biofilm

A layer of bacteria on the tooth surface that plays a key role in dental caries.

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Lactic Acid Production

Oral bacteria metabolize sugars, producing lactic acid, which is a major factor in tooth demineralization.

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Demineralization

The process where teeth lose minerals, particularly calcium ions, due to an acidic environment.

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Mutans Streptococci

A type of bacteria commonly associated with enamel decay.

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Remineralization/Demineralization See-Saw

The balance between tooth mineral loss (demineralization) and gain (remineralization).

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Vipeholm Study

A study demonstrating the link between sugar consumption frequency and dental caries.

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Fermentable Carbohydrate

Sugars that bacteria can break down to produce acids, lowering pH in the mouth.

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Critical pH Enamel

The pH level (5-5.5) at which enamel begins to dissolve.

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Critical pH Dentine

The pH level (6-6.5) at which dentine begins to dissolve.

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Demineralization

The process of tooth mineral loss due to acidic environment.

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Remineralization

The process of tooth mineral regrowth when pH returns to normal.

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Stephan Curve

A graph showing how plaque pH drops when exposed to fermentable sugars.

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Frequency of Acid Attacks

How often fermentable carbohydrates are consumed.

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Time Below Critical pH

The length of time that the pH in the mouth is below the critical pH level.

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Plaque Bacteria

Bacteria in plaque that produce acid when they consume fermentable carbohydrates.

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Hydroxyapatite

The primary mineral component of tooth enamel and dentine.

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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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Aetiology of Dental Caries PDF

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.

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