Post on 05-Apr-2018
7/31/2019 (RestoDent) Caries
1/17
DENTAL CARIES - WHAT IS THAT?
7/31/2019 (RestoDent) Caries
2/17
DENTAL CARIES IS AN INFECTIOUSMICROBIOLOGIC DISEASE OF THE
TEETH THAT RESULTS IN LOCALIZED
DISSOLUTION & DESTRUCTION OFTHE CALCIFIED TISSUES.
7/31/2019 (RestoDent) Caries
3/17
CAUSATIVE FACTORS RESPONSIBLE FOR THE
DEVELOPMENT OF DENTAL CARIES CAN BE
DIVIDED INTO TWO MAIN GROUPS:
1. Essential factors
a. Bacteria
b. Dietc. Tooth
d. Time
2. Modifying factors
a. Geographic
environment
b. Systemic health
c. Race and sex
d. Heredity
e. Tooth structurecharacteristics
f. Saliva
7/31/2019 (RestoDent) Caries
4/17
bacteria
diet
tooth
time
Geographic
environment
Systemic
health
Race and
sex Heredity
Tooth structure
characteristics
Saliva
caries
7/31/2019 (RestoDent) Caries
5/17
DEVELOPMENT OF DENTAL CARIES DEPENDS
ON FOUR INTERRELATED ESSENTIAL FACTORS:
1. teeth
2. bacteria
3. diet (fermentable carbohydrates; acidic
foods and drinks)
4. time
7/31/2019 (RestoDent) Caries
6/17
1. TEETH (HOST)
Primary host factor but its composition,
morphological characteristics, and locations
influence the caries process
7/31/2019 (RestoDent) Caries
7/17
I. COMPOSITION
Caries susceptibility of
a tooth is inversely
proportional to its
fluorine, calcium andtin contents.
7/31/2019 (RestoDent) Caries
8/17
II. MORPHOLOGICAL CHARACTERISTICS
The areas on the
tooth surface where
the food can stagnate
are considered non
self-cleansable suchas
a. pits and fissures
b. contact areas
c. area of nearapproach
d. gingival embrasures
e. facial or lingual
surfaces apical to the
7/31/2019 (RestoDent) Caries
9/17
Conversely, the areas onthe tooth surface wherethe food is movingcontinuously are
considered self-cleansable. The followingareas on the tooth arerelatively self-cleansable:
a. tips of cusps
b. crest of marginal andcrossing ridges
c. all inclined planes ofcusps and ridges
d. occlusal, incisal, facial and
lingual embrasurese. facial or lingual surfaces
incisal or occlusal to theheight of contour with theexception of pits if present
f. axial angles of teeth.
7/31/2019 (RestoDent) Caries
10/17
III. LOCATIONS
The closer theposterior teeth to theramus (vertical portionof the mandible), thegreater is theprobability of foodaccumulation there,with concomitant
greater difficulty incleansing them.Therefore, they will bemore susceptible to
decay.
7/31/2019 (RestoDent) Caries
11/17
BACTERIA
Dental plaque - a gelatinous mass of bacteria adhering to the toothsurface
Plaque is formed primarily of microorganisms.
Two principal groups of bacteria implicated in dental caries:
1. mutans streptococci
S. mutans & S. sobrinus2. lactobacilli
Mutans Streptococci & lactobacilli acidogenic & aciduric bacteria
Mutans Streptoccoci are strongly associated with the onset of caries
Lactobacilli are associated with active progression of cavitated lesions
Acidogenic acid-producing
Aciduric acid-tolerant
Cariogenic organism that cause caries
Cariogenicity potential degree to which a tooth is like to become carious
7/31/2019 (RestoDent) Caries
12/17
DIET
Three principal changes identified with the shiftfrom low to high caries experience:
First, protective factors are deleted from food
materials during harvesting, processing, storageand/or preparation
Second, cariogenic factors are added to foodmaterials such as sucrose, fructose, lactose and
glucoseThird, the frequency of meals, usually three, withbetween meal snacks
7/31/2019 (RestoDent) Caries
13/17
Carbohydrates are known to be the most cariogenic ofall food materials
Sucrose is the most detrimental, followed by fructose,
lactose, galactose and glucoseWhen considering the relationship of the diet and dentaldecay, the following factors need to be considered:1. Frequency of consumption.
The more frequently one eats or drinks the greater
potential for acid production and the greater thelikelihood of the development of decay.2. Consistency of Foods.
Some foods are cleared more rapidly from themouth than others. Foods that stay around themouth longer have more decay causing potential. Acidic foods and drinks cause the oral environment tobecome acidic. When acidic foods are consumed
frequently, they have the potential to dissolve toothstructures.
7/31/2019 (RestoDent) Caries
14/17
TIME
The time it takes for teeth to decay varies andis influenced by many factors such as:a. areas affected on the teeth
b. position of teeth in the mouthc. the length of time the teeth have been in the
mouth and individual differences.
7/31/2019 (RestoDent) Caries
15/17
A KNOWN SEQUENCE OF EVENTS FOLLOWS THE ORAL INTAKE
OF SUGAR BY A CARIES SUSCEPTIBLE PERSON:
Food taken into the mouth is retained in the area of the
plaque;
The acidogenic bacteria of the plaque reduce the
sugars to acids; The acids in the plaque are in contact with the tooth
surface to which the plaque is attached;
And since tooth enamel is soluble in acid, the enamel
beneath the plaque is slightly dissolved. THIS IS THE BEGINNING OF A CARIES LESION
7/31/2019 (RestoDent) Caries
16/17
1. A tooth surface without caries. 2. The first signs of demineralization, a small "white spot" has
been formed (initial caries, incipient caries). 3. The enamel surface has broken down. 4. A filling has been made, but as can be seen, the
demineralization has not been stopped and the lesion issurrounding the filling.
5. The demineralization proceeds and undermines the tooth. 6. The tooth has fractured - an effect of a process which could
have been stopped at an early stage
1 2 3 4 56
7/31/2019 (RestoDent) Caries
17/17