Cariology Midterm

What is the term for healthcare that reacts only when emergencies occur due to poor access?

Ping-pong healthcare

What are three protective factors considered in CAMBRA?

Fluoride, saliva, and antibacterial agents

What is the base material used to promote remineralization during caries excavation?

Calcium hydroxide (Ca(OH)₂)

Which surface lesion progresses faster: occlusal or interproximal?

Occlusal

What is recommended to minimize BPA exposure after placing sealants?

Remove uncured resin layer (air-inhibited layer)

What makes dentin caries progress faster than enamel caries?

Higher organic content and tubule structure

What diagnostic tool measures mineral loss in caries?

Transverse Microradiography (TMR)

What type of sealant is more moisture-tolerant and releases fluoride?

Glass ionomer sealant

What index is used to classify severity of fluorosis?

Thylstrup-Fejerskov (TF) index

How can uncured sealant be identified?

It appears shiny or oily after curing

What fluoride treatment can be safely used for babies and young children?

Fluoride varnish

What is the name of the fluoride-enriched crystal that is more resistant to acid?

Fluorapatite

What zone contains necrotic, empty tubules in dentin?

Dead tracts

What are some practical ways to avoid BPA exposure in daily life?

Avoid microwaving plastics, use BPA-free containers

What is the critical pH for demineralization of fluorapatite?

4.5

Why is BPA considered controversial?

It is a xenoestrogen and may mimic estrogen

How does enamel respond to caries?

Chemically, through mineral loss

What is the purpose of the 'Lift the Lip' technique?

To detect early signs of caries in infants

What tool is used for assessing caries risk in children?

CAMBRA

What is the optimal fluoride concentration in drinking water as recommended by the U.S. HHS?

0.7 ppm

What is tertiary dentin?

Dentin formed in response to external stimuli or caries

Where do white spot lesions first appear in enamel?

At prism boundaries

What is stepwise caries excavation?

Removing bulk decay and re-evaluating after 6-12 months to avoid pulp exposure

What structure allows lateral spread of caries into dentin?

Dentino-enamel junction (DEJ)

What is tertiary dentin?

Dentin formed in response to carious stimuli by odontoblasts

What condition did H. Trendley Dean study across U.S. communities?

Fluorosis and its relationship to fluoride levels

What is the only adverse effect of fluoride at recommended water levels?

Very mild to mild fluorosis

How is enamel different from dentin in caries response?

Enamel is acellular; dentin has cellular response

What is the role of fluoride-releasing sealants?

To act as a reservoir for fluoride

Which city was the first to implement community water fluoridation?

Grand Rapids, Michigan

At what age should a child have their first dental visit?

By age one

What compound in dental materials raised health concerns in the 1990s?

Bisphenol A (BPA)

What is the mechanism by which acid dissolves hydroxyapatite?

Low pH causes enamel minerals to dissolve to rebalance ion loss

How does fluoride inhibit dental caries?

By promoting remineralization and inhibiting bacterial acid production

What are white spot lesions an early indicator of?

Demineralization and caries progression

What is the progression pattern of pit and fissure caries?

Enamel: cone tip at surface; Dentin: cone base at DEJ

Which method was used to detect BPA release in 1996?

In vitro testing by Olea et al.

How does dentin respond to caries?

Biologically, by forming tertiary dentin

What condition is caused by excessive fluoride intake during tooth development?

Dental fluorosis

Who first observed 'Colorado Brown Stain' and linked it to water?

Dr. Frederick McKay

According to the CDC, fluoridation of drinking water is one of the greatest achievements in what?

20th-century public health

What is the importance of removing plaque in caries prevention?

Stops lesion progression and allows remineralization

What age group is affected by Early Childhood Caries (ECC)?

Children under age 6

What role does saliva play in remineralization?

Provides calcium, phosphate, and fluoride

What are two signs of active white spot lesions?

Dull surface and plaque presence

What zone in dentin contains blocked tubules?

Sclerotic zone

What conditions favor enamel remineralization?

Shallow lesions, fluoride exposure, plaque removal

Which type of dentin forms throughout life and narrows the pulp chamber?

Secondary dentin

What is the first visible clinical sign of ECC?

White spot lesions

Which lesion type shows white opacity only when dry in early stages?

Initial enamel white spot lesion

Question

Answer

What is one benefit of using fluoride varnish over mouth rinse in children?

Safe for younger children who cannot spit

What does a shiny white spot lesion suggest?

An inactive carious lesion

Why is water fluoridation a systemic form of fluoride delivery?

Because fluoride is ingested and incorporated during tooth development

What conclusion did the NTP-CERHR draw about BPA at current exposure levels?

Some concern for developmental effects in infants

What radiographic score corresponds to caries reaching the outer half of dentin?

Score 4

What is the clinical significance of white spot lesions?

They are early, reversible signs of caries

Why is fluoride exposure from sealants considered minimal?

BPA is largely confined to the uncured surface and is removed after curing

What socioeconomic group is disproportionately affected by ECC?

Low-income and minority populations

What happens when caries reaches the pulp?

Pulpal inflammation and possibly irreversible pulpitis

Which dietary habit increases caries risk more: high sugar quantity or high frequency?

High frequency

What is the difference between primary and secondary dentin?

Primary forms during tooth development; secondary forms throughout life

What clinical tool can be used for infant oral exams?

Knee-to-knee positioning

What is the best indicator of caries activity in white spot lesions?

Surface texture and presence of plaque

How is sclerotic dentin identified histologically?

Tubules appear occluded with highly organized crystals

Which resin monomer is used in UltraSeal XT HYDRO?

UDMA and TEGDMA

What lesion type typically starts at the cervical third?

Smooth surface lesions

What public health agency declared water fluoridation a top 10 public health achievement?

Centers for Disease Control and Prevention (CDC)

At what pH does enamel begin to demineralize?

Below 5.5

What effect does a drop in pH have on hydroxyapatite solubility?

It increases solubility and promotes demineralization

What is the role of anticipatory guidance in ECC prevention?

To educate parents on oral hygiene and nutrition for future prevention

Why is daily use of fluoride toothpaste important in young children?

To promote remineralization and prevent ECC

How do tertiary dentin and dead tracts differ?

Tertiary dentin is reparative; dead tracts are necrotic

What is the mechanism of fluoride release from GI sealants?

Fluoride diffuses at the restoration-tooth interface

Why is complete remineralization of deep carious lesions unlikely?

The deeper structure lacks adequate mineral supply

What is the role of the dentino-enamel junction in caries spread?

It allows lateral spread of caries due to lower mineral content

What feature distinguishes tertiary dentin from primary and secondary?

It is less organized and formed in response to stimuli

Why do we not microwave polycarbonate containers?

They may release BPA under heat

What is the purpose of the CAMBRA form?

To assess risk and guide treatment decisions based on individual patient factors

Why is saliva critical in preventing caries?

It buffers acids and provides minerals for remineralization

What is an advantage of glass ionomer sealants over resin-based?

They are less technique-sensitive and release fluoride

Which lesion types show a cone-shaped lesion with base at DEJ?

Dentin caries in pit and fissure or smooth surface lesions

Which mineral does fluoride replace in hydroxyapatite?

Hydroxyl (OH⁻) group

What was the purpose of the NTP-CERHR monograph?

To assess human reproductive and developmental effects of BPA

What are common risk factors for ECC?

High sugar intake, low fluoride, poor oral hygiene

What happens in the zone of dead tracts?

Dentinal tubules appear empty due to necrotic odontoblasts

How can you eliminate the air-inhibited layer after curing a sealant?

Wipe or polish the surface

What is the typical age range for ECC to develop?

0 to 5 years

What is the relationship between sugar frequency and caries?

More frequent sugar intake increases acid exposure time

How does fluoride help in the remineralization process?

It enhances crystal growth and reduces enamel solubility

What is the ideal method to arrest deep caries without exposing the pulp?

Stepwise excavation with calcium hydroxide placement

What does the conversion of hydroxyapatite to fluorapatite do?

Increases acid resistance of enamel

What happens when the concentration of Ca²⁺, PO₄³⁻, and OH⁻ ions drop in plaque fluid?

The equilibrium shifts to demineralization

What type of bacteria are responsible for acid production in ECC?

Acidogenic bacteria like Streptococcus mutans

What is the direction of dentin caries progression?

From DEJ toward the pulp following dentinal tubules

What is the controversy regarding BPA related to dental sealants?

Potential hormone disruption due to estrogen mimicry

What does ICDAS stand for?

International Caries Detection and Assessment System

What type of dental materials contain bis-GMA and TEGDMA?

Resin-based sealants and composites

Who discovered the correlation between mottled enamel and low caries?

G.V. Black and Frederick McKay

What causes the chalky appearance in early enamel caries?

Light scatter due to subsurface porosity