AAPD QE SESSIONS QUESTIONS & ANSWERS
Anticipatory Guidance - Answer -Provide developmentally relevant info about a child's
health to help parents prepare for milestones in the future.
-Physical
-Emotional
-Psychological
Koch's Postulates - Answer -Describes requirements for a microorganism to be
considered an etiology case agent for a diseased
What are Koch's Postulates for disease? (3) - Answer -1) found in all cases of the
disease (e.g. Salmonella)
2) organisms should be grown on artificial media for several subcultures
3) a pure subculture should produce disease in a susceptible animal
Relationship between S. Mutans and caries - Answer -Is NOT absolute
What is the extended caries ecological hypothesis? - Answer -1) Dental plaque is a
dynamic microbial ecosystem in which non-mutans bacteria are the key players for
maintaining dynamic stability
-mainly non-mutan streptococci and Actinomyces
2) Some non-mutans streptococci have the ability to increase both their acidogenicity
and acid urban energy in low pH environments
3) Non-mutans were once believed to be helpful or benign, however in the right biofilm
they can produce acid and act to destabilize the homeostasis of the plaque biofilm ——
> demineralization
What are the 4 main Non-mutan Streptococci? - Answer -1) Streptococcus sanguis
2) Streptococcus gordonii
3) Streptococcus oralis
4) Streptococcus mitis
**Play a significant role in shifting the dental plaque environment towards acidic and
promote the colonization of more acid-tolerant and acidogenic bacteria such as Mutans
streptococci and lactobacilli
What are the 4 zones of a dental carious lesion? - Answer -From superficial to deep
1) Surface zone
2) Body of lesion
3) Dark zone
-large hydroxyapatite crystals due to remineralization
,4) Translucent zone
-small hydroxyapatite crystals due to demineralization
What is the transmission method of biofilm to infants? - Answer --Primary route of
transmission is SALIVA
-VERTICAL TRANSMISSION from mom or primary caregiver
What are the earliest bacterial colonizers found in oral biofilm? (3) - Answer -**MOS**
1) Streptococcus mitis
2) Streptococcus oralis
3) Streptococcus salivarus
**prior to tooth eruption, these bacteria are transient
What are examples of vertical and horizontal transmission? - Answer -Vertical = parent
to child
Horizontal = between spouses, non-parent transfer
What is the window of infectivity for biofilm transmission to young children? - Answer -
From 19 to 3o months of age
What are the carcinogenic bacteria found in ECC? - Answer -1) Streptococcus mutans
2) Scardovia wiggsiae
3) Veillonella parvula
4) Streptococcus cristatus
5) Actinomyces gerencseriae
What are risk indicators for dental caries? - Answer --Factors that have been
associated with the risk for caries
-Factors that are modifiable by the individual or the dentist
1) Poor oral hygiene
2) Inadequate fluoride exposure
3) Frequency of between meal carb snacks
4) Inadequate saliva (due to meds or med condition)
5) Recreational drug use
6) Radiation therapy ——> Xerostomia
What are 2 factors that predict future caries? - Answer -1) Demineralized or cavitated
lesions of enamel or dentin
2) Stained occlusal pits or fissures
What are alkali generating oral bacteria? (Protective) - Answer -1) Streptococcus
sanguinis
-makes alkali from arginine and dec cariogenicity of acidic bacteria
, 2) Streptococcus salivarius
-make alkali from urea
3) Veillonella spp
-converts lactic acid to weaker acids
Acquired Pellicle characteristics - Answer -1) Composed of salivary proteins
-Mucin, proline-rich proteins, histatin, statherin
2) ~1 micron thick
3) Critical role in the control of bacterial colonization
4) May protect against dietary acids
5) Facilitates remineralization by maintaining calcium and phosphate close to enamel
surface
What is the Stephan graph curve? - Answer --Illustrates the decrease in pH instantly
returns to normal after 20-30 min
-pH levels of </= 5.0 may persist in caries active patients for several hours
What is the average critical pH for hydroxyapatite and fluorapetite? - Answer -
Hydroxyapatite = 5.5
Fluorapetite = 4.5
-Varies depending in total calcium and phosphate concentration in saliva
-low concentration of Ca and Phosphate cause increase in critical pH
-possibly as high as 7.0 in some people
Fluoride enhanced remineralization is dependent on the availability of ... - Answer -
Phosphate and calcium ions
What is the process of remineralization? - Answer -Calcium and phosphate ions are
supplied from a source external to the tooth
——> promote ion deposition into crystal voids in demin enamel to produce net mineral
gain
What amount of fluoride is found in baby formula? (Ppm) - Answer -Reconstituted
Powdered Concentrate
-Milk based: 1.03 ppm
-Soy based: 1.07 ppm
Anticipatory Guidance - Answer -Provide developmentally relevant info about a child's
health to help parents prepare for milestones in the future.
-Physical
-Emotional
-Psychological
Koch's Postulates - Answer -Describes requirements for a microorganism to be
considered an etiology case agent for a diseased
What are Koch's Postulates for disease? (3) - Answer -1) found in all cases of the
disease (e.g. Salmonella)
2) organisms should be grown on artificial media for several subcultures
3) a pure subculture should produce disease in a susceptible animal
Relationship between S. Mutans and caries - Answer -Is NOT absolute
What is the extended caries ecological hypothesis? - Answer -1) Dental plaque is a
dynamic microbial ecosystem in which non-mutans bacteria are the key players for
maintaining dynamic stability
-mainly non-mutan streptococci and Actinomyces
2) Some non-mutans streptococci have the ability to increase both their acidogenicity
and acid urban energy in low pH environments
3) Non-mutans were once believed to be helpful or benign, however in the right biofilm
they can produce acid and act to destabilize the homeostasis of the plaque biofilm ——
> demineralization
What are the 4 main Non-mutan Streptococci? - Answer -1) Streptococcus sanguis
2) Streptococcus gordonii
3) Streptococcus oralis
4) Streptococcus mitis
**Play a significant role in shifting the dental plaque environment towards acidic and
promote the colonization of more acid-tolerant and acidogenic bacteria such as Mutans
streptococci and lactobacilli
What are the 4 zones of a dental carious lesion? - Answer -From superficial to deep
1) Surface zone
2) Body of lesion
3) Dark zone
-large hydroxyapatite crystals due to remineralization
,4) Translucent zone
-small hydroxyapatite crystals due to demineralization
What is the transmission method of biofilm to infants? - Answer --Primary route of
transmission is SALIVA
-VERTICAL TRANSMISSION from mom or primary caregiver
What are the earliest bacterial colonizers found in oral biofilm? (3) - Answer -**MOS**
1) Streptococcus mitis
2) Streptococcus oralis
3) Streptococcus salivarus
**prior to tooth eruption, these bacteria are transient
What are examples of vertical and horizontal transmission? - Answer -Vertical = parent
to child
Horizontal = between spouses, non-parent transfer
What is the window of infectivity for biofilm transmission to young children? - Answer -
From 19 to 3o months of age
What are the carcinogenic bacteria found in ECC? - Answer -1) Streptococcus mutans
2) Scardovia wiggsiae
3) Veillonella parvula
4) Streptococcus cristatus
5) Actinomyces gerencseriae
What are risk indicators for dental caries? - Answer --Factors that have been
associated with the risk for caries
-Factors that are modifiable by the individual or the dentist
1) Poor oral hygiene
2) Inadequate fluoride exposure
3) Frequency of between meal carb snacks
4) Inadequate saliva (due to meds or med condition)
5) Recreational drug use
6) Radiation therapy ——> Xerostomia
What are 2 factors that predict future caries? - Answer -1) Demineralized or cavitated
lesions of enamel or dentin
2) Stained occlusal pits or fissures
What are alkali generating oral bacteria? (Protective) - Answer -1) Streptococcus
sanguinis
-makes alkali from arginine and dec cariogenicity of acidic bacteria
, 2) Streptococcus salivarius
-make alkali from urea
3) Veillonella spp
-converts lactic acid to weaker acids
Acquired Pellicle characteristics - Answer -1) Composed of salivary proteins
-Mucin, proline-rich proteins, histatin, statherin
2) ~1 micron thick
3) Critical role in the control of bacterial colonization
4) May protect against dietary acids
5) Facilitates remineralization by maintaining calcium and phosphate close to enamel
surface
What is the Stephan graph curve? - Answer --Illustrates the decrease in pH instantly
returns to normal after 20-30 min
-pH levels of </= 5.0 may persist in caries active patients for several hours
What is the average critical pH for hydroxyapatite and fluorapetite? - Answer -
Hydroxyapatite = 5.5
Fluorapetite = 4.5
-Varies depending in total calcium and phosphate concentration in saliva
-low concentration of Ca and Phosphate cause increase in critical pH
-possibly as high as 7.0 in some people
Fluoride enhanced remineralization is dependent on the availability of ... - Answer -
Phosphate and calcium ions
What is the process of remineralization? - Answer -Calcium and phosphate ions are
supplied from a source external to the tooth
——> promote ion deposition into crystal voids in demin enamel to produce net mineral
gain
What amount of fluoride is found in baby formula? (Ppm) - Answer -Reconstituted
Powdered Concentrate
-Milk based: 1.03 ppm
-Soy based: 1.07 ppm
