Introduction to Dental Caries CLD 100

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Questions and Answers

What is a primary factor that contributes to susceptibility to dental caries?

Frequency of brushing

The presence of saliva

The position of the tooth (correct)

Presence of fluoride in water

Which type of carbohydrate is most likely to be cariogenic?

Starches

Fiber-rich carbohydrates

Simple carbohydrates (correct)

Complex carbohydrates

What role does Streptococcus mutans play in dental caries?

It promotes salivary flow.

It ferments sucrose to produce glucan and acid. (correct)

It causes inflammation in gums.

It protects teeth from demineralization.

What is the critical pH level at which tooth material begins to dissolve?

5.5 Signup and view all the answers

How does the biochemical structure of teeth influence caries susceptibility?

Surface enamel is more mineralized than subsurface enamel. Signup and view all the answers

Which factor modifies the risk of dental caries by facilitating remineralization?

Calcium and phosphate ions in saliva Signup and view all the answers

What impact does the frequency of carbohydrate intake have on dental health?

Increased frequency leads to more acid attacks. Signup and view all the answers

Why is the time period of exposure crucial for the development of dental caries?

It aids in sustaining an acidic pH environment for demineralization. Signup and view all the answers

What characterizes cavitated caries?

Extends into dentine and is irreversible Signup and view all the answers

What type of caries is typically seen in teenagers and may increase pulp exposure?

Adolescent caries Signup and view all the answers

Which classification system assesses the shape and depth of a carious lesion?

WHO system Signup and view all the answers

Which of the following categories describes incipient caries?

Caries involving less than half the thickness of enamel Signup and view all the answers

What is considered intentional residual caries management?

Leaving deep caries to prevent pulp exposure Signup and view all the answers

Which of the following tooth surfaces is NOT commonly restored in adult caries?

Incisal Signup and view all the answers

How does caries begin in enamel?

Once bacterial plaque deposits in pits and fissures Signup and view all the answers

Which of the following accurately describes residual caries?

Carious tissue is left after restoration Signup and view all the answers

What type of caries is characterized by lesions on unrestored surfaces?

Primary caries Signup and view all the answers

Which classification of caries involves lesions developing adjacent to restorations?

Secondary caries Signup and view all the answers

What term describes caries that have become stationary or static?

Arrested caries Signup and view all the answers

Which class of restoration design targets proximal surfaces of anterior teeth involving the incisal edge?

Class IV Signup and view all the answers

Which type of caries is described as rapidly invading and can result in pulp exposure?

Acute caries Signup and view all the answers

What is the first evidence of caries activity known as?

Incipient caries Signup and view all the answers

Which type of caries affects exposed root surfaces, predominantly in older patients?

Root caries Signup and view all the answers

In the classification of the pathway of caries spread, what term describes when caries in the dentine exceeds the caries in the contiguous enamel?

Backward caries Signup and view all the answers

What is the primary cause of dental caries?

Interaction between acid-producing bacteria and fermentable carbohydrates Signup and view all the answers

Which theory suggests that caries is a chemico-parasitic process involving the decalcification of enamel?

Acidogenic theory Signup and view all the answers

What does the Caries Balance Concept emphasize?

Caries are the result of a complex interaction of pathological and protective factors. Signup and view all the answers

What are the primary factors identified in a high caries risk patient?

High sugar intake and poor salivary flow Signup and view all the answers

Which of the following best describes affected dentine?

Dentine that has lost mineral content but is structurally sound Signup and view all the answers

What role do enamel lamellae play in dental caries development?

They provide pathways for microorganisms to invade enamel. Signup and view all the answers

How is dental caries most accurately defined?

A microbial disease characterized by the destruction of organic tissue and demineralization of calcified tissues. Signup and view all the answers

Which factor is NOT typically considered a protective factor against dental caries?

High sugar consumption Signup and view all the answers

What is a key characteristic of the proteolytic theory of dental caries?

It emphasizes the importance of the organic portion of the tooth. Signup and view all the answers

What does caries risk assessment evaluate?

The likelihood of a patient developing dental caries based on individual factors. Signup and view all the answers

Which zone of dentinal caries is characterized by normal collagen and odontoblastic processes?

Zone 1 - Normal dentine Signup and view all the answers

What is a key characteristic of Zone 2 of dentinal caries?

Inter-tubular dentine is demineralized Signup and view all the answers

Which zone of dentinal caries is described as turbid and contains bacteria?

Zone 4 - Turbid dentine Signup and view all the answers

What differentiates infected dentine from affected dentine?

Presence of bacteria in infected dentine Signup and view all the answers

Which diagnostic method relies on detecting softened tooth structure using an explorer?

Tactile examination Signup and view all the answers

What appearance does a carious lesion have under ultraviolet examination?

Dark shadow against a fluorescent background Signup and view all the answers

Which zone of dentinal caries is capable of remineralization?

Both B and C Signup and view all the answers

Which radiographic examination method is primarily used to detect interproximal caries?

Bitewing radiographs Signup and view all the answers

Study Notes

Overview of Dental Caries

Dental caries is a widespread chronic disease caused by the interaction of acid-producing bacteria and fermentable carbohydrates, leading to demineralization of enamel and dentine.

Definition of Dental Caries

A microbial disease affecting calcified tooth tissues, characterized by demineralization and destruction of the tooth structure (Shafer).
Pathological process resulting in localized dissolution of teeth (Sturdevant).
Involves softening of hard tissue and cavity formation (WHO).

Theories of Dental Caries

Acidogenic Theory: Proposed by Miller; involves decalcification of enamel and the impact of carbohydrates and microorganisms.
Proteolytic Theory: Established by Heider Bodecker; highlights the role of organic components in tooth structure and microbial invasion.
Proteolysis-Chelation Theory: Introduced by Schatz; explains enamel demineralization via keratinolytic microorganisms and neutral pH chelators.
Caries Balance Concept: Focuses on the balance of pathogenic and protective factors in caries progression.

Aetiological Factors

Primary Factors: Include tooth characteristics (susceptible areas, position, biochemical structure), substrate (dietary factors), bacteria (e.g., Streptococcus mutans), and effective time for caries development.
Modifying Factors: Saliva's role in composition, pH, and viscosity influences caries risk.

Classification of Dental Caries

Based on anatomical site, lesion status (primary or recurrent), speed of progression (acute, chronic, rampant, arrested), treatment design (Class I to VI), and extent (simple, compound, complex).
Notable types include pit and fissure caries, root caries, and smooth surface caries.

Dentinal Caries Histopathology

Carious lesions in dentine take a triangular shape with zones of varying characteristics from normal to infected dentine.
Zones of Dentinal Caries:
- Zone 1: Normal dentine with intact structures.
- Zone 2: Sub transparent dentine, demineralized but bacteria-free, capable of remineralization.
- Zone 3: Transparent dentine without bacteria, can still remineralize.
- Zone 4: Turbid dentine with bacteria, lack of self-repair.
- Zone 5: Infected dentine, decomposed tissue filled with bacteria.

Differences Between Infected and Affected Dentine

Infected Dentine: Soft, demineralized, bacteria-infested and non-remineralizable.
Affected Dentine: Demineralized but not invaded by bacteria, maintains uninterrupted collagen structure and potential for remineralization.

Detection of Dental Caries

Visual examination for cavitation, color changes, and surface roughness.
Tactile examination using an explorer for softened tooth structure.
Radiographic examination using periapical and bitewing radiographs for interproximal caries detection.
Ultraviolet illumination reveals carious lesions as dark spots against the fluorescent background.

Caries Risk Assessment

Evaluates susceptibility and presence of risk factors to identify individuals at high risk for developing caries.
Criteria for identifying high caries risk patients include diet, saliva composition, oral hygiene practices, and fluoride exposure.

Prevention of Dental Caries

Maintaining oral hygiene through regular brushing and flossing.
Reducing consumption of refined sugars and promoting a balanced diet rich in nutrients.
Utilizing fluoride treatments and sealants to strengthen tooth enamel and reduce the risk of decay.

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Description

This quiz covers essential aspects of dental caries as taught in the CLD 100 course by Dr. S. Bredenkamp. You will learn definitions, theories, aetiological factors, classification criteria, and histopathological zones of caries. Additionally, the quiz will address the differences between infected and affected dentine, along with detection methods for caries.