most prevalent chronic disease affecting the human race | Dental Caries |
characterized by demineralization of inorganic substances and destruction of the organic substances | Dental Caries |
3 factors that affect development of caries | host, microflora, substrate |
Essential Factors (etiology): ____tooth/teeth erupted in the oral cavity | natural |
Essential Factors (etiology):____ teeth do not develop dental caries | unerupted |
Essential Factors (etiology):complete coverage of crown of a tooth by dental restorative material isolates it from highly ____environment thus preventing caries formation | cariogenic |
Essential Factors (etiology):most cariogenic food especially refined sugars because these are readily fermentable | Carbohydrates |
Factors that determine cariogenecity of Carbohydrates | Frequency of ingestion, Physical form, Chemical composition, Route of administration, Presence of other food constituents |
Essential Factors (etiology):tenacious film that forms on the tooth surface composed of mucin, desquamated epithelial cells and bacteria | Dental Plaque |
ability of the bacteria to rapidly form lactic acid and other acids from sugars | Acidogenicity |
the ability of bacteria to survive in low pH environment | Aciduricity |
Pathogenecity of bacteria is influenced greatly by ______________relationship | plaque and diet |
Most cariogenic bacteria | Streptococcus mutans |
Capable of utilizing sucrose to synthesize a sticky insoluble polysaccharide (glucans) that serve as a structural matrix for attachment of bacteria on tooth surface | Streptococcus mutans |
Role of acids: Bacterial degradation of carbohydrates to form _____ that demineralizes the inorganic structures of the teeth | lactic acid |
Causative Bacteria of Dental Caries | Streptococcus mutans, Lactobacillus acidophilus, Actinomyces |
Composition of saliva:serves as a lubricant | Mucus |
Composition of saliva:initiates the digestion of starch | Amylase |
Composition of saliva:begins digestion of fat | Lingual lipase |
Composition of saliva:Electrolyte solution ( ____________) moistens food | Na+, Cl-, K+, HCO3- |
Composition of saliva:Proteins and enzymes | statherins, Proline-rich proteins, histatins, lysozymes, salivary peroxidase |
Composition of saliva:Antimicrobial action | Proteins and enzymes |
Composition of saliva:Lubrication | Proteins and enzymes |
Composition of saliva:Buffer capacity and remineralization | Proteins and enzymes |
Systemic Factors | Hereditary, Pregnancy and lactation |
Theories on Etiology of Dental Caries: by Miller | Acidogenic Theory |
Theories on Etiology of Dental Caries: stated that dental caries is a chemicoparasitic process with two stages | Acidogenic Theory |
Theories on Etiology of Dental Caries: Decalcification of enamel which results in total destruction | Acidogenic Theory |
Theories on Etiology of Dental Caries: Decalcification of dentin as preliminary stage, followed by dissolution of the softened residue | Acidogenic Theory |
Theories on Etiology of Dental Caries: by Gottlieb | Proteolytic Theory |
Theories on Etiology of Dental Caries: Caries is essentially a proteolytic process whereby microorganisms invade inorganic pathways and destroy them in their advancement | Proteolytic Theory |
Theories on Etiology of Dental Caries: dissolution of organic substance and demineralization of inorganic substance | Proteolytic Theory |
Theories on Etiology of Dental Caries: bacterial attack on enamel initiated by keratinolytic microorganisms | Proteolysis-chelation theory |
Theories on Etiology of Dental Caries: consists in a breakdown of protein and other organic components of enamel, chiefly keratin | Proteolysis-chelation theory |
Theories on Etiology of Dental Caries: resulting in formation of substances forming soluble chelates with the mineralized component of the tooth and decalcify enamel or even alkaline Ph | Proteolysis-chelation theory |
Clinical Classification of Dental Caries:occlusal surfaces of posteriors and lingual pits of anteriors | Pit and fissure |
Clinical Classification of Dental Caries:facial, lingual, proximal areas below contact points, gingival 3rd of buccal and lingual surfaces | smooth surface |
Clinical Classification of Dental Caries:deep penetrating | Acute crown caries |
Clinical Classification of Dental Caries:rapid clinical destruction of teeth | Acute crown caries |
Clinical Classification of Dental Caries:pulp easily involved | Acute crown caries |
Clinical Classification of Dental Caries:pain is a constant symptom | Acute crown caries |
Clinical Classification of Dental Caries:shallow disintegrating type | Acute Root Caries |
Clinical Classification of Dental Caries:affects roots at interproximal surface | Acute Root Caries |
Clinical Classification of Dental Caries:slow, long standing lesion | Chronic crown and root caries |
Clinical Classification of Dental Caries:dark brown in color with decalcified dentin leathery in consistency and with secondary dentin deposition | Chronic crown and root caries |
Clinical Classification of Dental Caries:delayed pulp involvement | Chronic crown and root caries |
Clinical Classification of Dental Caries:absence of pain | Chronic crown and root caries |
Clinical Classification of Dental Caries:static or stationary caries that does not show any marked tendency for further progression | Arrested caries |
Clinical Classification of Dental Caries:brown stain, hard and polished surface | Arrested caries |
Arrested caries: dentin is referred to as _____dentin | eburnated |
Clinical Classification of Dental Caries:virgin caries | Primary caries |
Clinical Classification of Dental Caries:starts from intact surface of teeth | Primary caries |
Secondary caries: recurrence of caries after treatment or occurs in the immediate vicinity of a restoration | marginal caries |
Secondary caries: seen on teeth with marked attrition of broken off crown | central caries |
Main culprit for pathological conditions in the oral cavity, specifically for hard tissues of the oral cavity which is the tooth | Dental caries |
Multifactorial disease which causes destruction and demineralization of hard tissues | Dental caries |
How to protect tooth (pedodontic) | prophylactic odontotomy, sealant |
How to protect tooth (pedodontic):conservative occlusal restorations of deep pit and fissures prior to caries formation | Prophylactic Odontotomy |
How to protect tooth (pedodontic):adherent materials placed on the occlusal surfaces of teeth | Sealant |
produced by sucrose formation by MS which is responsible for the stickiness of plaque and enables plaque to stick on the tooth surface | Dextran |
With ability to adhere to tooth surface | Bacteria |
Essential Factors (etiology):a structure entity in which the microbes are embedded in a highly organized intracellular matrix | Dental Plaque |
Essential Factors (etiology):is a highly organized and ordered sequence of events | Plaque formation |
Thin protein containing film derived from salivary glycoproteins | Acquired pellicle |
20— 500 nm thick within the first two hours of exposure to saliva | Acquired pellicle |
Always present in the oral cavity | Acquired pellicle |
Site of bacterial proliferation and growth | Acquired pellicle |
Site of acid-base regulation at the tooth surface which provides a matrix for remineralization | Acquired pellicle |
A reservoir for calcium ion exchange between the tooth and saliva | Acquired pellicle |
Functions to reduce friction between the teeth | Acquired pellicle |
Acquired pellicle which is less than __ hours of age acts as a protective coating of the enamel against acid | 24 |
Contains high concentrations of calcium and phosphate ions | saliva |
Action of Saliva to Neutralize Acid Attack: | Wash Acid Away, bicarbonate component directly buffers acids |
at pH ______ = surface enamel is etched and roughened | 3.0-4.0 |
at pH ___ = surface enamel is intact but subsurface enamel (underneath) is lost | 5 |
After tooth demineralization, the tooth may undergo: | remineralization, progress to cavitation |
If Fluoride ion is part of the remineralization process, the enamel is restored to soundness and becomes more resistant to caries attack, w/o cavitation = there will be a change in color due to | exogenous stains |
If Fluoride ion is part of the remineralization process, the enamel is restored to soundness and becomes more resistant to caries attack, w/ cavitation = there is formation of ____ | eburnated dentin |
enamel zones: Advancing front of the carious lesion | Translucent Zone |
enamel zones: zone of active demineralization and hypocalcification | dark zone |
enamel zones: most severely demineralized area | body of the lesion |
enamel zones: occupies greatest part of affected area | body of the lesion |
enamel zones: Unaffected by caries attack | Surface Zone |
enamel zones: Area which is hypermineralized by contact of the saliva | Surface Zone |
enamel zones: Has greater concentration of fluoride ion than the immediately subadjacent enamel | Surface Zone |
dentinal zones:Walls of dentinal tubules and matrix becomes decalcified | Zone of complete decalcification |
dentinal zones:Dentinal tubules are obliterated because of calcification of Tome's fiber | Zone of transparency |
dentinal zones:Formation of fatty materials and beginning precipitation of calcium droplets in the protoplasm of Tome's fiber | Zone of fatty degeneration |
CARIES OF DENTIN: The ______ act as tracts leading to the pulp (path for micro-organisms). | dentinal tubules |
DENTINAL CHANGES:initial penetration of the dentin by caries | Early Dentinal Changes |
DENTINAL CHANGES:dentinal sclerosis | Early Dentinal Changes |
DENTINAL CHANGES:calcification of DT and sealing off from further penetration by micro-organisms, | Early Dentinal Changes |
DENTINAL CHANGES:more prominent in slow chronic caries. | Early Dentinal Changes |
DENTINAL CHANGES:Behind the transparent sclerotic zone, decalcification of dentin appears. | Early Dentinal Changes |
DENTINAL CHANGES:microorganisms may be found penetrating the tubules | Early Dentinal Changes |
DENTINAL CHANGES:Pioneer Bacteria | Early Dentinal Changes |
DENTINAL CHANGES:acidophilic forms are more prominent | Early Dentinal Changes |
DENTINAL CHANGES:proteolytic organisms might appear to predominate | Early Dentinal Changes |
DENTINAL CHANGES:decalcification of walls, confluence of the dentinal tubules, | Early Dentinal Changes |
DENTINAL CHANGES:tiny "liquefaction foci", described by Miller are formed by the focal coalescing and breakdown of dentinal tubules | Early Dentinal Changes |
DENTINAL CHANGES:These are ovoid areas of destruction parallel to the course of the tubules which filled with necrotic debris and increase in size by expanding. | Early Dentinal Changes |
DENTINAL CHANGES:The destruction of dentin by decalcification and then proteolysis occurs in numerous focal areas- leading to a necrotic mass of dentin of a leathery consistency | Early Dentinal Changes |
DENTINAL CHANGES:Clefts present in the carious dentin that extends at right angles to the dentinal tubules, accounts for the peeling off of dentin in layers while excavating. | Early Dentinal Changes |
dentinal zones:due to degeneration of the odontoblastic process. This occurs before sclerotic dentin is formed and makes the tubules impermeable. | Zone of Fatty Degeneration of Tome's Fibers |
dentinal zones:deposition of Ca salts in the tubules. | Zone of dentinal sclerosis |