Aetiology of Dental Caries
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Aetiology of Dental Caries

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Questions and Answers

What is the primary byproduct produced by anaerobic bacteria that contributes to enamel demineralisation?

  • Lactic acid (correct)
  • Citric acid
  • Hydrogen peroxide
  • Acetic acid
  • Which type of bacteria is most commonly associated with enamel caries?

  • Streptococcus sanguinis
  • Mutans streptococci (correct)
  • Lactobacillus
  • Enterococcus faecalis
  • According to the findings from the Vipeholm study, what dietary factor increases the likelihood of developing caries?

  • Low carbohydrate diet
  • Increased calcium intake
  • Frequent consumption of cariogenic food (correct)
  • High fiber intake
  • What condition results when sugar is consumed more frequently than every 2-3 hours?

    <p>Loss of calcium ions from the tooth</p> Signup and view all the answers

    What was a significant ethical concern regarding the Vipeholm study?

    <p>Lack of informed consent</p> Signup and view all the answers

    What is the primary cause of dental caries?

    <p>Bacterial activity on tooth surfaces</p> Signup and view all the answers

    Which tissue types are affected by dental caries?

    <p>Enamel, dentine, and cementum</p> Signup and view all the answers

    Which statement best describes the carious process?

    <p>It involves chemical dissolution of tooth structures due to microbial activity.</p> Signup and view all the answers

    Which of the following is NOT a factor in the aetiology of dental caries?

    <p>Healthy eating habits</p> Signup and view all the answers

    How does understanding dental caries contribute to professional practice?

    <p>It enables effective prevention and treatment strategies.</p> Signup and view all the answers

    What psychological or sociological factor can contribute to poor oral health?

    <p>Attitudes towards oral health</p> Signup and view all the answers

    Which statement best captures the reversibility of dental caries?

    <p>Dental caries is reversible in its earliest stages only.</p> Signup and view all the answers

    What is a necessary component of the patient assessment process for dental caries?

    <p>Evaluating the patient's overall health</p> Signup and view all the answers

    What is the primary cause of dental caries?

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

    Which structure of the tooth is most susceptible to carious lesions?

    <p>Defective margins</p> Signup and view all the answers

    What type of microorganisms are primarily involved in the development of dental caries?

    <p>Plaque bacteria</p> Signup and view all the answers

    What is the role of time in the aetiology of caries?

    <p>Accumulation time of plaque bacteria affects caries risk</p> Signup and view all the answers

    How do plaque bacteria contribute to the process of caries?

    <p>They metabolize sugars to produce lactic acid</p> Signup and view all the answers

    Which part of the tooth structure is least susceptible to caries?

    <p>Smooth surfaces</p> Signup and view all the answers

    What defines the process of dental caries as per the comprehensive definition?

    <p>A localized, chemical dissolution of tooth surfaces</p> Signup and view all the answers

    What nutritional component do plaque bacteria primarily depend on?

    <p>Carbohydrates</p> Signup and view all the answers

    Which type of enamel is more vulnerable to caries formation?

    <p>De-mineralized enamel</p> Signup and view all the answers

    Which areas of the tooth are recognized as particularly vulnerable to caries?

    <p>Defective margins and pits</p> Signup and view all the answers

    Which type of sugars are considered intrinsic sugars?

    <p>Naturally occurring in unprocessed foods</p> Signup and view all the answers

    What is the primary difference between intrinsic and extrinsic sugars?

    <p>Intrinsic sugars are packaged intracellularly, while extrinsic sugars are not bound within a cellular structure.</p> Signup and view all the answers

    Which carbohydrate is most rapidly metabolised to produce extracellular polysaccharides?

    <p>Sucrose</p> Signup and view all the answers

    How do simple sugars affect dental health?

    <p>They diffuse rapidly and are metabolised quickly by bacteria to produce acid.</p> Signup and view all the answers

    What happens when the pH becomes critical in relation to tooth enamel and dentine?

    <p>Teeth begin to lose mineral content due to demineralisation.</p> Signup and view all the answers

    Which carbohydrate is likely to be less cariogenic?

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

    What type of sugar is lactose considered, and where is it found?

    <p>Intrinsic, found in unprocessed dairy products</p> Signup and view all the answers

    What does saliva become when the environment is acidic?

    <p>Supersaturated with phosphate and hydroxide ions</p> Signup and view all the answers

    What is the critical pH for enamel?

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

    What is the effect of a pH below the critical level on teeth?

    <p>Demineralization occurs</p> Signup and view all the answers

    Which of the following carbohydrates is packaged intracellularly?

    <p>Starch in rice and potatoes</p> Signup and view all the answers

    Which carbohydrate is not completely digested within the mouth?

    <p>Complex carbohydrates (e.g., starch)</p> Signup and view all the answers

    What happens in a neutral environment regarding tooth minerals?

    <p>Tooth remineralizes</p> Signup and view all the answers

    How long did Stefan's studies indicate for the pH to return to normal after sugar exposure?

    <p>1 hour</p> Signup and view all the answers

    What is the relationship between frequency of acid attacks and caries risk?

    <p>Lower frequency leads to lower caries risk</p> Signup and view all the answers

    Which bacteria are favored as pH drops in dental biofilms?

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

    What occurs when the pH is higher than the critical pH?

    <p>Demineralization stops</p> Signup and view all the answers

    Why does time play a critical role in the caries process?

    <p>Need for consistent exposure to acid</p> Signup and view all the answers

    What substance returns to teeth during the remineralization process?

    <p>Saliva minerals</p> Signup and view all the answers

    What happens to the microbial population in plaque biofilm as it thickens?

    <p>Anaerobic bacteria become favored</p> Signup and view all the answers

    Study Notes

    Aetiology of Dental Caries

    • Dental caries is a localized, chemical dissolution of tooth surface due to metabolic activity in a biofilm (a microbial deposit) on the tooth.

    • All dental hard tissues are susceptible to caries, although some areas are more prone.

    • Four main aetiological factors contribute to dental caries:

      • Susceptible tooth surface
      • Fermentable carbohydrates
      • Plaque bacteria
      • Time
    • The average cost of a tooth extraction in hospital for a 5-year-old and under is £836. Between 2015-2016, approximately £50.5 million was spent on tooth extractions on those under 19, and £7.8 million on those under 5.

    • Caries is a reversible process, especially in its early stages.

    • Caries occurs when the pH of the mouth drops below critical levels.

    • Key factors in the process include:

      • Involves microbes and their metabolites
      • Involves chemical dissolution
      • Affects all hard tissues
      • Involves fermentable carbohydrates
      • Often localized
      • Can be reversible
    • Factors that affect susceptibility to caries:

      • Pits and fissures
      • Smooth surfaces
      • Proximal surfaces
      • Defective margins/ledges/overhangs
    • Bacteria in the biofilm require food to survive. Sugars in the diet provide a substrate for oral commensal bacteria to metabolise and produce lactic acid.

      • Simple sugars (glucose, fructose, sucrose) are quickly metabolised and cause a rapid drop in pH. More of these in the diet results in higher risk.
      • Complex carbohydrates like starch are less cariogenic, because they aren't completely digested in the mouth.
      • Different types of sugar—intrinsic sugars are naturally occurring sugars in unprocessed foods, extrinsic sugars are not bound to a cellular structure. Examples include milk sugars, free sugars, and added sugars.
    • Critical pH for enamel is 5.5, while critical pH for dentin is 6.5. These values trigger remineralization or demineralization processes. When pH drops below the critical level, demineralization occurs when tooth tissue loses minerals to saliva or plaque, and this process can reverse with healthy pH levels and saliva

    • Time is critical for caries development. Regular acid attacks (due to frequent sugar intake) lead to more demineralization. Infrequent attacks allow for remineralization. The Stephan curve shows the fluctuations in mouth pH, which relates to the frequency and time of sugar intake. Short gaps between intake of cariogenic foods mean prolonged periods of low pH, which increases the occurrence of caries.

    • Bacteria, such as lactobacillus and streptococcus mutans, thrive in low-pH environments.

    • These bacteria are involved in demineralization, causing a further drop in pH, leading to continuous dental caries.

    • The evidence of the aetiology of dental caries comes from various studies:

      • 1954 study by Orland using germ-free rats confirmed the need for bacteria.
      • 1952 Vipeholm study in a Swedish mental hospital revealed a correlation between sugar frequency and caries development.
      • Tristan de Cunha study highlighted the influence of introducing fermentable carbohydrates on caries prevalence.

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    Aetiology of Dental Caries PDF

    Description

    This quiz explores the aetiology of dental caries, focusing on the localized chemical processes and the four main contributing factors. It highlights the role of tooth surfaces, fermentation of carbohydrates, plaque bacteria, and time in the development of caries. Understanding these elements can provide insights into the prevention and management of dental health.

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