Cariology 2nd discussion (Prelims)

multifactorial

DENTAL CARIES is [?] because its development is dependent on the interaction of the four primary factors

host (tooth surface)
substrate (carbohydrates),
presence of oral bacteria (in the biofilm)
time

what are the 4 primary factors of dental caries

caries balance

what do you call the balance between demineralization and remineralization of the tooth

Demineralization

Net lost of minerals by the toot

Remineralization

Mineral is added back to partially demineralized enamel.

pathologic

Demineralization is a [?] factoes

protective

Remineralization is a [?] factoes

Acid producing bacteria
Sub-normal saliva flow and function
Frequent eating/drinking of fermentable carbohydrate
Poor oral hygiene

What are the pathologic factors in the caries balance?

Saliva flow and components
Remineralization (fluoride, calcium, phosphate)
Antibacterial (fluoride, chlorhexidine, xylitol)
Good oral hygiene

What are the protective factors in the caries balance?

symbiosis
ph 7

In a healthy person, the MICROBIOME IS IN [?], the oral microflora live in a mutually beneficial relationship with the host (person) and striving in a neutral Ph (?)

oral microbiome

Topic: Dental caries activity

Disruptions of [?], lead to overgrowth of harmful bacteria.

localized
tooth structure

Topic: Dental caries activity

At the tooth level, DENTAL CARIES ACTIVITY is characterized by [?] demineralization and loss of [?], the caries lesion.

carbohydrates
organic
lower
5.5
6.2

Topic: Dental caries activity

Some bacteria in the biofilm metabolize refined [?] for energy and PRODUCE [?] ACID BY-PRODUCTS.

Organic acids, if present in the biofilm ecosystem for extended periods, can [?] the pH in the biofilm to below a critical level (? for enamel, ? for dentin).

acidogenic
aciduric
dysbiosis
acidification

Topic: Extended periods of low pH level

With EXTENDED PERIODS OF LOW PH, there is a shift in the microbiome to bacteria that are [?] and [?], causing [?] IN THE MICROBIOME. This change in turn will lead to further [?] of the environment.

calcium
phosphate
demineralization
remineralization

Topic: Extended periods of low pH level

The low pH drives [?] and [?] from the tooth to the biofilm in an attempt to reach equilibrium, hence resulting in a net loss of minerals by the tooth or [?].

When the pH in the biofilm returns to neutral and the concentration of soluble calcium and phosphate is [?] relative to that in the tooth, the mineral can then be added back to partially demineralized enamel in a process called [?].

damage
restitution

Dental caries lesions result from a dynamic process of [?] (demineralization) and [?] (remineralization) of the tooth matter.

Demineralization and Remineralization

What takes place several times a day over the life of the tooth and are modulated by many factors

worm theory
chemical theory
parasitic or septic theory

Topic: Etiology and Theories of Dental Caries

Exogenous theories consist of what theories? (x3)

exogenous theories

Topic: Etiology and Theories of Dental Caries

what theories deal with direct action of bacteria and more accepted explanation in caries development.?

endogenous theories

Topic: Etiology and Theories of Dental Caries

what theories deal with disturbance in mineral balance?

humoral theory
vital theory

Topic: Etiology and Theories of Dental Caries

Endogenous theories consist of what theories? (x2)

worm theory

What theory from exogenous theory believed tooth worm bore a hole through the teeth and hid beneath the surface; drank blood of teeth and fed on roots of jaws. (Dates back as far as 5000 BC referenced in a Sumerian text)

chemical theory (acid theory)
robertson 1835

What theory from exogenous theory opined that caries was caused by CHEMICAL DISINTEGRATION OF THE TOOTH and

Who and what year did they believed that putrefaction of protein led to formation of ammonia which was subsequently oxidized to nitric acid

parasitic or septic theory
ficinus
1843

What theory from exogenous theory mentioned FILAMENTOUS MICROORGANISMS caused decomposition of the teeth

Who recognized the FIRST ORGANIC MATRIX IN ENAMEL and what year?

Humoral theory

What theory from endogenous theory has four elemental fluid (humors) of the body and believed that the Imbalance in this 4 humors determines the person’s physical and mental constitution

blood
phelgm
black bile
yellow bile

What are the four element fluid (humors) of the body in the humoral theory

vital theory

What theory from endogenous theory postulated that tooth decay originated like BONE GANGRENE from within the tooth itself.

hippocrates
celsus
galen
avicenna
18th

Vital theory is proposed by [?] during [?] century

Chemico-parasitic theory (miller 1890)
Proteolytic theory
Proteolysis-chelation theory

New theories on etiology caries consist of what theories? (×3)

Chemico-parasitic theory (miller 1890)

The theory said that caries IS CAUSED BY ACIDS produced by oral bacteria following fermentation of SUGAR

decalcification
destruction
preliminary
dissolution
subsequent

Chemico-parasitic theory consists of 2 stages

1 - ? of enamel, ? of dentin (? stage)
2 - ? of the softened residue of enamel & dentin (? stage)

Heider and bodecker 1878 and abbot in 1879

In the proteolytic theory who said that organic portion of the tooth serves as PATHWAYS FOR ADVANCING MICROORGANISMS causing demineralization of the teeth and therefore dental caries.

Gottlieb in 1944
staphylococcus

In the proteolytic theory who uggested that the initial lesion of the carious process is due to the PROTEOLYTIC ENZYMES attacking the lamellae, rod sheaths, tufts and walls of tubules and

Believed that the yellow pigmentation characteristic of caries was produced by the proteolytic organism (?)

Pincus in 1949
inorganic

In the proteolytic theory who proposed that the first step in the carious process is the BREAKDOWN OF DENTAL CUTICLE.

Nasmyth’s membrane and enamel proteins are acted upon by sulfatase enzyme producing SULFURIC ACID. This acid plus the calcium of hydroxyapatite crystals destroys the [?] component of enamel

chelating
schatz
proteloysis
chelation

In the proteloysis-chelation theory state that dental caries is a bacterial destruction of organic components of enamel and the breakdown products of this components have [?] PROPERTIES dissolving the minerals in enamel

Who [?] said that there is simultaneous microbial degradation of organic component BY [?] and dissolution of inorganic part BY [?]

modified keyes-jordan diagram

Modifying risk and protective factors that influence the dental caries process.