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Question 1
What does D3MFT measure?
The number of teeth with cavities
The number of teeth with fillings
summing the number of teeth with obvious decay into dentine, missing due to decay, and filled teeth
The number of teeth with root canals
Question 2
What does the D3MFT index not account for?
Teeth with obvious decay
Teeth missing due to decay
Teeth with gum disease
Teeth with fillings
Question 3
What percentage of adults aged 20-65 have untreated caries?
30%
10%
90% have a carious lesion or restoration 25% have untreated caries
40%
Question 4
What is the planktonic bias
testing on free-floating (planktonic) bacteria rather than the communities/biofilms
Question 5
Why antibiotics don’t “cure” caries
• Slow growing cells are less susceptible to antimicrobials • Altered gene expression and gene transmission • EPS impedes penetrance
Question 6
Why mechanical disruption (brushing) is critical
• disrupted biofilm releases planktonic bacteria = easier to manage • Biofilm traps acid against tooth surface, resisting exogenous buffering • EPS provides strong surface adhesion that is not easily washed off
Question 7
Steps to biofilm formation
1. Acquired Pellicle formation 2. Initial Adhesion 3. Maturation 4. Dispersion
Question 8
Steps to initial adhesion of pellicle
1. reversible attachment 2. permanent/irreversible attachment 3. microbial succession
Question 9
what happens during microbial succession?
At first, its mostly streptococci, then microbiota becomes more diverse O2 decreases --> mostly anaerobic --> more fermentation
Question 10
What is biofilm dispersion?
biofilms can release bacteria to colonize new areas the remaining plaque can eventually calcify into calculus (tartar).
Question 11
3 stages of the caries process
Acidogenic stage:
Production of acid
Aciduric stage:
Selection of bacteria that can survive in low pH
Proteolytic stage:
Degradation of the organic matrix of teeth (after acids have demineralized inorganic matrix)
Question 12
Where can fermentation take place
GI and Oral cavaity
Question 13
What is Specific Plaque Theory (60s-80s)
Only pathogen bacteria are responsible for disease. Emphasis on - Streptococcus mutans (early colonizer) - Lactobacillus (late colonizer, deep dentinal caries) - Actinomyces (late colonizer, root caries)
Question 14
What is the tooth Worm Theory?
Sumerians in 5000 BC to the Egyptians, Greeks and Chinese up to the Middle Ages • worm eating tooth away like apple
Question 15
Which sugars are also highly cariogenic but do not build glucans like sucrose
Glucose/dextrose fructose
Question 16
What condition did the Homo rhodesiensis specimen exhibit?
extensive dental caries
severe gum disease
no dental caries
minimal dental caries
Question 17
What period is known for the earliest documented dental treatments?
Mesolithic period
Neolithic period
Iron Age
Stone Age
Question 18
Where was the earliest evidence of dental caries intervention found?
Greece
France
Northern Italy
Southern Italy
Question 19
What theory did the Greek and Roman beliefs about health originate from?
Hippocrates theory
Aristotle's theory
Plato's theory
Galileo's theory
Question 20
What were the four humors/fluids believed to be within the body?
• Phlegmatic: phlegm • sanguine: blood • melancholic: black bile • choleric: yellow bile
Oxygen, Carbon Dioxide, Nitrogen, Argon
Air, Fire, Earth, Water
Protein, Carbohydrate, Fat, Water
Question 21
What period saw an increase in sugar cane consumption leading to an increase in caries?
Late 17th to early 18th century
Early 16th century
11th to mid-18th century BC
19th to early 20th century
Question 22
What did Leeuwehoek discover using material scraped off his own teeth?
Early discovery of microbes
Vitamins
Minerals
Human DNA
Question 23
What did Pierre Fauchard propose caused tooth decay?
Tartaric acids derived from sugars and starches
Iron
Calcium
Fluoride
Question 24
What is the Chemoparasitic Theory?
vitamins
First to propose that microorganisms ferment carbohydrates to produce acids that demineralize tooth enamel
proteins
lipids
Question 25
Process in the Chemoparasitic Theory?
base
neutral solution
alkali
Oral bacteria + fermentable carbohydrates → acid (H+) → demineralized enamel
Question 26
What is the primary acid produced by Streptococcus mutans?
citric acid
propionic acid
acetic acid
lactic acid
Question 27
What is the significance of Streptococcus mutans in cariology research?
model bacterium: • Highly acidogenic • Aciduric (survives in low pH environments) • Produces extracellular glycans via glucosyltransferases (biofilm formation) • Strongly associated with smooth surface caries • Easily cultured in a laboratory
vaccine developer
antibiotic producer
symbiotic organism
Question 28
What was the primary focus of early microbiological research from the late 1800s to the mid 1900s?
Genetic engineering
Pure monocultures of bacteria
Viral research
Molecular biology
Question 29
What did Koch's postulates require to prove a bacteria causes a disease?
▪ Association: Find the bacteria in all examples of ill patients ▪ Isolation: Isolate that bacteria in a pure culture ▪ Inoculation: Induce disease in a healthy host with that bacteria ▪ Reisolation: Reisolate that bacteria again from the induced patient
Symptom observation
Genetic analysis
Environmental factors
Question 30
What significant improvements in technology allowed researchers to image the surfaces of stubborn bacterial conditions in the 1970s?
Confocal Laser Scanning Microscopy
X-ray Microscopy
Scanning Electron Microscopy
Light Microscopy
Question 31
What type of communication do biofilm bacteria exhibit?
Electrical signaling
Minimal
Quorum sensing
Hormone release
Question 32
What percentage of human bacterial infections are associated with biofilms?
80%
70%
60%
100%
Question 33
Why do antibiotics become less effective once a biofilm matures on a heart valve?
Because biofilms protect bacteria from antibiotics
Antibiotics become more effective
The body builds resistance
The biofilm dissolves
Question 34
Why are S. mutans models alone insufficient to explain disease?
They are not relevant to humans
They are too expensive
They are not accurate
They dramatically underestimate the activity and resistance of biofilm-mediated disease
Question 35
What does sucrose do to plaque architecture?
Has no effect
Increases the number and activity of cariogenic bacteria
Increases the number of non-cariogenic bacteria
Decreases the activity of bacteria
Question 36
What is an acquired pellicle
thin, bacteria-free conditioning film Made of: • salivary proteins • glycoproteins • lipids • phospholipids
Bacterial biofilm
Salivary film
Dental plaque
Question 37
Which bacteria predominantly adhere to the acquired pellicle initially?
Porphyromonas
Streptococci
Lactobacilli
Fusobacteria
Question 38
What type of attachment do bacteria utilize appendages for?
Carbohydrate fermentation
Permanent/Irreversible attachment
Reversible attachment
Initial attachment
Question 39
What happens to the biofilm during the maturation stage?
It remains unchanged over time.
It calcifies into tartar immediately.
It becomes thinner and less acidic.
It thickens and produces more acid • more difficult to remove with brushing • more likely to cause gingivitis/periodontal disease • more likely to cause caries
Question 40
What triggers the dispersion of mature biofilms?
Increased acidity.
Increased temperature.
Nutrient limitation, environmental changes, or signaling molecules.
Presence of fluoride.
Question 41
Stage of Biofilm formation times
1 hour
8 hours
I. 2H II. 8H III. 14H IV. 1-4 D V. 5D
6 hours
Question 42
What type of carbohydrate are dentists most concerned about
CARIOGENIC fermentable carbohydrates
fermentable for gut bacteria =/= fermentable for plaque bacteria
Question 43
What was the primary theory regarding the cause of dental caries before the 1960s?
Specific plaque hypothesis
Genetic predisposition
Non specific plaque hypothesis
Environmental factors
Question 44
What is the non specific plaque hypothesis?
Plaque is a localized accumulation of bacteria.
Plaque is a chemical accumulation of bacteria.
Plaque is a specific accumulation of bacteria.
Plaque is a genetic accumulation of bacteria.
Question 45
What leads to the selection of more acidogenic and aciduric bacteria in the plaque biofilm?
Changes in environmental factors (sugar, pH, saliva, etc.)
Antibiotics
Vitamins
Minerals
Question 46
What is the process by which dental caries develops?
A genetic mutation
A viral infection
A chemical reaction
dysbiotic shift in the total plaque biofilm composition
Question 47
What is the new model proposed for understanding dental caries?
Specific pathogen model
Mechanical plaque hypothesis
Ecological plaque hypothesis
Genetic plaque hypothesis
Question 48
What is the primary process involved in carbohydrate fermentation?
electrochemical process
aerobic process
anaerobic process
enzymatic process
Question 49
Which of the following can perform carbohydrate fermentation?
plants, yeast, or viruses
bacteria, viruses, or archaea
bacteria, yeast, or fungi
animals, yeast, or bacteria
Question 50
What are the main products of bacterial carbohydrate fermentation?
acid and oxygen
acid and sugar
alcohol and gas
acid, alcohol, and gas
Question 51
What does FODMAP stand for?
Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polysaccharides
Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Phosphates
Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols
Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Proteins
Question 52
What type of fermentation typically takes minutes?
Gastrointestinal fermentation
Oral fermentation
Oral fermentation
Gastrointestinal fermentation
Question 53
Which of the following is considered the most cariogenic?
Fructose
Glucose
Sucrose (table sugar)
Lactose
Question 54
What does salivary amylase break cooked starches down into?
Lactose
Fructose
Matose (glucose+glucose) or glucose
Sucrose
Question 55
Which sugar is moderately cariogenic and fermented more slowly?
Sucrose
Lactose
Glucose
Fructose
Question 56
What is the primary reason sucrose is used as a model fermentable carbohydrate in caries research?
It is a preservative
It is a common food additive
It is rapidly fermented into acid and serves as substrate for extracellular glucan production
It is a source of dietary fiber
Question 57
How does sucrose contribute to cariogenic plaque formation compared to other sugars?
Produces more cariogenic plaque than glucose or fructose alone
Promotes the growth of beneficial bacteria
Reduces the risk of tooth decay
Is less likely to cause cavities