(RestoDent) Caries

7/31/2019 (RestoDent) Caries

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DENTAL CARIES - WHAT IS THAT?


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DENTAL CARIES IS AN INFECTIOUSMICROBIOLOGIC DISEASE OF THE

TEETH THAT RESULTS IN LOCALIZED

DISSOLUTION & DESTRUCTION OFTHE CALCIFIED TISSUES.


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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


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bacteria

diet

tooth

time

Geographic

environment

Systemic

health

Race and

sex Heredity

Tooth structure

characteristics

Saliva

caries


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DEVELOPMENT OF DENTAL CARIES DEPENDS

ON FOUR INTERRELATED ESSENTIAL FACTORS:

1. teeth

2. bacteria

3. diet (fermentable carbohydrates; acidic

foods and drinks)

4. time


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1. TEETH (HOST)

Primary host factor but its composition,

morphological characteristics, and locations

influence the caries process


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I. COMPOSITION

Caries susceptibility of

a tooth is inversely

proportional to its

fluorine, calcium andtin contents.


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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


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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.


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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.


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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


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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


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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.


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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.


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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


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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

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