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Cappelli: Prevention in Clinical Oral Health Care
Test Bank
Chapter 1: Epidemiology/Biology of Dental Caries
MULTIPLE CHOICE
1. The factors that are the cause of dental caries are grouped into all but which of the
following categories?
a. age
c. microorganism
b. host susceptibility
d. substrate
ANS: A
Correct: Although a person's age may be correlated to their risk of developing caries, it
is not a direct causal factor for caries.
Incorrect: Host susceptibility, microorganism, and substrate represent the categories
of causal factors that must intersect over a defined period of time for caries to occur.
REF: 2
OBJ: Caries Epidemiology
2. Which of the following primary processes predominate when pathological factors
outweigh the preventive factors?
a. cavitation
c. demineralization
b. remineralization
d. restoration
ANS: C
Correct: Once preventive measures are no longer adequate, the pathogenesis of caries
can begin with the primary stage known as demineralization.
Incorrect: Cavitation is the progression of caries past the demineralization stage;
remineralization can occur when preventive factors supersede pathological factors;
and restoration is the surgical repair of a carious lesion and is not related to this
question.
REF: 3
OBJ: Caries Epidemiology
3. Which of the following primary processes predominate when preventive factors
outweigh the pathological factors?
a. cavitation
c. demineralization
b. remineralization
d. restoration
ANS: B
Correct: If preventive factors outweigh pathological factors, remineralization of an
incipient carious lesion can occur, thereby reversing the pathological condition.
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Incorrect: Cavitation is the progression of caries past the demineralization stage;
demineralization can occur when pathological factors supersede preventive factors;
and restoration is the surgical repair of a carious lesion and is not related to this
question.
REF: 3
OBJ: Caries Epidemiology
4. Which of the following is not considered a pathological factor related to caries?
a. fermentable carbohydrates
c. increase in salivary flow
b. decrease in salivary flow
d. increase in oral pathogens
ANS: C
Correct: Increase in salivary flow is actually a preventive factor for caries.
Incorrect: Fermentable carbohydrates, decrease in salivary flow, and increase in oral
pathogens can contribute to the progression of caries.
REF: 3
OBJ: Caries Epidemiology
5. An adequate salivary flow rate is known as a caries preventive factor because of all of
the following features except:
a. it aids in the formation of a bolus of food
b. it aids the mechanical cleansing of the oral cavity
c. it serves as a buffer against acid by-products or oral pathogens
d. it facilitates the host response to pathogenic microorganisms in dental plaque
ANS: A
Correct: Although an adequate flow of saliva does serve to aid in the formation of a
bolus of food, this feature does not directly help to prevent caries.
Incorrect: Answers b, c, and d are primary preventive features of saliva that inhibit
caries formation.
REF: 3
OBJ: Caries Epidemiology
6. The cycle of demineralization-remineralization is affected by which of the following?
a. cariogenic bacteria
d. all of the above
b. plaque control
e. none of the above
c. fluoride exposure
ANS: D
Correct: Cariogenic bacteria, plaque control, and fluoride exposure play a role in the
delicate balance between demineralization and remineralization.
Incorrect: See rationale for correct response.
REF: 3 | 4
OBJ: Caries Epidemiology
7. Which of the following is not traditionally recognized as one of the types of surfaces
used to define caries?
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a. irregular surface caries
c. smooth surface lesions
b. pit and fissure caries
d. root caries
ANS: A
Correct: Irregular surface is not used to describe any tooth surface, let alone a surface
prone to caries.
Incorrect: Pit and fissure, smooth surface lesions, approximal lesions, and root caries
are the four traditionally recognized surface types to define dental caries.
REF: 5
OBJ: Types of Caries
8. Pit and fissure caries can occur in which locations?
a. incisal edges of maxillary and mandibular incisors
b. lingual surfaces of maxillary incisors
c. buccal surfaces of maxillary molars
d. lingual surfaces of mandibular molars
ANS: B
Correct: The lingual surfaces of maxillary incisors often have a lingual pit that is
prone to caries.
Incorrect: All other choices represent smooth surfaces of the teeth described.
REF: 5
OBJ: Types of Caries
9. Which of the following surfaces is most susceptible to caries formation?
a. pit and fissures
c. root surfaces
b. smooth surfaces
d. approximal surfaces
ANS: C
Correct: Normally, root surfaces are protected by the gingival attachment. As the
gingiva moves apically, as in periodontal disease, the outer layer of the root, the
cementum, is exposed and is highly susceptible to caries.
Incorrect: All of these surfaces are prone to caries at varying levels. However, pit and
fissures, smooth surfaces, and approximal surfaces are covered by enamel and are thus
more resistant to caries.
REF: 5
OBJ: Types of Caries
10. Which of the following is the predominate index used today to measure caries
experience, worldwide?
a. American Dental Association, ADA
b. Basic Screening Survey, BSS
c. World Health Organization, WHO
d. Decayed, Missing, and Filled Teeth (DMFT) Index
ANS: D
Correct: The DMFT is the sum of an individual's decayed, missing, and filled surfaces
and, therefore, measures one's caries experience.
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Incorrect: The ADA is a professional organization which represents the dental
profession, the BSS is a method of collecting oral health information developed by the
Association of State and Territorial Dental Directors to standardize surveillance in the
U.S., and the World Health Organization (WHO) is the United Nations specialized
agency for health.
REF: 5
OBJ: Coronal Caries
11. Early childhood caries (ECC) occurs in which teeth?
a. the primary dentition
b. newly erupting permanent molars in children
c. newly erupting permanent incisors in children
d. early childhood caries is not a recognized type of caries
ANS: A
Correct: ECC is defined by its age and disease presentation in the primary dentition
only.
Incorrect: ECC, by definition, does not occur in permanent teeth. ECC is a recognized
type of caries.
REF: 6
OBJ: Early Childhood Caries
12. Root caries formation tends to begin where?
a. the coronal pit and fissures
b. the apical aspect of the root surface
c. at or below the cemento-enamel junction, CEJ
d. approximal coronal surfaces
ANS: C
Correct: Normally, root surfaces are protected by the gingival attachment. As the
gingiva moves apically, as in periodontal disease, the CEJ is exposed, and root caries
can form.
Incorrect: No coronal surface can be the origin of root caries, by definition. The apical
aspect of the root is always covered by the periodontal ligament and the alveolar bone,
except in extreme cases of periodontal disease.
REF: 6
OBJ: Root Caries
13. Causes of gingival recession include all but which of the following?
a. calculus
c. toothbrush trauma
b. occlusal trauma
d. root caries
ANS: D
Correct: Root caries can potentially occur as a result of gingival recession. It is
impossible for root caries to precede, and therefore be a cause for, gingival recession.
Incorrect: All of the other choices are potential causes of gingival recession.
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REF: 7
OBJ: Root Caries
14. Risk factors and indicators for dental caries can be categorized into which of the
following?
a. nonmodifiable factors (i.e., age, gender, race, etc.)
b. controllable factors (i.e., lifestyle)
c. environmental factors (i.e., fluoridation of community water)
d. a and c
e. a, b, and c
ANS: E
Correct: All of these categories are used to identify risk factors and indicators.
REF: 7
OBJ: Definitions of Risk
15. Which geographic region of the United States has the highest caries prevalence?
a. Northeast
b. West
c. South
d. the regional variation is approximately the same throughout the country
ANS: A
Correct: The Northeast has been shown to have a significantly higher caries burden
than other U.S. regions.
Incorrect: See correct rationale.
REF: 8
OBJ: Geographic Variation
16. Which of the following factors is not considered contributory to the increasing
incidence of caries in the elderly?
a. xerostomia secondary to polypharmacy
b. natural deterioration of the dentition
c. decrease in motor skills
d. adverse dietary changes
ANS: B
Correct: If proper preventive strategies are employed throughout one's life, natural
deterioration does not occur in the dentition. The other factors associated with
advancing age, however, can lead to carious deterioration of the dentition.
Incorrect: While aging alone does not increase the risk for future caries, factors
associated with aging can have a profound effect on caries risk status.
REF: 8 | 9
OBJ: Sociodemographic Factors
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