Aetiology of Dental Caries hard
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Which of the following factors is essential for the development of dental caries?

  • High fluoride content
  • Low pH levels
  • Time (correct)
  • Presence of saliva

What type of carbohydrates primarily contributes to caries formation?

  • Simple sugars
  • Complex carbohydrates
  • Fermentable carbohydrates (correct)
  • Non-fermentable carbohydrates

Which of the following statements best describes the aetiological agents involved in caries development?

  • Only chemical factors are responsible for caries.
  • Carious lesions require multiple interactions between various agents. (correct)
  • A single type of bacteria acts alone in causing caries.
  • Caries can develop in the absence of a susceptible tooth surface.

Which statement best identifies a key characteristic of the plaque bacteria involved in caries formation?

<p>They metabolize fermentable carbohydrates producing acids. (D)</p> Signup and view all the answers

Which definition best encompasses the nature of caries?

<p>A localized chemical dissolution facilitated by microbial metabolic activities. (B)</p> Signup and view all the answers

How does the accumulation of plaque biofilm affect caries susceptibility?

<p>It enhances the potential for metabolic activity leading to caries. (B)</p> Signup and view all the answers

Which of the following tooth surfaces is generally considered less susceptible to caries?

<p>Smooth surfaces of incisors (C)</p> Signup and view all the answers

What role do metabolites of microbes play in the caries process?

<p>They are responsible for the acidification of the environment around the tooth. (A)</p> Signup and view all the answers

Which type of carbohydrates provides the most food for oral bacteria to produce acid?

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

Which of the following factors contributes to increased plaque biofilm accumulation in defective tooth margins?

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

What characteristic of complex carbohydrates makes them less cariogenic compared to simple sugars?

<p>They are not completely digested in the mouth. (D)</p> Signup and view all the answers

What type of sugars are sucrose, fructose, and glucose categorized as?

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

What is the primary byproduct of bacteria metabolizing sugars that can lead to dental caries?

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

Which of the following statements about intrinsic sugars is accurate?

<p>They are found in whole fruits and vegetables. (D)</p> Signup and view all the answers

What role do defective tooth margins play in dental health?

<p>They facilitate plaque biofilm accumulation. (A)</p> Signup and view all the answers

Which of the following sugars is metabolized the fastest by oral bacteria?

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

Which of the following shows an incorrect relationship between carbohydrates and dental caries?

<p>Complex carbohydrates trigger more plaque than simple sugars. (A)</p> Signup and view all the answers

What is a consequence of having food debris caught in the grooves and pits of teeth?

<p>Increased plaque build-up and potential for caries. (D)</p> Signup and view all the answers

What is the result of infrequent acid attacks on dental health?

<p>Less time below critical pH and reduced demineralisation (D)</p> Signup and view all the answers

Which of the following statements best describes the role of plaque bacteria in tooth dissolution?

<p>Certain bacteria can produce lactic acid and contribute to tooth dissolution as pH drops. (D)</p> Signup and view all the answers

How does frequent snacking impact dental health?

<p>It increases the time teeth spend in the demineralisation zone, raising caries risk. (C)</p> Signup and view all the answers

What factor can influence the microbial population in plaque biofilm?

<p>The thickness of the biofilm and available oxygen levels. (C)</p> Signup and view all the answers

Which bacteria are primarily associated with caries formation in low pH environments?

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

What happens to anaerobic bacteria as the plaque biofilm becomes thicker?

<p>Their growth is favored due to reduced oxygen levels in deeper layers. (A)</p> Signup and view all the answers

What occurs when sugar is present in the mouth but no plaque bacteria are present?

<p>No acid is produced, thus preventing tooth dissolution. (D)</p> Signup and view all the answers

What characterizes intrinsic sugars?

<p>They are present in natural form and contained within cells. (C)</p> Signup and view all the answers

How does the processing of intrinsic sugars affect their cariogenic potential?

<p>Decreases cariogenic potential because they are broken down slowly. (C)</p> Signup and view all the answers

Which of the following is an example of extrinsic sugar?

<p>Quickly metabolized glucose. (A)</p> Signup and view all the answers

Why are complex carbohydrates such as starch considered less cariogenic?

<p>They require more time to be broken down before sugars are released. (C)</p> Signup and view all the answers

Which of the following statements accurately describes extrinsic sugars?

<p>They can cause dental caries quickly due to rapid metabolism. (A)</p> Signup and view all the answers

What is a major source of extrinsic sugars?

<p>Table sugar. (B)</p> Signup and view all the answers

What happens to the starch found in food such as bread when consumed?

<p>It requires further processing to release sugars for metabolism. (D)</p> Signup and view all the answers

Which sugar is known to be highly cariogenic?

<p>Extrinsic sugars from chocolates. (B)</p> Signup and view all the answers

Which of the following best explains why plaque bacteria have an advantage with extrinsic sugars?

<p>Extrinsic sugars are easily available for quick metabolism. (B)</p> Signup and view all the answers

What defines cariogenic substances in relation to sugar retention?

<p>They are metabolized quickly, leading to the production of acid. (B)</p> Signup and view all the answers

What occurs when the pH of the environment is below the critical threshold?

<p>Demineralisation leading to caries (D)</p> Signup and view all the answers

Which of the following best describes the Stephan Curve?

<p>A graph showing pH changes in dental plaque after sugar exposure (A)</p> Signup and view all the answers

Why is the timing of sugar intake significant for dental health?

<p>Infrequent sugar attacks reduce time for demineralisation (B)</p> Signup and view all the answers

Which of the following statements about the critical pH is accurate?

<p>The critical pH is essential for tooth demineralisation and caries formation (B)</p> Signup and view all the answers

Which mineral component is essential for the formation of hydroxyapatite in teeth?

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

What is a consequence of having too frequent acid attacks on teeth?

<p>Increased likelihood of tooth dissolution (A)</p> Signup and view all the answers

How do fermentable carbohydrates impact tooth health?

<p>They lead to rapid demineralisation and caries formation (C)</p> Signup and view all the answers

What happens to minerals when the pH rises back to neutral after an acidic event?

<p>They can be reabsorbed into the tooth structure (B)</p> Signup and view all the answers

What is the ideal time interval between sugar intakes to minimize the risk of dental caries?

<p>2-3 hours (C)</p> Signup and view all the answers

What is the result of having a resting plaque pH of 6.5-7 before sugar exposure?

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

Flashcards

Chemical Dissolution

The process where chemicals and microbial metabolites break down hard tissues like tooth enamel.

Susceptible Tooth Surface

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

Plaque Bacteria

Microbial community (biofilm) that metabolizes fermentable carbohydrates leading to caries.

Fermentable Carbohydrates

Sugars that readily get metabolized by plaque bacteria, producing acids.

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Dental Caries Aetiology

Cause of dental caries, which involves susceptible tooth surfaces, plaque bacteria, fermentable carbohydrates, and time.

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Dental Caries

Localized chemical decay of tooth surface due to bacterial metabolism of fermentable carbohydrates.

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Localized Chemical Dissolution

Breakdown of tooth structures by the action of acids produced by plaque bacteria.

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Susceptible Tooth Areas

Specific areas on teeth more likely to accumulate plaque, increasing the risk of caries, often due to shape or accessibility.

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Defective margins

Areas on a tooth where the restoration (filling) doesn't meet the tooth properly, creating gaps.

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Pit and fissure surfaces

The grooves and pits on teeth where food and plaque can accumulate.

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Smooth surfaces

The flat surfaces of teeth where plaque can still accumulate.

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Proximal surfaces

The surfaces of teeth that touch other teeth.

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Ledges/overhangs

Areas on a filling that stick out, making it hard to clean.

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Fermentable Carbohydrates

Sugars that bacteria in plaque can use to produce acid, contributing to tooth decay.

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Sucrose

A sugar that bacteria quickly metabolize to create acid.

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Complex Carbohydrates

Sugars not easily broken down by bacteria, so they don't cause as much acid production as simple sugars.

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Intrinsic sugars

Sugars naturally occurring in foods.

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Extrinsic sugars

Sugars added to foods.

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Intrinsic Sugar

Naturally occurring sugars in unprocessed foods, contained within cells.

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Extrinsic Sugar

Sugars not bound in cells, readily available for bacteria.

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Fermentable Carbohydrate

Sugars that can be broken down by bacteria in the mouth, producing acid.

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Simple Sugar

Sugars like glucose, fructose, and sucrose.

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Complex Carbohydrate

Large sugar chains like starch, needing more breakdown.

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Cariogenic

Forms cavities, caused by bacterial activity.

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Lactose

An example of a sugar that is not packaged intracellularly.

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Plaque Bacteria

Bacteria that are present in the mouth and can metabolize sugars to produce acid.

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Salivary Amylase

An enzyme in saliva that breaks down some types of starch.

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Extrinsic vs Intrinsic

Extrinsic sugars are easily accessible to mouth bacteria whereas intrinsic sugars are contained within cells.

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Acidic Mouth Time

Length of time the mouth's pH is below a critical level, increasing caries risk

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Frequent Snacking

Eating frequently exposes teeth to low pH for longer periods, increasing caries risk

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Plaque Bacteria

Microbial community in the mouth, metabolizing sugars to produce acid, leading to enamel erosion.

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Low pH & Bacteria

Low pH environment selects for bacteria that thrive in this environment, speeding up acid production.

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Thick Biofilm

Increased plaque build-up due to poor oral hygiene, limiting oxygen and fostering anaerobic bacteria.

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Anaerobic Bacteria

Bacteria thriving in oxygen-scarce environments, producing more acid, increasing caries risk.

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Caries Risk Factors

Factors like infrequent snacking, low pH time, and plaque bacteria combination increase tooth decay risk.

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Demineralization

The process where minerals are lost from tooth enamel due to an acidic environment, leading to cavities.

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Remineralization

The process of restoring minerals to tooth enamel, counteracting tooth dissolution, when the pH returns to normal.

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Critical pH

The pH level where tooth demineralization begins, usually below 5.5.

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Fermentable Carbohydrates

Sugars that bacteria can easily metabolize, producing acids that lower the pH in the mouth.

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Hydroxyapatite

The main mineral that makes up tooth enamel.

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Stephan Curve

A graph that shows how the pH in the mouth changes after consuming fermentable carbohydrates.

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Time (in Caries)

The duration of exposure to acidic conditions, crucial in caries development.

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Frequency of Sugar Intake

How often sugar is consumed, impacting the duration of acid attacks on teeth.

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Saliva and Remineralization

Saliva plays a role in remineralization. Minerals return to the teeth from saliva when pH returns to normal.

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Dental Plaque pH

A healthy balance of minerals in the plaque, often around 6.5-7.0.

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Study Notes

Aetiology of Dental Caries

  • Dental caries is a localized chemical dissolution of tooth surfaces by metabolic activity in a microbial biofilm.
  • The process is initiated by the interaction of four factors: susceptible tooth surface, fermentable carbohydrates, plaque bacteria and time.
  • All dental hard tissues are susceptible, but some areas more so (e.g., pits and fissures, smooth surfaces, proximal surfaces, and areas with defective margins).
  • Bacteria need fermentable carbohydrates to survive and produce lactic acid, thus lowering the pH.
  • Sucrose is the most easily metabolized sugar, leading to more rapid acid production.
  • Complex carbohydrates (like starch) are less cariogenic because they're not easily metabolized in the mouth.
  • Intrinsic sugars are naturally occurring sugars in foods (e.g., fruit).
  • Extrinsic sugars come from added sugars (e.g., table sugar, honey, syrups).
  • Frequent sugar intake lowers the pH of the mouth to critical levels, causing demineralization.
  • When the pH rises above critical levels, remineralization happens, and the tooth recovers.

Plaque Bacteria

  • Plaque bacteria (e.g., lactobacillus and streptococcus mutans) play a crucial role in the caries process.
  • Bacterial metabolic activity converts fermentable carbohydrates into acids.
  • As the biofilm thickens, oxygen levels decrease, fostering anaerobic bacteria, which further decrease the pH.
  • This leads to a cascading effect, decreasing the pH even further than simple sugars.

Time

  • Time is crucial for the caries process; without the other factors existing for a period of time, caries will not occur.
  • Frequent acid attacks lead to more demineralization.
  • The Stephan curve illustrated how the mouth's pH drops during and after sugar intake, returning to normal later.
  • Infrequent attacks mean less time below critical pH, leading to less demineralization.

Evidence for Aetiology

  • Studies on germ-free rats and those fed sugar-free diets confirmed the need of bacteria and fermentable carbohydrates.
  • The Vipeholm study of patients in a Swedish mental hospital showed a direct link between types and frequency of sugar intake and dental caries development.

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Description

This quiz focuses on the aetiology of dental caries, detailing the factors that contribute to its formation. It covers how microbial activity, tooth surface susceptibility, and dietary carbohydrates interact to cause tooth decay. Understanding these concepts is crucial for preventing and managing dental caries.

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