Dental Plaque and Biofilm Overview
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Questions and Answers

Which type of carbohydrate generally has the highest cariogenic effect?

  • Fructose
  • Glucose
  • Sucrose (correct)
  • Galactose
  • What is the first step that disaccharides must undergo before they can promote caries?

  • Enter the bacterial plaque directly
  • Be converted into monosaccharides (correct)
  • Be broken down into polysaccharides
  • Be neutralized by saliva
  • Which carbohydrate cannot enter the bacterial plaque due to its larger structure?

  • Starch (correct)
  • Sucrose
  • Glucose
  • Fructose
  • What type of bacteria are primarily dominant on the tooth surface after 24 hours?

    <p>Coccus and filaments (A)</p> Signup and view all the answers

    What enzyme is primarily responsible for breaking down starch in the mouth?

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

    What occurs to the number of streptococci in the first 12 hours?

    <p>It increases constantly (B)</p> Signup and view all the answers

    Which of the following sugars is known as 'milk sugar'?

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

    Which structure is associated with supragingival plaque?

    <p>Plaque where the gingiva does not cover (D)</p> Signup and view all the answers

    What effect does the buffering capacity of saliva have on caries formation?

    <p>It neutralizes the acid environment (B)</p> Signup and view all the answers

    What characterizes subgingival plaque?

    <p>It is responsible for periodontal disease (A)</p> Signup and view all the answers

    Which of the following is a monosaccharide?

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

    What happens to the bacterial composition of plaque as it ages?

    <p>Streptococcus mutans increases in number (C)</p> Signup and view all the answers

    Why might caries occur in areas that cannot be easily cleaned?

    <p>Sticky nutrients remaining in the mouth (A)</p> Signup and view all the answers

    What kind of environment do fissure plaque create?

    <p>A separate ecological environment for each fissure (A)</p> Signup and view all the answers

    When does calculus formation start in fissures?

    <p>On the seventh day (A)</p> Signup and view all the answers

    Which of the following is true regarding the remodeling phase of plaque?

    <p>It's not obvious until plaque is removed (D)</p> Signup and view all the answers

    What is the primary role of the pellicle on dental enamel?

    <p>Acting as a diffusion barrier (A)</p> Signup and view all the answers

    Which type of plaque formation occurs within the first 8 hours?

    <p>Young Plaque (A)</p> Signup and view all the answers

    Which bacteria are primarily observed in the early soft plaque surface?

    <p>S. mitis and S. sanguis (C)</p> Signup and view all the answers

    What primarily influences bacterial adhesion to teeth?

    <p>The hydrophobic structures of bacteria (B)</p> Signup and view all the answers

    At what bacterial concentration is S. sanguis able to hold plaque effectively?

    <p>10,000/ml (B)</p> Signup and view all the answers

    Which phase of plaque is characterized by rapid bacterial growth after the initial stage?

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

    The remodeling phase is known for which specific characteristic?

    <p>Stabilization of existing bacteria (D)</p> Signup and view all the answers

    In plaque studies, which organism is most commonly found as a premature colony-forming microorganism?

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

    What factor predominantly affects the cariogenic effect of carbohydrates?

    <p>The time carbohydrates remain in the mouth (D)</p> Signup and view all the answers

    Why do carbohydrates consumed outside of normal meals have a higher caries-causing effect?

    <p>Due to increased salivation during meals (B)</p> Signup and view all the answers

    Which carbohydrate is identified as the most cariogenic?

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

    What is a significant consequence of glucans in dental plaque?

    <p>They promote bacterial accumulation (B)</p> Signup and view all the answers

    Which bacteria is primarily associated with the effect of sucrose on dental caries?

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

    What was the objective of Stephan's experiment on pH changes after glucose intake?

    <p>To observe pH changes in dental plaque (A)</p> Signup and view all the answers

    What process happens to sucrose in dental plaque that contributes to its cariogenicity?

    <p>It is converted into glucan and fructose (C)</p> Signup and view all the answers

    How does a reduction in saliva influence caries formation?

    <p>It increases plaque formation (C)</p> Signup and view all the answers

    What is the primary role of Streptococcus mutans and Streptococcus sobrinus in dental caries?

    <p>They produce acids that lead to tooth decay. (B)</p> Signup and view all the answers

    How soon after the appearance of Streptococcus mutans can caries formation generally be observed?

    <p>Within 6-24 months (D)</p> Signup and view all the answers

    What type of extracellular polysaccharides can Streptococcus mutans form from sucrose?

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

    What role do extracellular polysaccharides (EPS) play in the cariogenicity of Streptococcus mutans?

    <p>They create an environment conducive to acid production. (D)</p> Signup and view all the answers

    What are glucans and fructans classified as?

    <p>Extracellular polysaccharides (B)</p> Signup and view all the answers

    Which chemical process characterizes dental caries?

    <p>Irreversible loss of material due to organic acids (C)</p> Signup and view all the answers

    What is the role of glycosidic bonds in the synthesis of extracellular polysaccharides?

    <p>They provide energy for synthesis. (B)</p> Signup and view all the answers

    Which of the following describes an irreversible chemical reaction in the context of dental caries?

    <p>The decay process cannot be reversed. (C)</p> Signup and view all the answers

    What happens to the pH level after a glucose rinse?

    <p>It drops below the critical pH within 2-5 minutes. (C)</p> Signup and view all the answers

    What is the main characteristic of extracellular polysaccharides (EPS) formed by sucrose?

    <p>They primarily consist of insoluble glucans. (B)</p> Signup and view all the answers

    How does sucrose affect the concentration of certain ions in dental biofilm?

    <p>It decreases the concentration of calcium and fluoride. (B)</p> Signup and view all the answers

    What pH level is considered non-cariogenic for foods consumed within 30 minutes?

    <p>Above 5.7. (A)</p> Signup and view all the answers

    Which statement about lipids in food is true regarding their impact on dental health?

    <p>They do not affect decay, but reduce adhesion rates. (C)</p> Signup and view all the answers

    What is produced as a final product from the breakdown of proteins in the mouth?

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

    What is the significance of ammonia in relation to dental health?

    <p>It neutralizes acids, providing an advantage against caries. (A)</p> Signup and view all the answers

    What does the critical pH level indicate in terms of dental health?

    <p>It is the threshold below which demineralization begins. (B)</p> Signup and view all the answers

    Flashcards

    Initial Plaque Formation

    The initial stage of plaque formation where bacteria colonize the tooth surface.

    Plaque Remodelling

    The process of plaque changing over time as bacteria adapt and multiply.

    Supragingival Plaque

    The type of plaque found on the tooth surface above the gum line.

    Subgingival Plaque

    The type of plaque found under the gum line, associated with periodontal disease.

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    Fissure Plaque

    The type of plaque found in the grooves of teeth, requiring special care.

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    Plaque Surface Layer

    The outer layer of plaque, directly exposed to the environment.

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    Plaque Body Layer

    The middle layer of plaque, containing a dense population of bacteria.

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    Intensive Microbial Layer

    The inner layer of plaque, closest to the tooth surface.

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    What is the Pellicle?

    A thin, acellular layer of adsorbed salivary proteins and other macromolecules on the enamel surface, approximately 10 micrometers thick.

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    What is the primary function of the Pellicle?

    The pellicle protects the enamel from abrasion and attrition, and acts as a barrier against substances entering and leaving the tooth.

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    What is Dental Plaque?

    A deposit of bacteria and their products on the tooth surface, particularly in areas that are not cleaned regularly.

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    How do bacteria attach to teeth?

    The hydrophobic nature of bacterial structures plays a significant role in their adhesion to the teeth, as they can bind to carbohydrate receptors on the pellicle.

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    What are the factors that influence bacterial adhesion?

    The concentration of bacteria in the oral environment is important for plaque formation. Certain bacteria, like Streptococcus mutans, require a higher concentration to adhere successfully.

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    What is Young Plaque?

    The first stage of plaque formation, characterized by the initial colonization of the tooth surface by bacteria within the first 8 hours.

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    What is Mature Plaque?

    The second stage of plaque formation, marked by rapid bacterial growth and an increase in the number of bacteria after 8 hours.

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    What is the Remodeling Phase of Plaque?

    The final stage of plaque formation, where the bacterial community changes and the plaque undergoes structural changes over time.

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    Caries causing bacteria

    Streptococcus mutans and Streptococcus sobrinus are the primary bacteria involved in the development of dental caries.

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    Acid production in caries

    Streptococcus mutans produces acids that weaken tooth enamel, contributing to the formation of cavities.

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    Timeframe for caries development

    The presence of Streptococcus mutans in the mouth can lead to the formation of caries within 6 to 24 months.

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    Extracellular polysaccharides in caries

    Extracellular polysaccharides, produced by Streptococcus mutans and Streptococcus sobrinus, contribute to the bacteria's ability to stick to teeth and promote caries.

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    Types of extracellular polysaccharides

    Glucans and fructans are types of extracellular polysaccharides produced by caries-causing bacteria.

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    Definition of dental caries

    Dental caries is a permanent loss of tooth material caused by the acids produced by bacteria in plaque.

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    Importance of early caries treatment

    Early diagnosis and treatment of caries are crucial to prevent further damage and financial burden.

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    Complex nature of caries

    Caries should be viewed as a complex process involving acid formation, reaction environment, and tooth structure.

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    Why are monosaccharides cariogenic?

    Simple sugars like glucose and fructose can easily enter bacterial plaque due to their small molecular size.

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    How do disaccharides cause caries?

    Disaccharides like sucrose, lactose, and maltose need to be broken down into monosaccharides before they can be used by bacteria to produce acid.

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    Why are polysaccharides less cariogenic?

    Large, complex sugars like starch are difficult for bacteria to break down due to their size and the limited availability of enzymes in the mouth.

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    How does saliva protect against caries?

    Saliva's buffering effect helps neutralize acid produced by bacteria, preventing plaque formation and caries.

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    What is the effect of different sugar types on caries?

    The type of sugar consumed can impact caries risk. Sucrose is more cariogenic than fructose or glucose.

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    How does the presence of multiple sugars affect caries?

    The presence of multiple sugar types together can increase caries risk compared to consuming them individually.

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    How does stickiness affect caries?

    Carbohydrates that stick to teeth for longer periods can increase the risk of caries, especially in hard-to-clean areas.

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    Where is caries risk higher due to food accumulation?

    Food remnants, especially sugary ones, can accumulate in hard-to-reach areas like interdental spaces and fissures, increasing the risk of caries.

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    Critical pH

    The point at which the pH of the mouth falls below 5.5, typically occurring within 2-5 minutes after a sugary rinse, and lasting for 10-30 minutes depending on individual caries activity.

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    Sucrose

    A type of sugar that is easily broken down by bacteria in the mouth, leading to the production of acid that can damage teeth. It's the most common sugar found in food and drinks.

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    Extracellular Polysaccharide (EPS)

    A complex, sticky substance produced by bacteria that helps them stick to the tooth surface and form a biofilm.

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    Intracellular Polysaccharide (IPS)

    A type of carbohydrate that is primarily found in the mouth and is responsible for the structural integrity of the biofilm.

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    Non-cariogenic food

    A type of food that does not cause a significant drop in pH in the mouth after consumption and is considered unlikely to contribute to tooth decay.

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    Lipid breakdown in plaque

    The breakdown of lipids (fats) by enzymes called esterases in dental plaque. This process releases fatty acids, which then combine with calcium and magnesium to form salts.

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    Protein breakdown

    A type of nutrient that is broken down into amino acids and urea, producing ammonia as a by-product. This ammonia can help counteract the effects of acids on tooth enamel, protecting against tooth decay.

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    Demineralization

    The process of minerals leaving the tooth surface, weakening enamel and making it more susceptible to decay.

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    Cariogenicity

    The tendency of a food to cause tooth decay. It is influenced by factors like how long the food stays in the mouth, its texture, and whether it dissolves easily.

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    Eating between meals

    Consuming carbohydrates outside of regular mealtimes often increases the risk of tooth decay.

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    Sucrose and Caries

    Sucrose is a type of sugar that is particularly prone to causing tooth decay, largely due to its ability to be broken down by specific bacteria in the mouth.

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    Sucrose Metabolism

    Bacteria in the mouth, particularly Streptococcus mutans, can break down sucrose into glucan and fructose. Glucan, a sticky substance, contributes to plaque buildup and the formation of cavities.

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    Glucan

    A substance that helps bacteria cling to tooth surfaces, making it easier for them to create acid and cause tooth decay.

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    Stephan's Curve

    Stephan's Curve is a graph that shows the changes in pH within dental plaque over time after consuming a sugar-containing solution.

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    Resting pH

    The pH level of dental plaque one hour after a meal, when no fermentable carbohydrates are present in the mouth.

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    10% Glucose Solution

    A solution used in studies to measure the pH changes in dental plaque after consuming sugar.

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    Study Notes

    Dental Plaque

    • Dental plaque is a deposit of bacteria and bacterial products located on unclean teeth or accumulations on restorations in the mouth.
    • Plaque formation depends on the position of the teeth, the roughness of tooth surfaces, and personal hygiene.
    • Plaque formation has three phases: young, mature, and remodeling.

    Biofilm

    • Biofilm is a term used to describe areas where microorganisms settle and reproduce on various surfaces.
    • It is found on surfaces like water pipes and plays a significant role in hospital infections.
    • In the oral cavity, microorganisms within the biofilm matrix have different behavior than bacteria floating freely.
    • One of the important factors enabling microorganisms in the oral flora to remain in this region is their ability to adhere to the tooth surface.

    Dental Pellicle

    • An electron microscope study shows a thin layer of cells without bacteria between the surface of the enamel and bacteria. This thin layer is called the Dental Pellicle.
    • Dental Pellicle is a protein layer forming on tooth enamel through selective binding of glycoproteins.
    • This prevents continuous deposition of salivary calcium phosphate.
    • It protects the tooth from acids produced by microorganisms following consumption of carbohydrates.

    Oral Biofilm

    • The human oral cavity has hundreds of different types of microorganisms, including bacteria, viruses, and fungi.
    • These live in complex communities, organized into a thin layer called biofilm.
    • Dental plaque, proteins from saliva, cover tooth surfaces immediately after their cleaning.
    • Bacterial retention to the film layer occurs due to microfilaments in the cell walls.
    • As bacteria increases, they communicate and create a community using signal molecules and secreting proteins, polysaccharides, nucleic acids, and other extracellular matrix components.
    • This matrix acts as the glue of the biofilm.
    • Microbial communities behave as a single unit, responding to environmental changes.

    Caries Microorganisms

    • Acidogenic bacteria in plaque convert sugar into acids, contributing to tooth demineralization.
    • Common acidogenic bacteria include Streptococcus, Actinomyces, Lactobacilli, etc.
    • The composition of the bacterial flora in necrotic soft caries dentin and partly decalcified deep areas of dentin is described in a table.
    • Specific microbial counts and ranges at various stages are provided.

    Caries

    • Dental caries is the irreversible loss of material caused by organic acids produced in bacterial plaques.
    • It causes pain and aesthetic issues.
    • Caries is a complex event involving chemical structures, reaction environments, and tooth structures.
    • The components of the chemical reaction in caries include reactants, reaction medium, and conditions, and the reaction products.

    Acids in the Mouth

    • Acids occur as a result of oral bacteria activity breaking down carbohydrates.
    • People with professions requiring constant contact with acids, like in battery factories, labs, etc., are at risk.
    • Breathing acidic air due to pollution is also a factor.
    • Some acidic drinks, herbal teas, and alcoholic beverages cause acidification.
    • Frequent vomiting during pregnancy and chronic alcoholism can lead to gastric juice reflux into the mouth.
    • Certain drugs, like aspirin and effervescent vitamin tablets, can also cause oral acidification.

    Carbohydrates' Role in Caries

    • Carbohydrates are the initial part of the chemical reaction in caries, leading to organic acid production.
    • Foods with a high proportion of carbohydrates are major risk factors for caries.
    • Factors altering carbohydrate-based cariogenicity include their type, the time they remain in the mouth, their texture (hard, sticky, liquid form), and when consumed outside of meal times.

    Sucrose and Biofilm

    • Sucrose is the most cariogenic carbohydrate.
    • It enables the formation of extracellular and intracellular polysaccharides, especially glucans.
    • Glucans cause bacteria to adhere to the tooth surface and form the structural biofilm layer.
    • The presence of sucrose increases oral biofilm porosity and facilitates sugar penetration.

    Stephan Curve

    • Stephan's experiment examined the changes in plaque pH after glucose consumption.
    • Patients with different levels of caries activity were studied.
    • An electrode measured the resting pH of plaque and changes resulting from a glucose rinse.
    • The curves show that the pH drops rapidly after glucose intake, reaching the critical pH level within 2-5 minutes, depending on caries activity.

    Factors Affecting Caries-Promoting Properties of Carbohydrates

    • Different carbohydrates have variable cariogenic effects.
    • Physical properties like duration of presence in the mouth, texture, solubility, and whether ingested as a meal or snack impact cariogenicity.
    • Outside of meal consumption, carbohydrates tend to have a higher cariogenic effect.
    • Individual factors, including saliva amount, flow rate, and tooth anatomy, influence the rate and severity of caries formation.

    Types of Plaque

    • Supragingival plaque is on the gums.
    • Subgingival plaque is under the gums, and it is a key factor in periodontal diseases.
    • Plaque in fissures, also called fissure plaque, is very narrow and in occlusal surfaces.

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    Description

    This quiz explores essential concepts related to dental plaque, biofilm, and dental pellicle. It delves into the formation of dental plaque, its phases, and the role of biofilms in the oral cavity and healthcare settings. Understanding these concepts is crucial for maintaining oral health and preventing infections.

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