Week 3: Carious Lesions and Caries Risk Assessment

mutans streptococcus

mo identified as the primary causative agent in caries process; most active during demineralization

acidogenic bacteria

bacteria on tooth surface biofilm metabolize acid from the fermentable carbohydrates ingested by the individual

lactobacilli

more active during progression of caries; acid producing and acid tolerant; reflect a high carbohydrate environment

susceptible tooth, cariogenic bacteria, dietary fermentable carbs

what is caries process?

demineralization

process by which the minerals of the tooth are dissolved by the organic acids produced by fermentable carbs by the acidogenic bacteria

remineralization

deposition of minerals into previously damaged areas of a tooth; process of replenishing calcium, phosphate and fluoride ions

saliva

balance or reverse the destruction of the tooth structure; acts as a buffer to acids and supplies minerals to replace calcium and phosphate ions dissolved during demineralization

time, pH of biofilm

what are some contributing factors?

4.5-5.5

what avg pH is critical for enamel demineralization?

6-6.7

what pH is demineralization for cementum?

arrested caries

carious lesion that has become stationary and does not show a tendency to progress further; frequently has a hard surface but takes on a dark brown-reddish-brown colour

rampant caries

widespread formation of chalky white areas and incipient lesions that may increase in size over a comparatively shorter time

decayed permanent teeth, missing bc of caries, filled bc of caries, teeth

dmft

dmft

measures experience

cambra

predicts and manages future risk

fluoride

inhibits demineralization; enhances remineralization

antimicrobial

CHX may be used for high/extreme risk; combine with fluoride; separate timing from fluoride toothpaste

early childhood caries

form of rampant caries seen in young children

amorphous calcium phosphate

contains same minerals as in the hydroxyapatite crystals of tooth enamel; prevents caries progression, enhance enamel remineralization, occlude dentinal tubules

casein phosphopeptides

derived from cow’s milk; contraindicated in people with milk allergies; self-applied products include trident white and trident extra care chewing gum

calcium sodium phosphosilicate

bioactive silica as a carrier for Ca and PO4; forms hydroxycarbonate apatite; continued release for 7 days post application; fluoride varnish; toothpaste; prophylaxis paste

sodium bicarbonate

neutralizes acids produced by acidogenic bacteria; has antibacterial properties; delivered in toothpaste or solution for people with low saliva flow