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Questions and Answers
The rate of colour change from green to yellow is indicative of degree of ______ activity.
The rate of colour change from green to yellow is indicative of degree of ______ activity.
caries
In the Snyder Test, a yellow color indicates ______ caries activity.
In the Snyder Test, a yellow color indicates ______ caries activity.
marked
The ______ Test is a modified Snyder Test that involves the collection of unstimulated saliva.
The ______ Test is a modified Snyder Test that involves the collection of unstimulated saliva.
Alban's
The Swab Test measures the ability of salivary microorganisms to form organic acids from a ______ medium.
The Swab Test measures the ability of salivary microorganisms to form organic acids from a ______ medium.
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The Reductase Test measures the activity of the ______ enzyme present in salivary bacteria.
The Reductase Test measures the activity of the ______ enzyme present in salivary bacteria.
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In the Reductase Test, a blue color after 15 minutes indicates ______ conducive activity.
In the Reductase Test, a blue color after 15 minutes indicates ______ conducive activity.
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The Enamel Solubility Test shows that organic acids formed from glucose can decalcify ______.
The Enamel Solubility Test shows that organic acids formed from glucose can decalcify ______.
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Severely decreased saliva flow is related to caries ______.
Severely decreased saliva flow is related to caries ______.
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Most young adults have erupting or newly erupted third molars without full chewing function but with highly caries-susceptible ______ and mesial surfaces
Most young adults have erupting or newly erupted third molars without full chewing function but with highly caries-susceptible ______ and mesial surfaces
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Occupations that require frequent food sampling can be a risk factor for dental ______
Occupations that require frequent food sampling can be a risk factor for dental ______
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The ______ of the molars are key risk surfaces for caries.
The ______ of the molars are key risk surfaces for caries.
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The ______ is a measure used to assess the degree of caries risk based on environmental challenges.
The ______ is a measure used to assess the degree of caries risk based on environmental challenges.
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In elderly people, exposed root ______ are particularly at risk for caries.
In elderly people, exposed root ______ are particularly at risk for caries.
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Caries activity tests need to be reproducible and ______.
Caries activity tests need to be reproducible and ______.
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Prior to dental caries assessment, background data should include dietary and oral hygiene ______.
Prior to dental caries assessment, background data should include dietary and oral hygiene ______.
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Key-risk teeth for dental caries include ______ which are prone to decay.
Key-risk teeth for dental caries include ______ which are prone to decay.
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The Lactobacillus Colony Count Test estimates the number of acidogenic and aciduric micro-organisms in a patient's saliva by counting the number of colonies on ________ agar plates.
The Lactobacillus Colony Count Test estimates the number of acidogenic and aciduric micro-organisms in a patient's saliva by counting the number of colonies on ________ agar plates.
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Saliva is collected for the Lactobacillus test by chewing ________ before breakfast.
Saliva is collected for the Lactobacillus test by chewing ________ before breakfast.
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The incidence of caries activity is represented by categories such as little or none for 1-1000 organisms, slight for 1000-5000, and ________ for 5000-10,000 organisms.
The incidence of caries activity is represented by categories such as little or none for 1-1000 organisms, slight for 1000-5000, and ________ for 5000-10,000 organisms.
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In the Snyder Test, the ability of salivary microorganisms to form organic acid from a carbohydrate medium is measured using Snyder's ________.
In the Snyder Test, the ability of salivary microorganisms to form organic acid from a carbohydrate medium is measured using Snyder's ________.
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To prepare the Snyder Test, 0.2ml of saliva is added into the tube of melted Snyder glucose __________.
To prepare the Snyder Test, 0.2ml of saliva is added into the tube of melted Snyder glucose __________.
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After incubation in the Snyder Test, the amount of acid produced is detected by changes in the ________ indicator.
After incubation in the Snyder Test, the amount of acid produced is detected by changes in the ________ indicator.
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The Lactobacillus Colony Count Test is considered to be inexpensive, non-invasive, and applicable to any clinical ________.
The Lactobacillus Colony Count Test is considered to be inexpensive, non-invasive, and applicable to any clinical ________.
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The colonies on the agar plate in the Lactobacillus test are incubated at ________ degrees Celsius for 4 days.
The colonies on the agar plate in the Lactobacillus test are incubated at ________ degrees Celsius for 4 days.
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Dental caries is an irreversible progressive disease affecting the calcified tissues of the ______.
Dental caries is an irreversible progressive disease affecting the calcified tissues of the ______.
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Caries activity is a measure of the speed of progression of a ______.
Caries activity is a measure of the speed of progression of a ______.
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Caries susceptibility refers to the number of new lesions that may develop in an individual over a ______ of time.
Caries susceptibility refers to the number of new lesions that may develop in an individual over a ______ of time.
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The course of a typical prediction study assesses caries increment at the end of the ______ period.
The course of a typical prediction study assesses caries increment at the end of the ______ period.
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Prediction studies often deal with the dichotomy between individuals for whom we believe the risk is ______.
Prediction studies often deal with the dichotomy between individuals for whom we believe the risk is ______.
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The higher the risk of developing caries, the more significant the effects of one single ______ measure.
The higher the risk of developing caries, the more significant the effects of one single ______ measure.
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The dichotomy between high true caries increment and low observed true caries increment is a focus of risk ______.
The dichotomy between high true caries increment and low observed true caries increment is a focus of risk ______.
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Correlations between one single etiologic or modifying risk factor and the risk for caries development can be quite ______.
Correlations between one single etiologic or modifying risk factor and the risk for caries development can be quite ______.
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In populations where only a minority will develop new carious lesions, a ______ predictive measure is necessary.
In populations where only a minority will develop new carious lesions, a ______ predictive measure is necessary.
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The first key risk age group for dental caries is ages ______ years.
The first key risk age group for dental caries is ages ______ years.
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From ages ______ to ______ years, the caries-reducing effect of fluoride is significantly higher.
From ages ______ to ______ years, the caries-reducing effect of fluoride is significantly higher.
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During the ages of ______ to ______ years, the second molars start to erupt.
During the ages of ______ to ______ years, the second molars start to erupt.
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The practice of giving infants sugar-containing drinks in nursing bottles at night increases the development of ______.
The practice of giving infants sugar-containing drinks in nursing bottles at night increases the development of ______.
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Monitoring changes in disease status is important for ______ active patients.
Monitoring changes in disease status is important for ______ active patients.
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Mothers with high salivary MS levels frequently transmit ______ to their babies.
Mothers with high salivary MS levels frequently transmit ______ to their babies.
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The total eruption time for second molars is approximately ______ to ______ months.
The total eruption time for second molars is approximately ______ to ______ months.
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Study Notes
Caries Activity
- Caries is a multifactorial, irreversible, progressive disease affecting calcified tooth tissues.
- It's characterized by demineralization of the inorganic portion and destruction of the organic portion of the tooth.
- Caries activity refers to the increment of active lesions (new and recurrent) over a defined time period.
- It measures the rate of caries progression in a specific timeframe.
Caries Susceptibility
- Caries susceptibility refers to the number of new cavities that can develop in an individual over time.
- It differs from caries activity, which focuses on the total number of cavities (both new and existing) at a given point.
The Course of a Typical Prediction Study
- The study's purpose is to evaluate the predictive power of a risk marker for dental caries.
- Caries recordings at the end of a follow-up period enable assessment of caries increment during that period.
- The study considers two dichotomies:
- Individuals with a high perceived risk versus those with a low risk
- Individuals with high true caries increment versus those with low true increment
Principles of Risk Prediction
- High caries risk in a population leads to the significance of preventive measures and strengthens correlations between single risk factors and caries development.
- In populations with a low prevalence of new caries lesions, accurate risk assessment is crucial for selecting high-risk individuals and developing targeted preventive strategies ("high-risk strategy").
Goals of Caries Risk Prediction
- Screen out low-risk patients to permit safe recommendations for longer recall intervals.
- Identify high-risk patients before they develop active caries.
- Monitor changes in disease status in caries-active patients.
Risk Groups for Dental Caries
- Caries lesions frequently initiate at specific ages.
- Key risk age group 1: Ages 1-2
- Key risk age group 2: Ages 5-7
- Key risk age group 3: Ages 11-14
- Also consider risk ages among young adults and adults (19-22).
Key-Risk Age Groups: Specific Details
- Age 1-2: Mothers with high levels of mutans streptococci frequently transmit these bacteria to their babies. One-year-old babies with plaque and gingivitis often develop multiple caries lesions over time. A frequent practice of giving infants sugar-containing beverages in nursing bottles will accelerate caries development.
- Age 5-7: Enamel in erupting/newly erupted teeth is highly susceptible to caries until secondary maturation (more than two years after eruption). Fluoride's caries-reducing effectiveness is higher in these teeth than in teeth undergoing secondary maturation. The years 5-7, specifically during the eruption of the first molars, constitute a crucial high-risk period.
- Age 11-14: Second molars erupt between 11-11.5 years for girls and around 12 years for boys. The eruption period is approximately 16-18 months. Approximal surfaces of newly erupted posterior teeth undergo secondary enamel maturation during this period, making them highly susceptible to caries.
- Young Adults/Adults: Erupting or newly erupted third molars often have incomplete chewing function but present highly caries-susceptible fissures and mesial surfaces, until completion of secondary enamel maturation. Also, frequent lifestyle changes (like moving away from home to study or work), affect dietary and oral hygiene practices among young adults, potentially impacting caries risks.
Other Risk Groups
- Individuals employed in occupations requiring frequent food sampling.
- Obese individuals due to frequent eating habits.
- Individuals abusing recreational drugs.
- Individuals with systemic diseases requiring medication.
- Individuals with psychiatric disorders.
- Individuals experiencing impaired salivary function or immune response.
Risk Individuals for Dental Caries
- Background data (general diseases, medications, social/family situations, dietary/oral hygiene habits)
- Clinical examination
- Caries activity tests
Key Risk Teeth
- Molars are often the primary teeth presenting high caries risk.
- The caries pattern in the dentition is reflected by the number of missing teeth and DMFS index (Decayed, Missing, and Filled Surfaces).
- Evaluating buccal-lingual distance and tooth crown width from the lips can potentially predict the risk of tooth loss.
Key Risk Surfaces
- Molar fissures
- Approximal surfaces of posterior teeth (from second molar mesial to first premolar distal)
- Maxillary incisor approximal surfaces, molar buccal, and mandibular molar lingual surfaces.
- Exposed root surfaces (specifically in elderly individuals), mainly on buccal and approximal areas.
Caries Activity Test
- Measures the degree to which local environmental challenges (e.g., dietary effect on microbial growth and metabolism) influence the probability of caries lesions' occurrence.
Requirements of Caries Activity Tests
- Tests should be reproducible and valid.
- There should be a strong correlation between caries activity scores and actual caries development.
- Tests must be performed simply
- Results should be available promptly (within hours or a few days).
- Tests should involve measurement of the mechanisms associated with caries development.
- Tests should be cost-effective, non-invasive, and applicable in all clinical settings.
Lactobacillus Colony Count
- Estimates the number of acidogenic and aciduric microorganisms in saliva by counting colonies cultured from saliva on peptone agar plates.
- Utilizes selective media to promote the growth of aciduric lactobacilli.
Lactobacillus Procedure
- Collect saliva by chewing paraffin before breakfast.
- Vigorously shake and dilute the specimen (0.4 ml sample).
- Distribute undiluted and diluted samples evenly on Rogosa SL agar plates.
- Incubate plates at 37°C for 4 days.
- Count developed lactobacilli colonies.
Lactobacillus Colony Count Test Values
- A key table correlating the number of colonies with caries activity levels (e.g., ranging from "Little or none" to "Marked").
Snyder Test
- Measures the ability of salivary microorganisms to form organic acid from a carbohydrate medium.
- Classical formula for Snyder's agar includes specific components and quantities per liter of purified water.
Snyder Procedure
- Melted Snyder glucose agar is cooled to 50°C.
- 0.2 ml of saliva is mixed into the agar tube.
- The agar solidifies and is incubated.
- Acid production is assessed using pH indicators.
- Changes in color compared to uninoculated controls (at 24, 48, and 72 hours) determine caries activity levels.
Snyder Test Results Table
- Key chart linking color changes (green to yellow) with specific caries activity designations (Marked, Definite, Limited, etc.).
Alban's Test
- A modified version of the Snyder test.
- Uses an unheated sample of semisolid agar.
- Patients spit unstimulated saliva directly into the agar tube.
- The tube is then incubated for four days.
Swab Test
- Determines the ability of salivary microorganisms to form organic acids from a carbohydrate medium.
- Indicator dye (bromocresol green) color change signals pH alterations during incubation.
Swab Procedure
- Sample oral flora by swabbing the buccal tooth surface with cotton.
- Incubate the sample within the medium.
Reductase Test
- Measures the enzymatic activity of saliva reductase present in salivary bacteria.
- Measures the reaction using a dye after mixing saliva with this dye .
- Caries activity is assessed based on color changes after 15 minutes.
Reductase Key Table
- Table that correlates saliva color changes (after 15 min incubation with a dye) with specific values representing the degree of caries activity (ranging from "Non conducive" to "Extremely conducive").
Enamel Solubility Test
- Assesses the enamel's demineralization ability by adding saliva and glucose to powdered enamel samples.
- Organic acids produced cause demineralization, increasing soluble calcium levels.
- Measurement of the increases calcium concentration is a direct indicator of caries activity.
Saliva Flow Test
- Measures saliva flow rate by collecting paraffin-stimulated saliva in a tube within 5 minutes.
- Decreased flow often relates to an increased susceptibility to caries.
- Saliva viscosity increases as flow rate decreases.
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Description
Explore the concepts of caries activity and susceptibility in dental health. This quiz evaluates your understanding of how caries progression and individual susceptibility can influence dental outcomes. Test your knowledge on predictive studies related to dental caries.
