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

What was a significant ethical concern regarding the Vipeholm study?

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

What is the primary cause of dental caries?

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

Which tissue types are affected by dental caries?

<p>Enamel, dentine, and cementum (C)</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. (D)</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 (C)</p> Signup and view all the answers

How does understanding dental caries contribute to professional practice?

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

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

<p>Attitudes towards oral health (D)</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. (D)</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 (C)</p> Signup and view all the answers

What is the primary cause of dental caries?

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

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

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

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

<p>Plaque bacteria (D)</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 (C)</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 (D)</p> Signup and view all the answers

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

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

What nutritional component do plaque bacteria primarily depend on?

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

Which type of enamel is more vulnerable to caries formation?

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

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

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

Which type of sugars are considered intrinsic sugars?

<p>Naturally occurring in unprocessed foods (C)</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. (C)</p> Signup and view all the answers

Which carbohydrate is most rapidly metabolised to produce extracellular polysaccharides?

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

Which carbohydrate is likely to be less cariogenic?

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

What does saliva become when the environment is acidic?

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

What is the critical pH for enamel?

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

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

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

Which of the following carbohydrates is packaged intracellularly?

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

Which carbohydrate is not completely digested within the mouth?

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

What happens in a neutral environment regarding tooth minerals?

<p>Tooth remineralizes (C)</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 (A)</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 (C)</p> Signup and view all the answers

Which bacteria are favored as pH drops in dental biofilms?

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

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

<p>Demineralization stops (D)</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 (C)</p> Signup and view all the answers

What substance returns to teeth during the remineralization process?

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

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

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

Flashcards

Dental caries definition

A localized chemical dissolving of tooth surface caused by bacteria metabolizing carbohydrates in biofilm.

Aetiology of dental caries

The causes of dental caries, primarily involving bacteria and fermentable carbohydrates in the biofilm.

4 aetiological factors

The four key causes of dental caries, including bacteria, fermentable carbohydrates, susceptible host, and mechanical factors.

Bacteria (aetiology)

The microorganisms responsible for the breakdown of carbohydrates in the oral biofilm, leading to acid production.

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Fermentable carbohydrates

Sugars and starches that can be broken down by oral bacteria, producing acids.

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Susceptible host

Factors that make a person more inclined to develop dental caries due to their oral environment.

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Mechanical factors

Factors influencing the removal of biofilm or the influence of the presence of the biofilm.

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Dental biofilm

A sticky film of bacteria formed on teeth that causes oral diseases.

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Dental Caries Aetiology

The cause of dental caries, a localized dissolution of tooth surfaces. It involves microbes, chemicals, and metabolites affecting hard tissue.

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Susceptible Tooth Surface

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

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Plaque Biofilm

A microbial deposit on the tooth surface, crucial for caries formation.

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Fermentable Carbohydrates

Sugars that bacteria use to produce acids, leading to tooth decay.

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Localized Chemical Dissolution

A process where specific parts of the tooth are broken down by chemicals.

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Pits and Fissures

Grooves in the teeth where plaque accumulates easily.

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Smooth Surfaces

Areas of teeth that are relatively flat and can accumulate plaque.

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Proximal Surfaces

The surfaces of teeth that touch adjacent teeth.

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Defective Margins

Areas of fillings or restorations that are flawed, making them susceptible to caries.

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Ledges/Overhangs

Elevated areas of a fillings/restorations, where food particles and bacteria can also accumulate.

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Fermentable Carbohydrate

Sugars and starches that bacteria in the mouth can break down to produce acid, contributing to tooth decay.

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Intrinsic Sugars

Naturally occurring sugars in unprocessed foods, typically found within fruits or vegetables.

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Extrinsic Sugars

Sugars added to processed foods or those that are not naturally part of a cell structure.

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Sucrose

A simple sugar, metabolized rapidly by bacteria, making it highly cariogenic.

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Complex Carbohydrates

Long chains of sugars like starch, less quickly broken down in the mouth.

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Critical pH

The pH level below which tooth enamel begins to lose minerals (demineralization).

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Acid Production

The process where bacteria break down fermentable carbs, creating acidic environment in the mouth.

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Demineralization

Loss of minerals (e.g., calcium and phosphate) from tooth enamel.

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Bacteria + Simple Sugars

Bacteria use simple sugars (fermentable carbs) as fuel to produce acids in the mouth.

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What causes acid in the mouth?

Bacteria breaking down fermentable carbohydrates creates acids.

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Caries development

Caries develops on a tooth surface covered in plaque biofilm, due to bacteria metabolizing sugar and producing lactic acid, which demineralizes enamel.

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Lactic acid & pH drop

Oral bacteria, especially mutans streptococci, break down sugar to produce lactic acid. This acid lowers the pH at the tooth surface, causing enamel demineralization.

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Sugar frequency (Demineralization)

Frequent sugar consumption leads to more calcium ions being lost from the tooth structure into the plaque, faster than they can be replenished through saliva.

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Vipeholm Study

A study showcasing the link between sugar frequency and caries development. High sugar frequency leads to higher caries rates. Lower sugar frequency, less caries.

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Germ-free rat experiments

Experiments with germ-free rats demonstrate that bacteria are necessary for caries to occur. Sugar is also required for the bacteria.

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Fermentable Carbohydrate

Sugars and starches that bacteria can break down, producing acids.

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Critical pH enamel

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

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Critical pH dentine

The pH level (6-6.5) where dentine starts to dissolve.

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Remineralisation

The process where minerals return to the tooth when pH returns to normal.

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Demineralisation (Caries)

Tooth dissolving when pH falls below the critical level.

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Stephan Curve

Graph showing how plaque pH changes when exposed to sugar, reaching a low and then recovering.

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Time (Caries)

Frequency and duration of lower pH environments impact caries risk. Less time below critical pH = lower risk.

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Frequency of Acid Attack

The number of times the teeth are exposed to acid-producing foods/drinks, influencing caries risk.

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Plaque Bacteria

Bacteria in plaque that break down fermentable carbohydrates causing demineralization.

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Hydroxyapatite

The main mineral component of teeth, important in building and maintaining tooth structure.

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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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