Glycolysis and pyruvate metabolism
Why this matters
This is the pathway that makes caries. Plaque bacteria run the same ten reactions you do, and the acid that dissolves enamel is their waste product. It also explains why your local anaesthetic fails in an abscess, why a patient on a sugary sipped drink is worse off than one who eats the same sugar at a meal, and why giving glucose before thiamine to a malnourished patient can cause permanent harm.
The big picture
Ten reactions split a six-carbon sugar into two three-carbon pieces, capture a little energy as ATP, and leave pyruvate. What happens to that pyruvate — and to the NADH made along the way — decides everything downstream: your muscles, your gut flora, and the pH of the plaque sitting on a tooth.
Two in, four out, net two — and the reason bacteria keep going is not the ATP but the NAD+ they get back when they dump the electrons onto pyruvate.
The 14 cards in this lesson
- 01The pathway you share with the plaque
- 02The ledger: two in, four out
- 03How an oxidation becomes an ATP
- 04Three one-way gates
- 05There is no single rate-limiting step
- 06Hexokinase and glucokinase
- 07The molecule that lets hormones steer glycolysis
- 08Fermentation is not about energy
- 09Lactate, not lactic acid
- 10Pyruvate at the crossroads
- 11Clinical alert — in the lesson
- 12How plaque turns sugar into acid
- 13Why the acid gets stronger, not just more plentiful
- 14Clinical alert — in the lesson
You have got it when
You are ready to continue when you can produce the ATP ledger from memory, explain why cells make lactate rather than lactic acid, and say why a feast of sugar produces a deeper pH fall than a trickle of it.
14 references, graded by tier: 1 tier-1 · 10 tier-2 · 3 tier-4 · sources last checked 2026-07-30
The full lesson entry includes
- All 14 teaching cards, each opening at Quick and expanding into Learn and Deep
- 5 final-challenge questions with worked rationales, and a micro-check on every card
- The 10-prompt recall deck, scheduled today, +1, +3, +7 and +21 days
- The misconceptions students actually hold, each with its correction
- All 14 references, tiered and annotated
More preclinical curriculum
Dentalverse's preclinical curriculum is independent study material written by a dentist. It is not accredited by any body, is not affiliated with any dental school, and is a supplement to a formal course rather than a substitute for one.
Dentalverse is an educational resource for dental students and dentists. This page is a study reference — it is not medical advice and does not replace clinical judgment. Always follow your institution's protocols and your supervisor's guidance.