Dental Caries

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Dental Caries by Mind Map: Dental Caries

1. Host Factors

1.1. 1-Susceptible Tooth

1.1.1. A-Position Mandibular Teeth Posterior Teeth Malposed/Crowded Teeth

1.1.2. B-Morphology Pits & Fissures k-type V-type I-type U-type Contact Area

1.1.3. C-Structure Enamel & Dentin Composition Abnormalities Newly Erupted Teeth Enamel Outermost Layer Composition Nutritional Status

1.1.4. D-Fluorides Cariostatic Effect Resists Acid Demineralization Enhances Remineralization Inhibits Bacterial Growth Not Exceed 1.5ppm Supply Form Sea food Water Topical Fluoridation

1.2. 2-Saliva

1.2.1. A-Washing Effect Inverse relationship Flow-rate Caries Incidence Xerostomia-related Conditions

1.2.2. B-Buffering Capacity Inverse relationship Buffers (bicarbonate/phosphate) Caries Incidence Diffuse into Plaque Decrease Acidity

1.2.3. C-Degree of Viscosity Direct Relationship Salivary glyco-proteins Caries Incidence Form Acquired Enamel Pellicle Protect Enamel

1.2.4. D-Antibacterial effect Lactoferrin Interfere with bacterial iron metabolism Peroxidase Inhibits sIgA Inhibits bacterial adhesion Prevents colonization Lysozyme Cell-Wall Lysis

2. Bacterial Plaque

2.1. Composition

2.1.1. Microorganisms 60-70%

2.1.2. Amorphous Matrix 30-40% Proteins Salivary Mucoids Gingival Fluids CHO Dextrans Levans Amylopectin Inorganic Content

2.2. Tenacious structure

2.2.1. diverse community of closely packed microorganisms

2.2.2. Embedded in Matrix

2.2.3. Organized Biofilm

2.3. Mechanism

2.3.1. Acquired Enamel Pellicle By Selective adsorption Act as Diffusion Barrier

2.3.2. Colonization of the Pellicle Pioneer Community Intermediate Community Mature Community

2.4. Role

2.4.1. Diffusion Limiting Membrane Retain produced organic acids in high % slows down buffers entry from Saliva

2.4.2. Contributes to Adhesiveness Bulk Resistance to washing by Saliva

2.5. Factors

2.5.1. Anatomy & Position of teeth

2.5.2. Presence of Appliances

2.5.3. Structure of tooth surface

2.5.4. Oral Hygiene Measures

2.5.5. Diet Composition

3. Cariogenic Bacteria

3.1. Features

3.1.1. Acidogenic

3.1.2. Acidouric

3.1.3. Synthesis of Extracellular Polysaccharides Dextrans

3.1.4. Synthesis of Intrracellular Polysaccharides Amylopectin

3.1.5. Active transport of fermentable sugars

3.1.6. Attachment Mechanisms

3.2. Types

3.2.1. Streptococcus Mutans Caries Initiation Transmissible Mechanism Adhesins sIgA Potease Enzymes

3.2.2. Lactobacillus Caries Progression Only Pits & fissure Caries Pioneers of Dentin Caries Caries Susceptibility tests

4. Ferment-able CHO

4.1. Types

4.1.1. Monosaccharides Glucose & Fructose Less Cariogenic

4.1.2. Disaccharides Sucrose & Maltose the Most Cariogenic

4.1.3. Polysaccharides Starch & Glycogen The Least Cariogenic

4.2. Total Amount

4.2.1. amount CHO Caries Incidence

4.3. Frequency

4.3.1. Frequency CHO Caries Incidence Availability of CHO Microorganisms Activity Acid Demineralization No Saliva Cleansing or washing

4.4. Texture

4.4.1. Sticky CHO is Cariogenic Longer time on tooth Slowly washed by saliva More accessible to microorganisms more Acids

4.5. Local Effect

4.5.1. Directly into Stomach No dental Caries

4.5.2. Directly to Oral Cavity Produce dental Caries

4.6. Refinement

4.6.1. Increases Carogencity % fermentable CHO Adhesiveness Removal of Fibrous Material

5. Sucrose is Arch Criminal

5.1. Many available forms

5.2. Most frequently consumed CHO

5.3. Low Molecular Weight

5.3.1. Easily diffused

5.4. Rapidly broken down

5.4.1. by bacterial enzymes

5.4.2. More Acids

5.5. Dextrans

5.5.1. Extracellular Polysaccharides

5.5.2. Water Insoluble

5.5.3. Glucose Polymer

5.5.4. Highlt Adhesive & Sticky

5.6. Levans

5.6.1. Extracellular Polysaccharides

5.6.2. Fructose Polymer

5.6.3. Water Soluble

5.6.4. Less adhesive & Sticky

6. Biochemical Reactions

6.1. 1-Acid Production

6.2. 2-Extracellular Polysaccharides

6.2.1. Sticky Plaque

6.2.2. bulk of Plaque

6.2.3. Additional source of CHO More Acids

6.2.4. Additional Store of CHO

6.3. 3-Intracellular Polysaccharides

6.3.1. Glucose, Fructose,Sucrose & Maltose

6.3.2. Store of Fermentable CHO

6.4. 4-Demineralization phase

6.5. 5-Remineralization phase