Oral disease classwork

1. Many sugars used in food manufacturing are cariogenic – they can be used by oral bacteria
to cause dental caries. Which one of the following extrinsic sugars is not considered to be
cariogenic?
A Dextrose
B Glucose
C Lactose
D Maltose
E Sucrose

2. There are many ‘alternative’ sugars available nowadays which are considered to be healthy
alternatives to refined sugars, such as sucrose. Many contain reduced amounts of calories
and are therefore considered useful when dieting. Which one of the following alternative
sugars is not cariogenic?
A Agave nectar
B Dried fruit
C Honey
D Xylitol
E Yacon syrup

3. The level of acidity in the oral cavity is maintained at the neutral pH 7 by the buffering action
of saliva. At what pH level does enamel and dentine demineralisation begin?
A pH 4.0
B pH 4.5
C pH 5.0
D pH 5.5
E pH 6.0

4. During the development of a cavity in a tooth, certain cells attempt to slow the bacterial
carious attack by laying down secondary dentine. This tissue helps to protect the pulp from
becoming inflamed by the bacterial activity. Which of the following cells are responsible for
the formation of secondary dentine?
A Ameloblasts
B Cementoblasts
C Fibroblasts
D Odontoblasts
E Osteoblasts

5. Which one of the following factors is relevant in the development of gingivitis?

A Bacterial plaque
B Carbohydrate foods
C Frequency of acid attacks
D Weak organic acids
E Refined sugars

6. There are various types of tooth surface loss which can cause dental problems over time.
Which type of tooth surface loss usually affects a single-standing premolar and results in a
sudden loss of tooth structure in the cervical region of the tooth?
A Abfraction
 B Abrasion
C Attrition
D Caries
E Erosion

7. Periodontal disease can be exacerbated by many medical factors. Which one of the
following conditions is not directly linked to a worsening severity of periodontal disease?
A Asthma
B Diabetes
C Stress
D Vitamin C deficiency
E Smoking

8. Bacterial plaque is linked with the development of both dental caries and periodontal
disease. Which one of the following describes the role of plaque in caries formation rather
than in periodontal disease?
A Acid formation
B Poor oral hygiene
C Presence of bacteria
D Presence of saliva

9. Periodontal disease is the infection of the supporting tissues (gingivae, periodontal ligament
and alveolar bone) of the teeth by oral micro-organisms. Which of the following treatments
is the most effective at resolving periodontal disease?
A Dietary advice
B Extraction and implants
C Fluoride mouthwash
D Metronidazole 400°mg
E Plaque/calculus removal

10. There are several conditions which may affect the periodontium of a patient and it is
important that they are recognised and treated by the dental team. Which of the following is
one such condition that presents in young patients as an acute inflammation of the oral
cavity, with the formation of many small blisters which become ulcerous before resolving?
A Acute herpetic gingivitis
B Acute lateral periodontal abscess
C Acute necrotising ulcerative gingivitis
D Juvenile periodontitis
E Subacute pericoronitis
 End of session test - answers

1. Many sugars used in food manufacturing are cariogenic – they can be used by oral bacteria
to cause dental caries. Which one of the following extrinsic sugars is not considered to be
cariogenic?
A Dextrose
B Glucose
C Lactose
D Maltose
E Sucrose
The correct answer is C. Lactose is a naturally occurring extrinsic sugar found in milk and
produces so little organic acid when consumed by oral bacteria it is considered non-
cariogenic. The other options are all free sugars, loosely similar to those previously termed
‘non-milk extrinsic sugars’.

2. There are many ‘alternative’ sugars available nowadays which are considered to be healthy
alternatives to refined sugars, such as sucrose. Many contain reduced amounts of calories
and are therefore considered useful when dieting. Which one of the following alternative
sugars is not cariogenic?
A Agave nectar
B Dried fruit
C Honey
D Xylitol
E Yacon syrup
The correct answer is D. This is a natural sugar alcohol which is widely used as an artificial
sweetener, as it is not metabolised by oral bacteria and therefore produces no weak organic
acids to cause caries. All the other options are cariogenic.

3. The level of acidity in the oral cavity is maintained at the neutral pH 7 by the buffering action
of saliva. At what pH level does enamel and dentine demineralisation begin?
A pH 4.0
B pH 4.5
C pH 5.0
D pH 5.5
E pH 6.0
The correct answer is D. pH 5.5 is termed the ‘critical pH’ below which the oral environment
is sufficiently acidic to allow tooth destruction to occur.

4. During the development of a cavity in a tooth, certain cells attempt to slow the bacterial
carious attack by laying down secondary dentine. This tissue helps to protect the pulp from
becoming inflamed by the bacterial activity. Which of the following cells are responsible for
the formation of secondary dentine?
A Ameloblasts
B Cementoblasts
C Fibroblasts
D Odontoblasts
E Osteoblasts
The correct answer is D. Odontoblasts lie along the amelodentinal junction throughout the
life of the tooth and lay down secondary dentine whenever a carious attack approaches the
junction.
5. Which one of the following factors is relevant in the development of gingivitis?
A Bacterial plaque
B Carbohydrate foods
C Frequency of acid attacks
D Weak organic acids
E Refined sugars

6. There are various types of tooth surface loss which can cause dental problems over time.
Which type of tooth surface loss usually affects a single-standing premolar and results in a
sudden loss of tooth structure in the cervical region of the tooth?
A Abfraction
B Abrasion
C Attrition
D Caries
E Erosion

The correct answer is A. This tooth surface loss occurs due to shearing forces acting on an
overloaded tooth, usually a single-standing premolar where the adjacent molars are missing.
Although it resembles an abrasion cavity in appearance, the loss occurs suddenly rather
than over a prolonged period of time.

7. Periodontal disease can be exacerbated by many medical factors. Which one of the
following conditions is not directly linked to a worsening severity of periodontal disease?
A Asthma
B Diabetes
C Stress
D Vitamin C deficiency
E Smoking

8. Bacterial plaque is linked with the development of both dental caries and periodontal
disease. Which one of the following describes the role of plaque in caries formation rather
than in periodontal disease?
A Acid formation
B Poor oral hygiene
C Presence of bacteria
D Presence of saliva

9. Periodontal disease is the infection of the supporting tissues (gingivae, periodontal ligament
and alveolar bone) of the teeth by oral micro-organisms. Which of the following treatments
is the most effective at resolving periodontal disease?
A Dietary advice
B Extraction and implants
C Fluoride mouthwash
D Metronidazole 400°mg
E Plaque/calculus removal

The correct answer is E. The removal of plaque and calculus, especially if subgingival, is the
most effective treatment to resolve periodontal disease or at least keep it under control.
Implants can also develop a similar inflammatory condition called peri-implantitis.
10. There are several conditions which may affect the periodontium of a patient and it is
important that they are recognised and treated by the dental team. Which of the following is
one such condition that presents in young patients as an acute inflammation of the oral
cavity, with the formation of many small blisters which become ulcerous before resolving?
A Acute herpetic gingivitis
B Acute lateral periodontal abscess
C Acute necrotising ulcerative gingivitis
D Juvenile periodontitis
E Subacute pericoronitis

The correct answer is A. This condition is caused by an initial infection with herpes simplex
virus and is usually seen in infants and children. Once resolved, the virus remains dormant
within the patient and can be reactivated at a later date, when it appears as a ‘cold sore’ on
the lip.