5the major virulence factors of S.mutans acid production (acidogenicity)acid tolerance (aciduricity)intracellular polysaccharide synthesis (storage of carbohydrates)extracellular polysaccharide synthesis (increases adhesion)ability to adhere to other bacteria and tooth surface
17Demineralization Remineralization when sugar present demin. rapidly occursbetween sugar episods remin. slowly occursif remin. periods exceeds demin. periods subsurface lesion will mineralizeif demin. periods exceed remin. cavitation will occurdemin. periods exceed remin. periods when sugar is frequent or prolonged
18Histology of incipient caries light microscopepolarized light microscopesurface zonebody of the lesiondark zonetranslucent zone
19Diagnostic methods Clinical-visual method Alternativ Sharp eyes and magnificationAlternativX-raysFOTI, QLFLaserfluorescenceECM, electrical impedance measurementUltrasonic caries detector
20Clinical characteristics of incipient lesion Colour (white, brown)Opacity, translucencysurface texturesurface hardness! Fragile surface layer,damage from probing!
21Common sites of occurence Cervical third of a toothPits and fissuresVestibular tooth surfaces after orthodontic treatment with multibonded appliancesCervical margins (in patients with prosthodontic restorations)
25Diet management Reduce number, duration and intensity of acid attacks reduce or eliminate sucrose from meals, eliminate from between-meal snacksconsume all sweets in one episod preferably following a meal
26Effects of fluorideEnhances the remineralization (precipitation into tooth structures)more acid resistant enamelantimicrobal activity