Dental Caries and Non-Carious Lesions

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Questions and Answers

What are the two main categories of lesions involving hard tooth tissue destruction?

Carious and non-carious lesions.

What causes dental caries?

Dental caries is caused by a bacterial infection that leads to localized damage to tooth enamel.

Describe the primary sites for caries initiation.

The primary sites for caries initiation are pits and fissures, smooth enamel surfaces, and root surfaces.

How do primary and secondary caries differ?

Primary caries develop on healthy teeth, while secondary caries occur around existing fillings. Signup and view all the answers

What is the significance of the dentin-enamel junction (DEJ) in the progression of caries?

The DEJ offers the least resistance to decay, allowing caries to spread laterally. Signup and view all the answers

What factors contribute to the rapid progression of root caries?

Root caries progress rapidly due to the rough texture of root surfaces and the thinness of the cementum. Signup and view all the answers

What pattern does smooth surface caries create as it advances?

Smooth surface caries form a cone with its base at the enamel surface and its apex toward the DEJ. Signup and view all the answers

What role do minerals in saliva play in caries management?

Minerals in saliva can help repair damaged areas through remineralization. Signup and view all the answers

What is the definition of erosion in dentistry?

Erosion is the pathological loss of tooth structure resulting from chemico-mechanical action, primarily due to acids. Signup and view all the answers

Name one type of exogenous acidic agent that can cause dental erosion.

Environmental factors, such as industrial acids, are one type of exogenous acidic agent. Signup and view all the answers

Which dietary factor is known to primarily cause extrinsic erosion?

Dietary acids, particularly from fruits and soft drinks, are known to cause extrinsic erosion. Signup and view all the answers

How can medications contribute to dental erosion?

Low pH medicaments and oral hygiene products in frequent contact with teeth can cause dental erosion. Signup and view all the answers

What lifestyle factors are important in the development of dental erosion?

The type of food and beverage consumed, along with the frequency and time of consumption, are important lifestyle factors. Signup and view all the answers

Identify a cause of endogenous acidic agents related to dental erosion.

Gastric acids from frequent regurgitation, as seen in bulimia, are a cause of endogenous acidic agents. Signup and view all the answers

What is abfraction in dental terms?

Abfraction is a wedge-shaped cervical defect at the CEJ caused by abnormally heavy forces from unbalanced occlusion. Signup and view all the answers

What type of forces contribute to the development of abfraction?

Unbalanced faulty occlusion results in abnormal heavy forces that contribute to abfraction. Signup and view all the answers

What is incipient caries, and why is it significant?

Incipient caries is the earliest stage of enamel caries activity that is reversible and can be remineralized. Signup and view all the answers

What characterizes cavitated caries, and what treatment is typically required?

Cavitated caries involves a broken enamel surface that has progressed into dentin, making remineralization impossible; treatment usually includes tooth preparation and restoration. Signup and view all the answers

How does the progression speed of acute caries compare to chronic caries?

Acute caries progress rapidly and cause swift tooth damage, while chronic caries progress slowly, allowing time for remineralization. Signup and view all the answers

What is toothbrush abrasion and how does it manifest?

Toothbrush abrasion is a type of pathological surface loss due to improper brushing techniques, characterized by linear, smooth lesions on the labial surface of teeth. Signup and view all the answers

What type of abrasion results from pipe smoking?

Pipe-smoking depression abrasion occurs at the latero-anterior portion of the arch, coinciding with the location of the pipe stem. Signup and view all the answers

What is iatrogenic abrasion and how can it occur?

Iatrogenic abrasion is caused by faulty dentistry, such as abrasion of opposing teeth by porcelain from a poorly fitted denture. Signup and view all the answers

Explain the differences between demineralization and remineralization in the context of caries.

Demineralization occurs when minerals are lost from the tooth structure, while remineralization involves the gain of minerals back into the tooth, potentially reversing early carious lesions. Signup and view all the answers

What factors contribute to the development of non-carious lesions?

Non-carious lesions arise from non-microbial origins such as abrasion from external objects or friction between teeth. Signup and view all the answers

What causes abfraction lesions in teeth?

Abfraction lesions are caused by excessive compressive and tensile forces during tooth flexure, leading to microfractures in the enamel. Signup and view all the answers

How does attrition affect teeth?

Attrition leads to mechanical wear of the tooth structure, resulting in flattened occlusal surfaces and potential exposure of dentin. Signup and view all the answers

What is enamel hypoplasia and where is it commonly found?

Enamel hypoplasia is a defect in enamel formation due to improper matrix development and is often seen on anterior teeth and first molars. Signup and view all the answers

What differentiates enamel hypocalcification from hypoplasia?

Enamel hypocalcification involves improper mineralization of the enamel, while hypoplasia is due to improper matrix formation. Signup and view all the answers

What are the visible characteristics of enamel hypoplasia?

Enamel hypoplasia presents as opaque white or brownish areas or pitted and grooved enamel. Signup and view all the answers

In what ways can discoloration affect an individual?

Discoloration can deviate from normal tooth shade, impacting the individual's social interactions and psychological well-being. Signup and view all the answers

What effects does attrition have on the vertical dimensions of teeth?

Attrition can lead to loss of vertical dimensions as enamel is worn off from cusp tips or incisal edges. Signup and view all the answers

What are the implications of excessive compressive forces on teeth?

Excessive compressive forces can lead to faulty occlusion and the development of microfractures or abfraction lesions. Signup and view all the answers

Study Notes

Non-Carious Lesions

Lesions involving hard tooth tissue are categorized into carious and non-carious.
Non-carious lesions cause tooth structure loss requiring intervention.
Dental caries is a bacterial infection causing localized enamel damage.
Acid-producing bacteria break down tooth minerals, leading to decay.
Cycles of demineralization and remineralization of tooth minerals are crucial for caries prevention.
Saliva or remineralizing solutions help repair damaged areas.

Dental Caries

Caries develop on healthy teeth (primary) or around existing fillings (secondary).
Primary caries has three distinct initiation sites:
- Pits and fissures (most susceptible)
- Smooth enamel (under buccal/lingual contours and proximal contacts)
- Root surfaces
Pits and fissures trap plaque, creating ideal decay conditions.
Caries follows enamel rods to the dentin-enamel junction (DEJ).
Caries spreads laterally through dentin to the pulp, causing dentin cavitation.
This process creates two cone-shaped decay patterns in enamel and dentin.

Smooth Surface Caries

Unique to enamel defects, smooth surface caries start in neglected enamel areas.
Plaque buildup in these areas contributes to caries initiation.
Caries follows enamel rod direction, forming a cone with its apex towards the DEJ.
Lateral spread occurs at DEJ leading to a cone-shaped pattern in dentin with a pulpally apex.
Continued decay can result in dentin cavitation.

Root Caries

Root surfaces, rougher than enamel, are more susceptible to plaque buildup.
Root caries progress faster than other caries types due to thin cementum.
Root caries are more common in older individuals due to gingival recession.

Extent of Primary Caries

Incipient caries is the initial, reversible stage.
Demineralized enamel surface can be remineralized.
Cavitated caries (erosion in the surface) is irreversible.
Treatment involves tooth preparation and restoration.

Rate (Speed) of Caries

Acute caries progress quickly, causing quick tooth damage.
Demineralization outpaces remineralization, creating soft, light-colored lesions.
Chronic caries advance slowly allowing time for remineralization leading to harder, darker lesions.

Abrasion

Pathologic tooth structure loss from friction (e.g., improper brushing, extraneous objects).
Common types include toothbrush abrasion (linear, polished surfaces), pipe-smoking abrasion (specific location) and occupational abrasions.
Iatrogenic abrasion (caused by faulty dentistry).

Erosion

Pathologic tooth structure loss due to chemico-mechanical action, mainly acids.
Exogenous acidic agents, including:
- Environmental factors (industrial acids).
- Battery factory workers exposed to sulfuric acid.
- Workers involved in certain cleaning.
- Acidic water in swimming pools.
- Dietary factors like fruit acids, soft drinks, acidic foods.

Medications

Low pH medicaments and oral hygiene products can cause tooth erosion.

Lifestyle and Behavior Factors

Type and frequency of food/beverage consumption affect tooth erosion.
Endogenous acidic agents like those in gastric acid from frequent regurgitation (bulimia) can cause erosion.

Abfraction

Wedge-shaped cervical defects from unbalanced occlusal forces.
Tooth flexure (bending) under mastication causes compressive and tensile stresses.
Microfractures in enamel occur leading to a characteristic wedge shape.
Enamel loss leads to dentin exposure causing wear.

Attrition

Mechanical wear of incisal or occlusal tooth surfaces from direct friction of teeth.
Physiological, continuous, and age-dependent process.
Accelerated by parafunctional mandibular movements like bruxism (tooth grinding).
Affects occluding surfaces, leading to flattening and facet formation.

Enamel Hypoplasia

Defect in enamel due to ameloblast injury during enamel formation.
Creates defective areas with opaque white, brownish, pitted, or grooved enamel.
Severe cases can result in enamel depression or loss.

Enamel Hypocalcification

Defect in enamel mineralization due to ameloblast injury during mineralization.
Leads to chalky white areas with no defects as in hypoplasia.
Ranges from pits to widespread defects.

Discoloration

Deviation from the normal tooth shade and color of an individual.
Not destructive but affects both socially and psychologically.
Example is Tetracycline staining in pregnant women.

Fracture

Tooth structure separation/loss from traumatic events (falling, blow, hard objects).
Results range from chipping to total crown loss, root displacement, and tooth splitting.

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Description

This quiz explores the concepts of non-carious lesions and dental caries. It covers the causes of tooth structure loss, the distinctions between types of caries, and prevention strategies involving demineralization and remineralization. Test your knowledge on these crucial dental topics!