ETIOLOGY OF DENTAL CARIES

Three primary factors in the keys triad

HOST, AGENT, ENVIRONMENTAL INFLUENCES

2 primary factors that causes cavities

SUSCEPTIBLE TOOTH, MICROBIAL FLORA, SUBSTRATE, TIME

How the third person or the community affect the individual as well as the individual’s own attitude and behavior towards hygiene practice.

TERTIARY RISK FACTORS

Most common clinical sites of caries initiation

PITS AND FISSURES

Second common clinical sites of caries initiation

CERVICAL TO THE CONTACT AREAS

Low carbonate level means (less, more) resistant to acid attack

LESS

One of the strongest indicators of increased caries risk

CHRONIC LOW SALIVA FLOW RATE

Flushes planktonic bacteria

BACTERIAL CLEARANCE

Cannot flush planktonic bacteria because of its thick consistency

VISCOUS SALIVA

Able to flush planktonic bacteria because of its thin consistency

SEROUS SALIVA

Bicarbonate ions, sialin, and urea hydrolyze to from ammonia causing pH to rise

BUFFERING CAPACITY

Supersaturated with calcium and phosphate ions

REMINERALIZATION

Surface or material on or from which an organism lives, grows, or obtains nourishment

SUBSTRATE

Foods that are beneficial to our teeth through their __crunchy or coarse texture__

FOOD DETERGENCY

Carcinogenicity in decreasing order

SUCROSE, GLUCOSE, FRUCTOSE

Sucrose is used by bacteria to produce extracellular polysaccharide called

DEXTRANS

First window of infectivity time frame

7-31 MONTHS

Second window of infectivity time frame

6-12 YEARS

Produces lactic acid from sucrase; acidic

ACIDOGENIC

Can live in pH as low as 4.2; tolera of acidic environment

ACIDURIC

It is the collective term for all the serotypes

STREPTOCOCCUS MUTANS

A gelatinous (soft, translucent, and tenaciously adhering) mass of bacteria adhering to the tooth surface

DENTAL PLAQUE

DENTAL PLAQUE is readily visualized on teeth after how many days with no oral hygiene measures

1-2 DAYS

Plaque is typically observed on the what part of tooth surface

GINGIVAL THIRD

Mechanical removal of plaque is effective on what part of tooth surface

CORONAL TWO-THIRDS

After 24 hrs., what streptococcus is being most dominant

STREPTOCOCCUS SANGUIS

First clinical sign of dental caries

WHITE SPOT LESION

Peak rates for the incidence of new lesions occurs how many years after the eruption of the tooth

3 YEARS

Occlusal pit-and-fissure lesions develop in less time than smooth-surface caries (TRUE or FALSE)

TRUE

Xerostomia can lead to clinical caries in as little as how many months

3 MONTHS

Layer/s of bacterial cells surrounded by extracellular polymeric substances firmly attached to a surface

DENTAL BIOFIILM

The visible accumulation of a supragingival or subgingival biofilm

DENTAL PLAQUE

How many days will it take for plaque to mature

4-9 DAYS

Stage of biofilm formation where there is deposition of salivary components known as acquired pellicle

INTIAL ADHERENCE AND LAG PHASE

What salivary mucins contribute to formation of acquired pellicle

MUC5B AND MUC7

Salivary acidic phosphoprotein promotes bacterial adhesion to tooth surfaces

STATHERIN

The first microorganisms to colonize the teeth

GRAM-POSITIVE COCCI

Planktonic is free-floating; Sessile is

Attached

Adherent bacteria secrete large amounts of water-insoluble extracellular polysaccharides to form the biofilm matrix; The growth of microcolonies within the matrix occurs

RAPID GROWTH

Bacteria in the interior of biofilms slow their growth or become static

STEADY STATE/DETACHMENT

With time, additional varieties of bacteria adhere to the early colonizers – a process known as what- within the biofilm

COAGGREGATION

Plaque formation and its mineralization to calculus take on average about how many days

10-12 DAYS

First stage before any demineralization; Without it, there will be no environment for the bacteria

PELLICLE

What type of sugar easily enters biofilm

SUCROSE

Metabolize sugar and produce lactic acid and extracellular polysaccharide like glucan

ACIDOGENIC BACTERIA

The metabolic pathway through which glucose generates cellular energy

GLYCOLYSIS

Carbon source to produce pyruvate through glycolysis, and then produce lactic acid under the action of lactate dehydrogenase

GLUCOSE

1 mole of glucose =

2 MOLES OF LACTIC ACID

Favors the proliferation of acidogenic and aciduric bacteria; results in a disturbance of Microbial Homeostasis

ACID PLAQUE ENVIRONMENT

Remineralization occurs at what pH

>5.5

Demineralization occurs at what pH

The key pathological and protective factors determine which side the balance swings and whether the caries process progresses, reverses, or is in balance

CARIES BALANCE

Graph showing behavior of pH in caries active & immune people, after a 10% glucose rins

STEPHAN CURVE

The resting plaque pH range

6-7 pH

Antibiotics can disrupt the oral flora (TRUE or FALSE)

TRUE

Critical pH

5\.5

Critical pH with fluoride

4\.5

Resting pH in caries active people

5\.8

Caries immune person – pH falls below 5 & takes long to return to 5.8 (TRUE or FALSE)

FALSE

Caries active persons – pH first falls below 5.5, but immediately returns to 6.5 (TRUE or FALSE)

FALSE