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Dental Calculus and Stain

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the term calculus means   an abnormal accretion (нарастание) or concretion (твердение), composed of mineral salts that may occur in hollow organs or ducts (канал, проток) of the body  
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Statement: dental calculus does not cause periodontal infections   true  
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What causes periodontal infections?   Bacterial Plaque  
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Statement: bacterial plaque causes periodontal infections   True  
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Statement: Dental Calculus Causes Periodontal Infections   False  
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Supragingival calculus is most commonly located at: and why?   1. lingual surfaces of the mandibular anterior teeth 2. facial surfaces of the maxillary first and second molars Due to presence of salivary glands in these areas.  
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Supragingival Calculus is also called:   1.supramarginal 2.extracoronal 3.coronal 4.salivary (source of minerals is from saliva  
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Subgingival calculus is most commonly found at:   1.clinical crown apical to the margin of the gingiva as well as the exposed root surface of the periodontal pocket 2.generalized or localized 3.interproximal areas most prone to this type of calculus  
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Subgingival calculus can also be called   1. Submarginal 2. Serumal (source of minerals is the blood serum)  
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Examination for Supragingival Calculus   1.visual exam with mirror 2.tactile exam (explorer) 3.dehydration with compressed air  
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Examination for Subgingival Calculus   1.visual exam of gingival tissue (signs of gingival inflammation) 2.tactile examination 3.radiographs (must be dense calculus, usually proximal deposits)  
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supra and subgingival calculus   basically the same – difference in the source of their minerals  
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Organic and Inorganic Composition of Calculus   75-85 % inorganic components 15-25% organic components and water  
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Inorganic Composition of Calculus Compared to Tooth Structure   Calculus: 75-85% inorganic salts enamel:96% inorganic salts dentin: 65% inorganic salts cementum: 45 to 50% inorganic salts  
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Statement: Subgingival calculus does not develop from the direct extension of supragingival calculus even though subgingival plaque forms from the extension of supragingival plaque   True  
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Is there a relation between the subgingival and supragingival calculus?   Subgingival calculus does not develop from the direct extension of supragingival calculus even though subgingival plaque forms from the extension of supragingival plaque  
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Is it possible to have subgingival plaque and to have no supragingival plaque?   Yes. It is possible. Subgingival calculus and supragingival calculus mineralize separately. it is possible to have on without the other.  
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Calculus. Inorganic Composition.   Inorganic Composition 1.calcium phosphorus carbonate sodium magnesium potassium 2. 2/3 of inorganic matter is crystalline mainly hydroxyapatite also 3. brushite whitlocktite octacalcium phosphate some fluoride in calculus  
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Organic Composition of Calculus   Outer Surface of Calcium is covered with live, microbial plaque. Organic Composition: 1. necrotic microorganisms 2.desquamated epithelial cells 3. salivary mucin 4. leukocytes  
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Statement: Sub and supragingival plaques mineralize separately.   True  
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Statement: Subgingival plaque is the direct extension of supragingival plaque.   True.  
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Three Phases of Calculus Formation   Three phases 1.pellicle formation 2.bacterial plaque formation/maturation 3.mineralization  
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Pellicle Formation as 1st Stage in Calculus Formation, Describe   Pellicle Formation composed of salivary mucoproteins or glycoproteins forms within minutes after soft and hard deposits have been removed from the tooth surface  
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Bacterial Plaque Formation and Maturation as the 2nd Stage in Calculus Formation   init colonized by dead epithelial cells and streptococcal microorganisms by day 5 – filamentous and fusiform bacteria enter, plaque near the gingival margin thickens & microflora matures -more gram negative anaerobes plaque extends apically and coronally  
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Mineralization. Minerals derived from where encourage supragingival calculus formation?   Minerals from Saliva  
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Mineralization. Minerals derived from where encourage subgingival calculus formation?   minerals from gingival sulcular fluid and inflammatory exudate supply the minerals for subgingival calculus  
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Heavy calculus formers have higher salivary levels of what?   calcium and phosphorus  
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Light calculus formers have higher levels of what?   parotid pyrophosphate  
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Physical Structure of Calculus   Arrngd in layers parallel to the tooth surface, appositional layers lk lk incremental lines sim to growth rings in a tree trunk calculus has a rough surface perf for plaque accumulation outer layer is only part calcified cov'd with viable, living pla  
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Types of Calculus Attachment to the Tooth   1. Pellicle attachment (typ of calculus, enamel/ rec scaled/debr th surfs, eas rem'd) 2. Mech-cal locking (restor/ surface irregulrts in cementum/enamel, more diff to rem) 3. Cemental Attachment (minerals of calculus interlckd w/srfce strctre of cementu  
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What is the major etiologic factor in the development of gingival and periodontal diseases.   Microbial Plaque  
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Name the ingredients in anti-calculus dentifrice that claim to reduce calculus retention?   Pyrophosphates or zinc (do not affect calculus already formed no effect on subgingival calculus formation limited effected with supragingival calculus formation some patients report dentinal hypersensitivity)  
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acts as a reservoir or haven for pathogenic microorganisms   Calculus  
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Mineralized bacterial plaque   Calculus  
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Statement: amount of calculus does not determine the degree of periodontal disease   True  
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Statement: Stain itself is not pathogenic.   True.  
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Statement: Source of Stain is important when determining treatment   True.  
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Extrinsic Stain   On outside of tooth  
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Intrinsic Stain   On inside of Tooth  
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Stain Source: Exogenous   develops from sources outside the body.. may be extrinsic or intrinsic  
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Stain Source: Endogenous   produced within or caused by factors within the body… always intrinsic  
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Yellow Stain Characteristics   dull, yellowish discoloration of bacterial plaque most common type of stain occurs at all ages most evident with poor POH similar distribution as plaque etiology usually food pigments  
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Most Common Type of Stain   Yellow Stain  
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Is yellow stain extrinsic or intrinsic?   Extrinsic  
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Green Stain Characteristics   light or yellowish green to very dark green embedded in plaque mainly on facial surfaces but may extend to proximal mainly on maxillary anterior teeth  
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What are the three forms green stain occurs in?   small curved line following gingival margin on facial 1/3 smeared irregularly on facial surfaces streaked – following grooves or lines in enamel  
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Is green stain extrinsic or intrinsic?   Extrinsic  
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Green Stain Composed of   ..chromogenic bacteria and fungi ..decomposed hemoglobin ..small amounts of inorganic elements: calcium potassium sodium  
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Green Stain Mainly Occurs in:   Children  
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Etiology of Green Stain   Etiology (Origin) poor POH chromogenic bacteria gingival hemorrhage blood pigments from hemoglobin are decomposed by bacteria  
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Clinical Approach to Green Stain   don’t scale the area – often demineralization under the stain light polish, fluoride  
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Other Green Stain   Other green stain chlorophyll preparations (ex: Clorets) metallic dust drugs (ex: marijuana leaves a grayish green stain  
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Black Line Stain Extrinsic or Intrinsic   Extrinsic  
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Black Line Stain. Clinical Features.   cntnus unintrrptd fine line 1mmw no thcknss band may be wider in severe cases fllws ging margin apr 1mm above crest,apprs black in base of pits,fissures,hvy deposits may be dtct'd w/expl,gingiva firm w/no bleeding in clean mouths w/tendency to fwr caries  
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Black Line Stain. Location   facial and lingual surfaces of teeth except rarely found on facial surfaces of maxillary anterior teeth most frequently lingual and proximal surfaces of maxillary posterior teeth  
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Where is black line stain most frequently found?   lingual and proximal surfaces of maxillary posterior teeth  
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Black Line Stain. Composition and Formation   composition and formation 1. iron compounds in saliva or gingival crevicular fluid become embedded in the dental pellicle, plaque and/or plaque bacteria 2. stain is a ferric sulfide compound 3. tends to recur despite meticulous plaque control  
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Black Line Stain. Occurence.   1. All ages, more common in childhood 2. More common in females 3. frequently found in clean mouths 4. tends to recur despite meticulous plaque control  
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Tobacco Stain. Clinical Characteristics   light brown to dark leathery brown or black diffuse narrow band or wide tar-like bank incorporated into calculus deposit heavy deposits can penetrate enamel and become exogenous intrinsic stain  
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Location of Tobacco Stain   location primarily cervical third any surfaces as well as pits and fissures most frequently on lingual surfaces  
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Composition of Tobacco Stain   Tobacco Stain composition tar products of combustion brown pigment from smokeless tobacco  
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Other Brown Stains 1(besides tobacco)   1 brown pellicle - stain from food 2 stannous fluoride - result of formation of stannous sulfide or brown tin oxide from reaction of the tin oxide in the Stannous fluoride compound; 3 Foodstuffs - tea, coffee  
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Other Brown Stains 2(besides tobacco)   4 Anti-microbial agents Chlorhexidine - Rx antimicrobial mouth rinse, causes brown staining esp on exposed root surfaces; consid a signf side effect of med 5 Betel Leaf betel leaf chew. cmmn East cntrs, caries inh effct,dark mahogany/blck stain, scali  
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What bacteria cause red and orange stains   Chromogenic bacteria  
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Orange and Red Stains Clinical Characteristics   Orange and Red Stains cervical third of teeth most frequently on facial and lingual surfaces of anterior teeth rare – red more rare than orange caused by chromogenic bacteria  
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Clinical Characteristic of Stain from Metallic Salts from Industrial Dust   copper or brass- green or bluish-green iron – brown to greenish brown nickel – green cadmium – yellow or golden brown primarily found on anterior teeth but can occur anywhere cervical third more commonly affected  
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How do Metallic Salts from Industrial Dust Stain Tooth Surface   how? worker inhales dust bringing metallic substance in contact with teeth metal gives color to plaque may penetrate tooth and become exogenous intrinsic stain  
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What color are the stains from iron supplements   Black or brown  
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What color are the stains from bismuth or Pepto-Bismol   Black or brown  
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How to prevent staining of teeth from drugs   ingest liquid medication through a straw or use tablet or capsule form  
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What are endogenous intrinsic stains   these stains develop during tooth development and are within the tooth structure  
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What are the reasons endodontically treated teeth discolor?   Endodontically treated teeth (pulpless teeth) ...hemorrhages in pulp chamber result in breakdown of blood and other elements of the pulpal tissue ...pigments from the decomposed hemoglobin and pulp tissue penetrate the dentinal tubules  
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What are the colors endodontically-treated tooth can take on?   wide range of colors from light yellow-brown to bluish-black, orange or greenish-orange  
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Tetracyclines have an   affinity for mineralized tissues – absorbed by the bones and teeth  
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Why is tetracycline not recommended to pregnant women?   .. A child's teeth can be affected if drug is administered to the mother during pregnancy or to the child in infancy or early childhood ..can be transferred through placenta and enter fetal circulation  
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What is the color of teeth affected by tetracycline and what does it depend on?   ..Light green to dark yellow or grayish brown ..depends on dosage, length of time drug was used and type of tetracycline used  
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What is amelogenesis imperfecta and what are the characteristics?   Imperfect Tooth Development – Hereditary amelogenesis imperfecta enamel partially or completely missing due to generalized disturbance of ameloblasts teeth are yellowish-brown or gray  
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What is dentinogenesis imperfecta and how is it characterized?   dentinogenesis imperfecta “opalescent” dentin abnormal dentin because of generalized disturbance of odontoblasts (dentin producing cells) teeth appear translucent or opalescent vary in color from gray to brown  
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Amelogenesis imperfecta occurs due to   generalized disturbance of ameloblasts  
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What is the color of teeth affected by amelogenesis imperfecta   teeth are yellowish-brown or gray  
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Name examples of endogenous intrinsic stain?   ..Endodontically treated teeth ..Use of tetracyclines ..Imperfect tooth development (genetic or environmental) ..  
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Dentinogenesis imperfecta occurs due to   generalized disturbance of odontoblasts (dentin producing cells)  
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Give examples of imperfect tooth development of environmental cause   ..Enamel hypoplasia ..Enamel hypocalcification  
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What is enamel hypoplasia   incomplete formation of enamel due to disruption of ameloblastic activity during the apposition and mineralization stages of enamel formation  
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Condition caused by too much of systemic fluoride   Fluorosis  
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Enamel hypoplasia caused by the following factors:   caused by a number of environmental factors poor nutrition protracted fever isolated trauma during tooth development too much systemic fluoride (fluorosis) during tooth development localized or generalized  
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What is enamel hypocalcification   enamel hypocalcification matter of when disturbance of ameloblast takes place occurs during maturation stage of enamel development white spots or flecks on the teeth same cause as enamel hypoplasia  
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Exogenous Intrinsic Stains from restorative materials such as amalgam occurs due to..   ..metallic ions seep into the enamel/dentin ..corrosion on the surface releases sulfides which stain the enamel near the margin- blackish color  
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Statement: most any extrinsic stain can become intrinsic over time   True  
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Statement: it is important to avoid tetracycline during pregnancy and through age 12   True  
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Statement: Tetracycline is safe to take during pregnancy and through the age of 12   False.  
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Dental Stains can be professionally removed through:   polishing abrasives use of curets air polishing with sodium bicarbonate dental whitening  
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Amorphous   Without definite shape or visible differentiation in structure. Describing an object that lacks definite visible shape or form  
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Without definite shape or visible differentiation in structure..   Amorphous  
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Apatite   Crystaline mineral component of bones and teeth that contains calcium and phosphate. an inorganic mineral composed of calcium and phosphate that is found in the bones and teeth  
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Crystaline mineral component of bones and teeth that contains calcium and phosphate. an inorganic mineral composed of calcium and phosphate that is found in the bones and teeth   Apatite  
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Calculus   The term calculus (biological stone or tartar) means an abnormal accretion or concretion composed of mineral salts that may occur in hollow organs or ducts of the body. Examples are gallstones  
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Chromogenic   a microorganism that reacts with the iron in saliva to create a stain on the surface of the teeth. Color of the stain is indicative of the color, or chroma, of the bacteria. E.g., a green stain is caused by bacteria such as Penicillium and Aspergillus.  
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a microorganism that reacts with the iron in saliva to create a stain on the surface of the teeth. Color of the stain is indicative of the color, or chroma, of the bacteria. E.g., a green stain is caused by bacteria such as Penicillium and Aspergillus.   Chromogenic  
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Dental Calculus   DC -hard, mnrzd, tenacious mass, forms on the clnc crowns of natural teeth as well as oral restr materials and dental prostheses. C. is actually minrzd bctrl plaque. C. plays an imprtnt role in combntn with the active bact. plaque in the progrssn of PDZs  
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Endogenous   develop or originate from inside the tooth  
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develop or originate from inside the tooth   Endogenous  
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Exogenous   develop or originate from sources outside the tooth  
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develop or originate from sources outside the tooth   Exogenous  
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Extrinsic   extrinsic: occur on the external surfaces of the tooth – removed by procedures of toothbrushing, scaling and/or polishing  
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occur on the external surfaces of the tooth – removed by procedures of toothbrushing, scaling and/or polishing   Extrinsic  
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Hypoplasia   underdevelopment of an organ or a tissue, usually resulting from the presence of a smaller-than-normal number of cells.  
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underdevelopment of an organ or a tissue, usually resulting from the presence of a smaller-than-normal number of cells.   Hypoplasia  
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  occur within the tooth substance – cannot be removed by scaling or polishing  
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occur within the tooth substance – cannot be removed by scaling or polishing   intrinsic  
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Matrix   Intercellular or intermicrobial substance of a tissue, or the tissue from which a structure develops, gains support, and is held together.  
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Intercellular or intermicrobial substance of a tissue, or the tissue from which a structure develops, gains support, and is held together.   Matrix  
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Mineralization   Addition of mineral elements, such as calcium and phosphorus, to the body or a part thereof with resulting hardening of the tissue.  
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Addition of mineral elements, such as calcium and phosphorus, to the body or a part thereof with resulting hardening of the tissue.   Mineralization  
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Nidus   Nucleus; focus; point of origin.  
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Nucleus; focus; point of origin.   Nidus  
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Pyrophosphate   Inhibitor of calcifictn that occurs in parotid saliva of humans in variable amounts; anticalculus component/active ingredient of mny commerc “tarter-control” dentifrices. compound found in parotid saliva that helps delay calcificatin of bacteria plaque.  
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Inhibitor of calcifictn that occurs in parotid saliva of humans in variable amounts; anticalculus component/active ingredient of mny commerc “tarter-control” dentifrices. compound found in parotid saliva that helps delay calcificatin of bacteria plaque.   Pyrophosphate  
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Lay term for calculus   tartar  
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Term tartar was first introduced in... by...   • The term tartar was introduced to medicine in the 16th century by Paracelsus, a German-Swiss physician. He noted that biological calcified masses resembled potassium bitartrate deposits on the bottom of wine casks (бочка, бочонок).  
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Extrinsic Stains Are Always Exogenous   True  
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Extrinsic Stains can be of endogenous origin.   False. Extrinsic Stains are Always Exogenous.  
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What type of stain is more common in females?   Black Line Stain. Usually occurs in clean mouths.  
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What is the etiology of the yellow stain?   usually food pigments  
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What is etiology of the Green Stain   ...Poor Oral Hygiene...Chromogenic bacteria... gingival hemorrhage (krovotechenie, blood pigments from hemoglobin are decomposed by bacteria).  
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Cinical Characteristic: Green Stain is frequently superimposed by...   materia alba and food debris  
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Statement. Green stain can become an exogenous intrinsic stain   True. Green stain can become embedded in enamel, become an exogenous intrinsic stain.  
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The attachment apparatus consists of the   periodontal ligament, alveolar bone and cementum  
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Statement: Exogenous stains originate outside of the tooth.   True  
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Statement: Endogenous stains originate outside of the tooth.   False  
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Statement: Tetracycline stain is a type of exogenous, intrinsic stain.   False. Tetracycline is an endogenous intrinsic stain.  
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What type of stains are tetracycline stains?   Endogenous Intrinsic Stain.  
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Light calculus formers have higher salivary levels of   parotid pyrophosphate  
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Black line stain is a "calculus-like" stain and is most often found in patients with good personal oral hygiene   True  
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A stain that is located on the outside of the tooth is termed an [a] stain. A stain that originates from a source within the tooth is called an [b] stain.   Extrinsic, endogenous  
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The most common type of extrinsic stain is [a] stain. The etiology of this stain is usually [c].   Yellow Stain. Food Pigments  
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Enamel hypoplasia represents incomplete formation of the enamel due to a disturbance in ameloblast function during the...   during the pre-eruptive apposition and mineralization stages of tooth development  
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A genetic disturbance in ameloblastic activity during tooth formation is termed [a]. This is an [b], [c] type of stain.   Amelogenesis Imperfecta, Endogenous Intrinsic  
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An environmental disturbance in ameloblastic activity during the apposition and mineralization stages of enamel formation is termed (a). This is an ... type of stain   Enamel hypoplasia. Endogenous Intrinsic Stain.  
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Statement: Tooth Color is determined by the color of the dentin. Enamel is translucent.   True  
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What are the main 4 characteristics of the black line stain?   ..highly retentive black or dark brown calculus like stain..forms along ging margin on primary or permanent teeth..more frequently found in females..doesn't cause oral disease.  
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Black Line Stain is not related to poor oral hygiene.   True  
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Black line stain is related to poor oral hygiene.   False  
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Black line stain occurs in clean mouths, with a tendency to have fewer caries.   True.  
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Statement: Tobacco stain could look like a black line stain, but is usually accompanied by large amounts of plaque.   True.  
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What type of stain is black line stain   Extrinsic stain  
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Subgingival plaque forms from the extension of supragingival plaque   True.  
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