Upgrade to remove ads
Only $35.99/year

Dental Biofilm, Dental Calculus, Dental Stains QUIZ 6

Terms in this set (158)

A dense, non-mineralized, complex mass of colonies in a gel-like intermicrobial matrix
Biofilm
Biofilm causes these 6 things
1. Bad breath
2. Caries
3. Gingivitis
4. Periodontitis
5. Calculus
6. Stains
Another term for bad breath. Caused by biofilm.
Halitosis
Instead of telling a patient they have gingivitis, what should we tell them instead? This helps get the patient to understand the seriousness of gingivitis.
Bacterial infection
bacteria (strep mutans) + sugar = acid
acid + tooth = decay
Caries
The main bacteria of dental biofilm is...
Strep Mutans
most harmful acid is formed in ___ minutes
20
it takes saliva between ___-___ hours to neutralize acid
1.5-2
decay leads to an _______, which leads to tooth loss. toxins can travel through bloodstream!
Abscess
inflammation and infection of the gums. It is the first stage of periodontal disease
Gingivitis
Gingivitis is a ________ infection, with proper brushing and flossing every night
Reversible
About how long does it take for gingivitis to reverse itself?
2 weeks with proper brushing and flossing
Periodontitis can be undetected by the paitient because it is:
painless
Destruction of supporting tissue around the tooth, leading to mobility and eventually tooth loss!
Periodontitis
"Tartar", Mineralized (hardened biofilm)
Is porous and attracts biofilm.
Calculus
Diseases related to periodontitis
1) Cardiovascular disease

2) Stroke

3) Respiratory infection

4) Premature/Low birth weight babies

5) Uncontrolled diabetes
Excrement (pooping) of bacteria causes
Bacterial stains
Biofilm may begin to mineralize within ____ hours if not removed with proper daily brushing and flossing.
24
stains can be a _____ surface, attracting more biofilm
rough
Bacteria produce unsightly stains in different colors such as... (think of halloween and christmas)
orange, black, red, green
Microbes such as bacteria, mycoplasms, yeasts, protozoa, and viruses that inhabit the oral mucosa.
Oral flora
Maturation of one bacterial strain causes...
alterations of the oral environment in which dominant bacterial strains prevail and proliferate.
When you have an infection, your body produces _________, which attacks and tries to get rid of the infection. This is why people lose their teeth when they have periodontitis, because the body is trying to get rid of the infected tooth.
Collagenase
How much bacteria inhabit the oral cavity?
750
How many bacteria out of the 750 in the oral cavity are responsible for perio and caries?
15
Oral flora at birth
Bacteria free
After birth, what begins to form in the mouth after 6-10 HOURS
Simple flora
What develops in the mouth 10 days to 5 months after birth?
Anaerobic flora
After 6 months, what is finally complete within the mouth?
Oral flora
Lubrication, digestion, buffer, speech, cleansing, antibacterial, remineralization
Saliva function
Active caries and periodontal disease are infectious diseases that are ________ from person to person
Transmissible
Composition of saliva
99.5% water, 0.5% solids
Glycoproteins, Enzymes, Antibodies, Desquamated epithelial cells, Leukocytes
Organic components of saliva
Act as a catalyst
Protein
Glycoproteins
1. Form the acquired pellicle
2. Assist colonization of Dental Biofilm
3. Lubrication
4. Inhibits bacterial sorption into teeth and gingiva
Enzymes
1. Proteins
2. Lysozymes
3. Lactoperidase
4. Parotid Amylase
Breaks bacterial cell wall
Lysozyme
Prevents bacterial growth
Lactoperidase
Breaks down starch
Parotid Amylase
WBC- phagocytosis
Leukocytes
Antibodies that inhibit bacterial colonization and attachment to teeth
Immunoglobulin A
Minerals and salts, calcium, phosphorus and fluoride, bicarbonates
Inorganic components of saliva
Mineralize or calcify dental biofilm into calculus. Comes from salivary glands
Minerals/salts
increased saliva flow _____ protective functions
enhances
Which inorganic components of saliva aid in remineralization?
Calcium, Phosphorus, and Fluoride
Which inorganic component of saliva acts as a buffer?
Bicarbonates
decreased saliva flow ____ protective functions
reduces
absence or extreme reductions of saliva
Xerostomia
caused from
-dehydration
-untreated diabetes
-obstruction of salivary duct
-certain pharmaceutical drugs
Temporary xerostomia
caused from
-head/neck radiation treatment
-surgical removal of salivary glands
-various diseases
Permanent xerostomia
What are examples of certains drugs that can cause xerostomia?
Antihistamines, decongestants, depression, antipsychotics
acquired pellicle forms within ______ after brushing.
minutes
a thin translucent, organic layer that forms on teeth
Acquired pellicle
Functions of the acquired pellicle
-barrier to acids
-lubrication
-attachment of bacteria
-calculus attachment
forms the acquired pellicle
Glycoproteins
Acquired pellicle is ______, or bacteria free
acellular
dental biofilm is resistant to:
antibiotics
dental biofilm cannot be ____ ____. It must be physically removed
rinsed off
Dental biofilm is formed within _____ after brushing
hours
Composition of biofilm
80% water, 20% solids
what results from the apical proliferation of microorganisms from supragingival biofilm?
subgingival dental biofilm
Phase 1: dental pellicle formation (minutes)
Phase 2: initial gram + bacterial colonization (hours)
Phase 3: additional bacteria coagulate with initial colonizers (6 hours)
Phase 4: Formation of Slime
Phase 5: Mature dental biofilm (7 days)
formation of biofilm
Mature dental biofilm is mainly gram ______ bacteria (subgingival)
negative
immunocompromised patients may respond to subgingival bacteria by producing excess amounts of ___________. This is the HOST RESPONSE
Collagenase
white or cream-colored cheesy mass that can collect over dental biofilm on unclean, neglected teeth; it is composed of food debris, mucin, and bacteria
Materia Alba
Composed of remnants of food that are retained after a meal; contributes to periodontitis and halitosis.
Food debris
Pigmentation of tooth surface caused by bacteria or food, chemicals, or tobacco
Stain
Factors influencing dental biofilm formation, accumulation and retention
1. Food
2. Cheeks, lips, tongue
3. Tooth Morphology
4. Host Factors (immunity)
5. Calculus
Determine which ones are MOSTLY gram positive, negative, or a mixture of both. Remember Ms. Darah's trick with the i's and t's!
a. Periodontal Health
b. Gingivitis
c. Periodontitis
a. gram +
b. mixture
c. gram -
Periodontal health has what type of bacteria; associated with minimal microbial flora
Gram Positive
Gingivitis has what type of bacteria?
both gram positive and gram negative
How much more bacteria do unhealthy gums with gingivitis have than a healthy sulcus?
10-20 times more
Periodontitis has what type of bacteria?
Gram Negative
Due to where salivary glands are located, these teeth may require more attention than others.
maxillary molars, mandibular anteriors
Mineralized dental biofilm
Calculus
calculus contains _______ bacteria
nonvital
calculus is not (in itself) a "_______ _____" in gingivitis/periodontitis.
primary factor
calculus is a plaque trap that attracts dental ______.
biofilm
Calculus is a "plaque trap", therefore it is a "______ _____" to gingivitis/periodontitis
Contributing factor
Composition of calculus
20-30% organic components and water
70-80% inorganic components
Calculus is ___-___% organic components and water
20-30
Calculus is ___-___% inorganic components
70-80
The main inorganic component of calculus
calcium phosphate
Enamel is ___-___% inorganic
95-97
Dentin is ___% inorganic
65
Cementum is ___-___% inorganic
45-70
Beginning stages of calculus formation
acquired pellicle formation, dental biofilm formation, mature dental biofilm
Mineralization of calculus
1. first occurs in the intermicrobial organic matrix provided by filamentous bacteria

2. "Foci" (centers) of mineralization form within 24-72 hours

3. Within time, foci grow and coalesce into a solid mass

4. As deposit matures, mineralization occurs within the bacteria

5. Mineralization consists of crystal formation

6. Calculus is deposited in layers beginning at the tooth surface
Mineralization of calculus first occurs within the ________ _____ _____ provided by filamentous bacteria.
intermicrobial organic matrix
"centers" of mineralization form within 24-72 hours
Foci
Within time, foci grow and coalesce into a _____ _____.
solid mass
as deposit matures, mineralization occurs within the ______.
bacteria
mineralization consists of ______ _______:
1) hydroxyapatite
2) octocalcium phosphate
3) whitlockite
4) brushite
crystal formation
Mineral source from saliva
Supragingival calculus
calculus is deposited in layers beginning at the ____ _____.
tooth surface
Supragingival calculus is most abundant near opening of ______ ______.
salivary ducts
Mineral source from gingival sulcular fluid and exudate
Subgingival calculus
Subgingival calculus is heaviest on the _____ ______.
Proximal surface
Subgingival calculus is porous and always harbors ______________and ____________ related to periodontal disease. it is a plaque trap!
Active dental biofilm and endotoxins
Supragingival calculus detection
a. Visual
b. Visual with air (chalky white)
c. Transillumination
d. Auditory
e. Tactile
Subgingival calculus detection
a. Visual with air (deflects gingiva)
b. Tactile
c. Gingival color change
d. Auditory
e. Radiographic evidence
f. Endoscopy- burnished/veneered calculus
Heavy, crusty calculus (most common). Easiest to remove, creamy yellow
Crustaceous
Ring like formation of calculus, usually subgingival
Ledge
-"burnished calculus"
-Smooth, very thin layer
-Result of incomplete removal of calculus
Veneer
-Minute little particles of calculus
-Hard to see and hard to detect unless teeth are very dry
-White to yellow color
Granular
show moderate to heavy calculus only
radiographs
The rate of formation of mature calculus
Average- 12 days
Range- 10-20 days
___% of calculus deposit mineralizes in 2 days
50
___-___% of calculus deposit mineralizes in 12 days
69-90
Calculus provides a "_____" for the collection of bacterial masses on the rough surface of the calculus deposit
haven
a. Pyrophosphate System (antitartar)
b. Zinc Citrate System
c. Zinc Chloride
d. Triclosan (antimicrobial)
Anti-calculus Dentifrice
A smooth surface leads to...
gingival healing
A smooth surface is easier to...
keep clean
Ways to control calculus
1. Daily personal oral hygiene
2. Diet (avoid sugar since it feeds bacteria)
3. Professional removal of calculus
------> smooth surface
4. Anti-calculus Dentifrice or mouthrinses
What benefits do anti-calculus dentifrice have?
Inhibits calculus crystal growth
predisposing factor of dental stains
poor POH
External source of stain, removable
Extrinsic
Internal source of stain, not removable
Intrinsic
external sources starts out extrinsic but may become intrinsic over time
Exogenous
produced from within; due to internal causes
Endogenous
can remove stains only on the pellicle or biofilm
toothbrushing
can remove stains on the tooth surface
scaling or polishing
stains within tooth deposit are removed with _____.
deposit
must be evaluated for intrinsic stains
whitening, veneers, crowns
-dental biofilm discolored by food pigments
-poor POH
-any age
yellow stains
-calculus like stain, about 1 mm wide
-continuous and close to gingival margin on the max posterior lingual and proximal surfaces.
-frequently found in clean "looking" mouths
-gram + rods
-All ages
black line
Black line stains are caused by what type of bacteria? (G+ or G-)
gram positive rods
-Calculus or enamel of lingual and cervical thirds.
-Varies with amount of dental biofilm—not the use of tobacco.
-Can be brown, black or tarlike
Tobacco
-Embedded in dental biofilm or enamel of ant. facial cervical thirds, then proximals, especially Maxillary Anteriors
-Caused by poor oral hygiene.
-Discolored by fungus, chromogenic bacteria and or blood pigments
-any age (mostly children)
-Use slurry of pumice polish. Then fluoride.
Green stains
Green stains are most common on:
Maxillary Anteriors
Green stains are difficult to remove and easily becomes _____.
intrinsic
-Color adheres to dental biofilm, may become intrinsic.
-Ant. Cervical 1/3.
-Copper: green-bluish green
-Iron: brown-greenish brown
-Nickel: green
-Manganese: black
-Cadmium: yellow
Metallic
Copper cause what color stains?
green-bluish green
Iron causes what color stains?
Brown-greenish brown
Nickel causes what color stains?
Green
Manganese causes what color stains?
Black
Cadmium causes what color stains?
Yellow
-Stannous fluoride
-Food (betel leaf from Eastern countries)
-Chlorhexidine (Prescription Mouthrinse)
-Tannin (coffee, tea, soy sauce, wine)
-Poor oral hygiene
-No dentifrice used
-Swimmer's stain-yellowish or dark brown due to chlorine or bromine in pool water
Brown stains
an antibacterial compound with substantial residual activity that is used as a liquid antiseptic and disinfectant (CAUSES BROWN STAIN IN TEETH)
Chlorhexidine
a substance found in tea and some grains that can bind minerals and decrease their absorption (CAUSES BROWN STAIN IN TEETH)
tannin
Chlorophyll, Marijuana, asthma inhalers, and metallic dusts cause what color stain?
Green stains
- chromogenic bacteria
- rare
- found on maxillary anterior facial and lingual surfaces
Orange and red stains
Rare red and orange stains can be caused from...
Chromogenic bacteria
extrinsic red dye used on teeth to detect dental biofilm
Disclosing solution
1. Necrotic Pulp
2. Drug induced
3. Systemic conditions
4. Endodontic/restorations
5. Pulpless or traumatized teeth
6. Stain in dentin
7. Demineralization
8. Attrition
Intrinsic stains
Systemic conditions that cause intrinsic staining
1. Prolonged jaundice
2. Rh incompatibility
Drug induced intrinsic stains
1. tetracycline
2. cipro
3. minocycline
Discolored tubules in dentin, discolored by blood and tissue, intrinsic
Necrotic pulp
-Generalized stain
-Color varies with dose, length of time, and age
-Stratification relates to tooth development
-Light green to dark yellow or gray brown
-Stratification relates to tooth development
-3rd trimester, infancy- tooth formation (age 8)
Tetracycline
What drugs induce green discoloration
Cipro and minocycline
yellow or green discoloration
Prolonged jaundice
Blood pigments from pulp into dentin
-green, brown, blue hue to teeth
Rh incompatibility
Loss of enamel allowing yellow dentin to show
Attrition
1. Amelogenesis imperfecta
2. Dentinogenesis imperfecta
3. Enamel hypoplasia
4. Fluorosis
Disturbances in tooth development
(Imperfect enamel formation)
-yellow-brown or gray-brown
-enamel partially or completely missing
-hereditary
-disturbance of ameloblasts
Amelogenesis imperfecta
(Imperfect dentin formation)
-translucent, opalescent gray, to bluish-brown teeth
-hereditary
Dentinogenesis imperfecta
white pits or spots, localized, disturbance in enamel, if on one tooth only=trauma
Enamel hypoplasia
(from ingesting water with excess fluoride)
-white spots that can become discolored light to dark brown
-severe effects (mottled enamel)
-toxic damage to ameloblasts
Fluorosis
Sets found in the same folder