RESTO I REVIEWER PT.

1 Composed mainly of Hydroxyapatite Crystals which

dissolve by the presence of acids
RESTORATIVE DENTISTRY
COMMONLY FOUND AT:
 Branch which deals with the restoration of
teeth destroyed by the dental caries and other  Pits and fissures
causes in order to prevent destruction of the  Proximal surface/Contact areas
tooth tissue and intercept the prognosis of  Smooth surfaces
disease
o To determine the prognosis of the case, MECHANISM OF DENTAL CARIES
we must have a thorough inspection in
Host + Bacteria + Diet = Caries
order to arrive at a correct treatment
plan
 Is the diagnosis, treatment, ang prognosis of
tooth that do not require full coverage Cavity is a condition that leads to dental caries being
restorations for correction untreated

TREATMENT RESULTS IN: Host

 Restoration of proper teeth form, function, and  Susceptible individual

esthetics  Tooth is the primary factor
 Maintenance of physiologic integrity of the
teeth in harmonious relationship with the Morphology
adjacent hard and soft tissues
 Is the structure/anatomy of the tooth
 To enhance the general health and welfare of
 Self cleansability matters!!
the patient
Location
INDICATIONS
 Less reachable teeth = more susceptible to
3 Primary Treatment
caries
 Caries
COMPOSITION
 Malformed, discolored, non-esthetic, fractured,
diastema  In caries formation, the susceptibility of the
o Fracture is common in children tooth is inversely proportional to the fluoride
 Restoration Replacement or Repair content and calcium content of the tooth
o Fluoride + Hydroxyapatite =
DENTAL CARIES
Fluoroapatite
 Infectious microbiologic disease  Fluoroapatite makes the teeth
 Results in localized dissolution and destruction harder
of the calcified tissues
SALIVA
o Can be transferred thru saliva
o Irreversible once cavitated  2nd major item in host pattern of the caries
 Cavitated – Sira na talaga formula
 Demineralization of inorganic substances o High salivary phosphate content = less
 Disintegration, dissolution of organic prone to caries
substances o Ph
o Viscosity
o Enamel
 96% FUNCTIONS OF INORGANIC PHOSPHATE
 4%
o Cementum  Contributor to the solubility product of calcium
 45-50% which is important in maintaining tooth
 55% structure
  Acts as a buffer for rapid neutralization of acids  Mainly because of eating
 Essential nutrient for oral microflora for habits
metabolic pathways
ENVIRONMENT
PH
 Areas with fluoridated water are less prone to
 6.2 – 7 = Normal pH caries
 5.6 – 5.7 = Critical pH o 1. ppm (Part per million)
 Below 5.5 = demineralization  More than 1 = Fluorosis
 Higher than 5.7 = remineralization
PARASITE (MICROORGANISMS)
Oral pH fluctuates depending on the condition of the
 Brought into contact with the tooth surface via
oral cavity
a bacterial plaque, creating a classic parasitic
VISCOSITY relationship
o 1mm of plaque contains millions of
 Serous microorganisms
o Thin and more watery  Streptococcus mutans
o Less prone to dental caries  Principal bacterial agent
 Mucinous in enamel
o Thick and gropy with plaque and biofilm  Lactobacillus acidophilus
o More prone to dental caries  Spreads the caries
 Actinomyces viscosus
FLOW  Initiate root caries
 Decreased salivary flow and production may Saliva is the vehicle by which microorganism transfer
have higher caries susceptibility occur
o In case of sickness, the survivability of
microorganisms depends on its RELATIONSHIP OF PLAQUE TO CARIES
attachment to the tooth surface
 Important in controlling both the oral flora and  Plaque is soft, transluscent, and tenaciously
mineral content of teeth adherent material
 Flushes the oral cavity  Gelatinous mass of bacteria adhering to the
tooth surface
o Cannot be removed by brushing but can
be removed by scaling
MUSCULAR ACTIVITY o Will calcify and turn into calcular
deposit
 Activities of the tongue, cheek, lips, and
muscles of the face will create and guide the THEORIES ON PATHOGENICITY OF PLAQUE
self cleansing activities within the oral cavity
Non-specific Plaque Hypothesis
HABITS
 Assumes that all plaque are pathogenic
 Poor eating habits = prone to caries
Specific Plaque Hypothesis
GROUP SUSCEPTABILITY
 Plaque is pathogenic only when signs of
 Females are more prone than males due to the associated disease are present
fact that the teeth of females erupt at an early
age so their teeth are exposed in an earlier time
than that of males
MEDIUM (DIET)
AGE
 Suitable substrate
 14 – 20 o Available nutrient to support bacterial
o Highest rate of caries activity growth
  Carbohydrate is the most cariogenic of all food CLINICAL SITES FOR CARIES FORMATION
materials
o Fermentable Carbs – chief offenders  Recesses of developmental pits and fissures
insofar as food is concerned  Smooth enamel surfaces that shelter plaque
o More fibrous and harder food increases  Root surface
muscular activity = less caries
PROGRESSION OF CARIOUS LESIONS
CARIES RISK ASSESSMENT
 Not consistent
 Upon consumption of carbs, pH level of plaque  Smooth Surface – 18 months +/- 6 months
remains at a cariogenic level after 30 mins  Newly erupted tooth – 3 years
 Occlusal pits and fissures – less than smooth
2 DETRIMENTAL CHANGES surface
 Frequent exposure to sucrose containing food –
1. Protective factor detected from food materials
3 weeks
during processing, storage, and preparation
 Poor oral hygiene – 3 weeks
o Less masticatory activity
2. Cariogenic factor added  Dry mouth (Xerostomia) – 3 months
o Food content
 Sugar and starchy food
3. Frequency of meals

TIME

 It’s not only what you eat

 Frequency of meals and the duration of eating
of food in mouth causes development of caries

CARIES RISK ASSESSMENT

 High
 Moderate
 Low
o Check Diet – frequency of sugar hits
and frequency of acid hits

SUGAR HITS

 More than 4x a day – high risk

 4x a day – at risk
 Less than 4x a day – low risk

SOFTDRINKS

 Contains sugar and acid = erosion

o Acidity due to phosphoric acid and
citric acid
 pH of mouth – 6.2 – 7.0
 pH of softdrinks – 2.47 – 3.35

“If you sip all day, you’ll get tooth decay”

 Eat – gargle – apply fluoride toothpaste – swish

and spit – no rinsing
o Gargling reduces the efficacy of
fluoride