Tech chapter W17 and W21

stains and biofilm and stuff

Step one in formation

pellicle formation, bringing glycoproteins to the nest for adhesion

Step two in formation

initial adhesion, planktonic bacteria attach, secrete sticky substance to help further adhesion

Step three in formation

maturation, more bacteria colonies form, this happens after 72 hours without disruption

Step four in formation

dispersion, they go all over

As biofilm matures…

start with gram positive, but as it matures we get more gram negative

Supragingival biofilm

mainly gram positive aerobic bacteria

Subgingival biofilm

mostly gram negative anaerobic bacteria and motile stuff

Composition of dental biofilm

80% water, 20% microorganisms and matrix

Inorganic elements of biofilm

calcium, phosphorus, fluoride

Organic elements of biofilm

polysaccharides, proteins

Biofilm is heaviest by

lower anterior linguals (whartons/submand) and max buccal (stensons/parotid)

Formation of dental calculus

mineralized dental biofilm

Microorganisms in biofilm

streptococcus mutans and streptococcus sobrinus (starters), lactobacilli

pH of biofilm

lowers when eating cariogenic food, takes about 1-2 hours to return to normal

Materia alba

cottage cheese, made of dead stuff and food

Calculus is covered with

nonmineralized dental biofilm containing live bacteria

S. Mutans

the big bad that begins it all (most of it)

Supragingival calc location

poorly contoured restorations and open contacts, others too

Calculus results from

deposition of minerals into a biofilm organic matrix causes what

What must be present for calculus formation

Nonmineralized biofilm must be present

Calculus inorganic components

calcium phosphate crystals

Source of minerals for supra calc

saliva

Source of minerals for sub calc

sulcular fluid

Incremental lines

between layers of calculus, indicate calculus grows in layers

Mineralization centers

origin or the start, touch, unite, get stronger

Maturation to mineralization

12 days is average can take 10 to 20

Formation time

strongly influenced by roughness of teeth and oral habits

Factors affecting calculus formation time

saliva composition/flow, diet, perio, crowding, s.mutans

Attachment by means of pellicle

superficial, easy to remove

Attachment to minute irregularities

difficult to remove

Attachment by direct contact to tooth

leaves behind crystals that continue biofilm production

Extrinsic stain

external, outside of tooth, can be removed

Intrinsic stain

occurs due to structural/thickness change of enamel

Exogenous

caused by sources outside tooth

Endogenous

caused by sources within tooth, always intrinsic

Yellow

very common. Usually due to bad self care diet or tobacco

Green

chromogenic bacteria causes color change, due to poor hygiene, chromogenic bacteria, biofilm retention, and MJ

Black line

make you want to cry no fun. Literally black line. 1mm wide not all over. Thinness makes it hard to remove. around the edges and gum line

Tobacco stain

Can be come exogenous intrinsic if penetrates irregularities

Brown

pellicle gets the stain. Common on buccal of max molars and mandibular lingual anteriors

Orange/red stain

rare. Possibly due to chromogenic bacteria or bad OH

Trauma

can cause discoloration, blood and residual pulp tissue decompose

Amelogenesis imperfecta

yellow to brownish. (genetic)

Dentinogenesis imperfecta

translucent/opalesant, many colors, due to abnormal dentin (genetic)

Hypoplasia

chalky white, yellow, or brown. Many causes, developmental

Minocycline

intrinsic, post eruption, blue to grey of permanent teeth

Intrinsic stain from outside source examples

amalgam tattoo, endo, stain in dentin from arrested decay, enamel erosion, attrition

Scoring methods

used to evaluation indicators of oral health status

Individual assessment score

type of scoring method used to measure amount or condition of oral disease, helps pt to recognize problem and motivate change

Clinical trial

type of scoring method to determine effectiveness of prevention or control of disease, uses large group and control group, determines baseline data

Epidemiologic survey

type of scoring method that provides info on trends and patterns of oral health/disease. Used to support health recommendations and interventions

Community surveillance

type of scoring method that identifies factors that affect oral health of population, helps plan disease prevention programs

Indices

way of expressing clinical observations with numbers, less subjective more standardized

Irreversible index

measures condition that will not change

Reversible index

measures condition that can change

Biofilm control record (index)

the only important one for now, the thing we use