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Questions and Answers
Which of the following factors does NOT contribute to the development of dental caries?
Which of the following factors does NOT contribute to the development of dental caries?
What is the role of extracellular polysaccharides synthesized by cariogenic bacteria?
What is the role of extracellular polysaccharides synthesized by cariogenic bacteria?
In the context of dental caries, what does the term 'ecological niche' refer to?
In the context of dental caries, what does the term 'ecological niche' refer to?
Which of the following best describes the modern approach to managing dental caries?
Which of the following best describes the modern approach to managing dental caries?
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What is primarily responsible for the process of demineralization in dental caries?
What is primarily responsible for the process of demineralization in dental caries?
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Which of the following factors does NOT contribute to prolonged carbohydrate clearance time?
Which of the following factors does NOT contribute to prolonged carbohydrate clearance time?
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What is the critical pH level below which net demineralization of dental hard tissues occurs?
What is the critical pH level below which net demineralization of dental hard tissues occurs?
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Which site on the tooth surface is most likely to favor plaque retention and promote decay?
Which site on the tooth surface is most likely to favor plaque retention and promote decay?
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What role does saliva play in the remineralization of dental enamel?
What role does saliva play in the remineralization of dental enamel?
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Which statement about the activities of saliva is true regarding microbiological control in the oral cavity?
Which statement about the activities of saliva is true regarding microbiological control in the oral cavity?
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Study Notes
Dental Caries
- Defined as a progressive, irreversible microbial disease affecting tooth enamel, leading to cavity formation.
- Modern dentistry focuses on recognizing caries as an infectious disease, considering factors like causative agents, symptoms, prevention, and treatment.
- A multifactorial disease with a complex interaction of cariogenic oral flora and fermentable dietary carbohydrates on tooth surfaces.
- A dynamic process that disrupts the balance between tooth structure and plaque, resulting in mineral loss.
Etiology of Dental Caries
Ecology
- The study of interactions between organisms and their environment.
Ecosystem
- A defined area containing a biological community.
Ecological Niche
- Combination of food and shelter for microorganisms.
Contributing Factors of Dental Caries
- Three primary factors: host, microflora, substrate
- Host factors include teeth, saliva
- Microflora involves bacteria like streptococci and lactobacilli.
- Substrate refers to dietary carbohydrates, specifically sugars.
- Time is also considered a crucial contributor in the development of caries.
Dental Plaque (Pellicle and Bacteria)
- An adherent deposit of bacteria and their products on tooth surfaces.
- Consists of an amorphous organic film (acquired pellicle) mainly glycoproteins precipitated from saliva.
- Attracts bacteria, especially streptococci.
Role of Bacteria
- Acidogenic (produce acid)
- Aciduric (tolerant to acid)
- Adhere to tooth surfaces
- Produce sticky extracellular polysaccharides (primarily glucose polymers) from sugars.
- These polysaccharides create a matrix and aid bacterial adhesion.
Role of Dietary Carbohydrates
- Not all carbohydrates have the same cariogenicity.
- Complex carbohydrates like starch are relatively harmless.
- Low-molecular weight carbohydrates (sugars) are rapidly metabolized by bacteria, leading to a rapid drop in plaque pH.
- This drop in pH (below 5.5) initiates demineralization of tooth enamel.
- Sucrose causes more rapid production of extracellular polysaccharides than glucose, fructose, and lactose.
Oral Carbohydrate Clearance
- Factors affecting clearance time include: saliva rinsing effect, masticatory muscle activity, and tongue/lip/cheek movement.
- Factors that potentially prolong clearance time: dental cavities, low salivary flow, and viscous saliva.
- The Stephan curve demonstrates the sudden drop in pH following a glucose rinse, returning to normal within 30-60 minutes.
The Host (Tooth Surface)
- Enamel pits and fissures, cervical areas, and areas adjacent to restorations are sites prone to plaque retention and subsequent caries.
- Exposed root surfaces due to gingival recession and surfaces adjacent to dentures/bridges are also at risk.
Environment of the Tooth (Saliva and Fluoride)
- Saliva functions in maintaining normal oral flora through bacterial clearance, direct antibacterial activity, and buffering.
- Saliva helps to maintain pH balance, enabling remineralization of enamel.
- Fluoride in saliva enhances the remineralization process.
- Reduced salivary flow impacts the buffering action of saliva, leading to increased food retention.
Time
- Caries progression involves periods of destruction and repair.
- Mechanical removal of plaque exposing the tooth to saliva allows for remineralization.
- Mineral re-precipitation occurs due to an external supply from the oral cavity and internal supply from the pulp.
Epidemiology of Dental Caries
- DMF index: crucial method to assess prevalence and treatment needs in populations.
- It does not provide a full measure given its reliance on visual inspection without X-rays.
Classification of Dental Caries
- Classifications based on chronology, affected tissue, anatomical site, restoration surface, new/recurrent lesions, activity, speed, and pathway.
Severity
- WHO system classifies based on the shape and depth of the lesion (D1-D4).
- D1: Clinically detectable enamel lesions with intact surfaces
- D2: Clinically detectable cavities limited to enamel.
- D3: Clinically detectable cavities extending into dentin.
- D4: Lesions extending into the pulp.
Other Factors
- Radiation caries can lead to three types of defects.
- Dental caries in various age groups (nursing, rampant, adolescent, and adult).
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Description
Explore the intricacies of dental caries, a progressive disease affecting tooth health. This quiz covers the multifactorial aspects of caries, including its causes, contributing factors, and the ecological interactions involved. Dive into understanding the roles of host factors and oral microflora in caries formation.
