question

Enamel is roughly ___% inorganic, ___ organic, and ___% water

answer

97, 1, 2

question

The chemical formula for hydroxyapatite is ___

answer

Ca10(PO4)6(OH)2

question

Typical ion exchanges in HAP are ___ for OH, ___ for Ca, and ___ for PO4

answer

F, Sr, CO3

question

___ ___ is the saliva-like phase associated with dental plaque (the extracellular aqueous phase)

answer

plaque fluid

question

___ ___ is a mixture of different salivas, and can contain bacteria, polysaccharides in biofilm, proteins, mucins, enzymes, cells from the mouth etc.

answer

oral fluid

question

at neutral pH, saliva is ___ with respect to ____, but minerals do not precipitate because they are bound to ___, and there is a lack of ___

answer

supersaturated, enamel, proteins, nucleators

question

precipitation will occur on tooth surface is there is a ___ site or a partially ____ site

answer

nucleation, demineralized

question

when sucrose is introduced into the bacteria inhabiting the plaque , ___ is produced as a metabolic byproduct; and as a result, ions such as ___ and ___ must be absorbed by the plaque fluid to counteract the increased acidity and restore equilibrium

answer

H+, PO4-, OH-

question

in reaction to the unsaturation of plaque, minerals will be released from multiple sources: ___, ___, ___, ___ ___, and ___ ___

answer

saliva, bacteria, calculus, CaF formations, tooth surface

question

Unsaturation limiting factors: 1. ___ ___, which provides more ions to plaque fluid at a faster rate; mainly due to saliva flow 2. ___ in plaque that can raise pH 3. decreased ___ ___ due to lack of fermentable CHO and reduced bacterial metabolism

answer

acid clearance, buffers, acid production

question

when ___ of plaque occurs, there will be a remineralization of partially demineralized enamel crystals

answer

supersaturation

question

presence of ions such as ( ___, ___ and ___) in ___ and ___ can lead to ____ and mineral gain on tooth surfaces

answer

Ca, PO4, F, buffers, saliva, supersaturation

question

___ + ___ will create acid, which will lead to ___ and mineral loss from tooth surfaces

answer

bacteria, substrate, acids

question

the surface of the tooth has a higher distribution of ___, ___, and PO4 relative to the interior of the tooth

answer

F, Ca, PO4

question

the interior of the tooth has a higher distribution of ___ and ___ compared to the outside of the tooth

answer

H2O, CO3

question

the concentration of fluoride is 10 times higher in the ___ of the tooth

answer

surface

question

loss of ___, ___, and ___ and the gain of ___, ___, ___ and ___ ___ are examples of chemical and physical exchanges with the oral environment (which happens faster at a low pH)

answer

CO3, H2O, Mg, F, PO4, Ca

question

post-eruptive enamel formation results in a different ___ ___

answer

tooth surface

question

post-eruptive tooth surface changes include reduced ___ and ___; in addition ___ at the surface increase in size, which make it more difficult to dissolve

answer

solubility, permeability, crystallites

question

greater time that a tooth is in the mouth = ___ susceptibility to caries

answer

greater

question

greater time of tooth in the mouth = ___ permeability

answer

increased

question

surface layer abrasions lead to ___ solubility in acid

answer

increased

question

when teeth are exposed to saliva, ___ resistance rapidly ___

answer

acid, increases

question

the risk for developing decay increases over time with exposed ___ ___ and ___ ___

answer

exposed root surfaces, cavity preparations

question

the pH of plaque covering an active lesion is ___ than a sound tooth, and takes ___ to recover

answer

lower, longer

question

lack of ___ is also a determinant in demineralization (in addition to pH)

answer

saturation

question

critical pH is NOT ___

answer

constant

question

people with low salivary concentrations of ___ and ___ will have a ___ critical pH

answer

Ca, PO4, higher

question

plaque fluid typically has ___ levels of calcium and phosphate, which ___ the critical pH

answer

higher, decreases

question

what is approximate critical pH of enamel?

answer

5.5

question

what is the approximate critical pH of dentin?

answer

6.2

question

what are the three factors affecting plaque pH and saturation levels?

answer

salivary, bacterial, dietary

question

functions of saliva that are essential in protecting against dental caries: 1. physical ___ ___ 2. provision of ___ (e.g. ___) to neutralize plaque acids 3. provision of ions such as ___, ___ and ___, which promote the remineralization of early carious lesions 4. reduction of ___ proliferation 4. contributing to the ___ ___ process occurring after the teeth have erupted

answer

cleansing properties, buffers, bicarbonate, calcium, phosphate, fluoride, bacterial, enamel maturation

question

what are the bacterial factors affecting pH?

answer

amount, composition, plaque matrix

question

if plaque is ___ saliva will have a greater effect on limiting the demineralization process

answer

thin

question

the dietary factors affecting pH include ___, ___ and ___ properties, indirect effect on ___, ___ ___ and ___

answer

carbohydrates, physical, chemical, plaque, salivary flow, composition

question

___ is the most cariogenic carbohydrate

answer

sucrose

question

___ ___ take a long time to metabolize, so are not considered cariogenic

answer

sugar alcohols

question

what are the three determinants of physical/chemical properties of dietary factors?

answer

retention time in the mouth, food acidity, and composition

question

the ecological hypothesis of plaque states that bacteria that can survive at ___ ___ will cause more damage since they are resistant to salivary flow

answer

low pH

question

what are the factors that involve plaque pH changes in relation to caries formation?

answer

extent of pH drop, time spent below critical pH, and the frequency the pH falls

question

the ___ ___ ___ are the teeth that are most susceptible to dental caries

answer

mandibular first molars

question

the ___ ___ and ___ are the least susceptible to dental caries

answer

mandibular incisors, canines

question

after the mandibular 1st molars, what three groups are susceptible to dental caries?

answer

1st maxillary molars, 2nd mandibular and maxillary molars

question

the ___ surface is the most common location for primary caries, followed by the ___-___ and ___-___

answer

bucco-lingual, mesio-distal

question

what is the order of susceptibility to caries on the mandibular first molars?

answer

O>B>M>D>L

question

what is the order of susceptibility to caries on the maxillary first molars?

answer

O>M>L>B>D

question

what is the order of susceptibility to caries on the maxillary lateral incisors?

answer

L>B

question

where are secondary/recurrent caries susceptible to caries?

answer

at the gingival margin of the restoration

question

where are root caries located

answer

close to the gingival margin

question

___ ___ surfaces have a 25-42% chance of becoming carious

answer

adjacent tooth

question

___ ___ have 75-95% chance of becoming carious; 4 out of 5 times, the lesion will be found on the same surface

answer

contralateral tooth

question

___ ___ is a type of enamel defect that can lead to hypoplastic enamel

answer

nutritional deprivation

question

___ ___ and ___ ___ are two genetic disorders that can lead to enamel defects

answer

amelogenesis imperfecta, dentogenesis imperfecta

question

___ ___ and ___ ___ are physical attributes that can affect tooth susceptibility to caries

answer

arch form, tooth position

question

____, ____ and ____ are physical attributes that can trap more plaque and food, leading to a higher probability of developing lesions in the area

answer

misalignment, overlapping, tipping

question

what are the two mutually dependent variables that relate to caries resistance with respect to the tooth?

answer

the nature of the enamel itself, the nature of the external environment

question

in a very early lesion, the very outermost ___ is dissolved; initial attack can be on/between the ___; enlargement of ___ diffusion pathways; ___ ___ remnants merge together

answer

microsurface, rods, intercrystalline, Tomes' processes

question

the first minerals to be solubilized in a very early lesion are ___ ___; ___ ___ and others follow

answer

CO3, Mg, Ca, P

question

the presence of the ___ helps to increase precipitation of ___ in outer surface layer

answer

pellicle, minerals

question

non-cavitated ("white spot") lesions are usually located at the ___

answer

gumline

question

non-cavitated lesions can look white or ___ due to ___ ___ incorporated from the environment during remineralization cycle

answer

brown, organic material

question

non-cavitated lesions will produce a white spot lesion due the ___ of ___

answer

scattering, light

question

___ ___ is the first reaction when dentin becomes affected

answer

tubular sclerosis

question

following tubular sclerosis is a change in ___ ___

answer

refractive index

question

following a change in the refractive index, ___ and ___ continue

answer

demineralization, sclerosis

question

continual demineralization and sclerosis leads to ___ ___

answer

transparent dentin

question

dentin has a much higher ___ and ___ component as compared to enamel

answer

organic, water

question

dentin HAP crystals are ___ and somewhat more ___ than those in enamel - therefore they are more susceptible to ___

answer

smaller, soluble, decay

question

in the first stages of tubular sclerosis, the dentinal tubules fill with ___ and ___, growing to form giant rhomboidal crystals

answer

Ca and PO4

question

once the dentinal tubules fill with crystals, there is a reduction in ___

answer

permeability

question

when sclerotic dentin is formed, the ___ ___ of dentin changes

answer

refractive index

question

___ ___ formation reduces permeability, and is an important defense mechanism of the ___-___ complex responding to different insults

answer

tertiary dentin

question

remineralization results in enamel that is less ___, ___ stronger, less susceptible to ___

answer

porous, mechanically, acid

question

recovery of salivary function, fluorides, antimicrobial therapies, mechanical plaque control, and diet control are all examples of ___/___ approaches to dental treatment

answer

therapeutic, biological

question

the caries process can be retarded, arrested, or reversed before any ___ ___ requiring clinical intervention has occurred

answer

physical cavitation

question

at initial cavitation, the demineralized lesion in the enamel is relatively ___ and limited to the ___ enamel

answer

hard, outermost

question

what are the four layers in carious dentin?

answer

bacteria rich, few bacteria, sclerotic/bacteria-free layer, vital-reaction layer

question

carious dentin gets ___ as it gets closer to the pulp

answer

harder

question

what are the two clinically differentiated layers of carious dentin?

answer

inner carious dentin (affected) outer carious dentin (infected)

question

in carious dentin, the ___ zone is invaded by bacteria, while the ___ zone is not invaded by bacteria

answer

discolored, transparent

question

the objective of excavation is to remove ___ and ___ tissue; and to avoid removal of sound ___ and ___ cytoplasmic extensions

answer

infected, necrotic, dentin, odontoblast

question

Who is a HUGE idiot?

answer

Luke Aiura

Cariology Lecture 2 – Histopathology and Physical Chemistry of Dental Caries – Flashcards

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