Friday, 26 August 2011


Dental caries

 Dental caries, also known as tooth decay or Dental cavity is a disease where bacterial processes change carbohydrate like sugar in food left on teeth to acid that demineralises hard tooth structure.
Two groups of bacteria are responsible for initiating caries: Streptococcus mutans and Lactobacillus. If left untreated, the disease can lead to pain, tooth loss and infection. Today, caries remains one of the most common diseases throughout the world. Cariology is the study of dental caries.


Dental caries is the multifactorial disease.

Listed here are 4 primary criteria required for caries development: the tooth surface (teeth enamel or dentin).There must be carious susceptible tooth structure like the tooth having heavy pits as well as fissures; caries-causing Bacteria such as streptococcus mutants; food particles, fermentable carbohydrates (such as sucrose); as well as time. In  the event that each one of these elements can be found then the teeth will get carious. The microorganisms may ferment the meals contaminants and produce acid. This particular acid will cause the actual dissolution and also the damage to the teeth surface leading to caries. These microorganisms combined with the food particles along with other tissue additionally form the oral plaque buildup which sticks to the tooth surface causing other dental care issues such as gum diseases. It is also the actual causative factor for caries The actual caries process does not have an unavoidable end result, and different people will be susceptible to various levels depending on the shape of their own tooth, dental hygiene routines, and also the buffing capacity of the saliva. Dental caries can occur on any surface area of a tooth that is exposed to the oral cavity, although not the actual structures which are retained within the bone are affected. Just about all caries occurs from acid demineralisation which exceeds saliva and fluoride remineralisation, and just about all acid demineralisation occurs exactly where a meal (containing carb such as sugar) remains on teeth. Though most caught food is remaining in between tooth, more than 80% of cavities occur inside pits and fissures on chewing surfaces where brushing, fluoride, and saliva cannot reach to re mineralise tooth like on easy-to-reach surfaces that develop few cavities. Fissure sealants positioned in chewing surface , block food particles to becoming caught as well as stop the actual caries process. Extracted teeth - where sealants were forced within pits and fissures under eating pressure and then the teeth dissolved in acid-- eaves the actual sealant as an impact associated with how deep food is pressured below eating stress as well as signifies the opportunity of better tooth brush style to force fluoride tooth paste within pits as well as fissures prior to cleaning to remineralise demineralised teeth like on easy to reach areas exactly where few cavities happen.
Sign & symptoms
An individual experiencing caries may not be aware about the condition. The earliest sign of a new carious lesion is the appearance of a chalky white spot on the surface of the tooth, suggesting an area of demineralization of tooth enamel. This is referred to as incipient decay.Since the lesion continues to demineralize, it can change brown but will ultimately turn into a "cavity". Before the cavity forms, the process is reversible, but when the cavity forms,the lost tooth structure can not be regenerated.Any lesion that looks brown and also shiny indicates dental caries were once present however that demineralization process has ceased, leaving the stain. The brown spot that is dull in appearance is possibly a sign of active caries.Since the enamel and dentin are destroyed the cavity gets to be more noticeable.The actual affected regions of the tooth alter colour and become soft to touch. When the decay travels through enamel, the dentinal tubules,which have passages to the nerve associated with the tooth,turn out to be exposed and results in pain in the tooth. The pain may worsen with exposure to heat, cold, or even sweet foods and drinks.

For the quite small lesions, topical fluoride is usually preferred. For larger lesions, a dental hand piece ("drill") is used to clear away large portions of decayed material from the tooth. A spoon excavator, a dental instrument can be used to remove decay properly and after that filled with a restorative material. Restorative materials include dental amalgam, composite resin, GIC.Now a day’s use of amalgam is definitely reduced because of its colour. Both composite and GIC are tooth coloured restorative material. When the decay is too extensive, there might not adequate tooth structure remaining to allow any restorative material for being placed with in the tooth, then a crown also referred to as cap is used. In some cases, when caries have reached pulp, endodontic treatment may be necessary for the restoration of a tooth. Endodontic therapy, also called as  "root canal". In some cases extraction is recommended if the tooth is far destroyed from the decay process to effectively restoration the tooth.
Oral hygiene
  1. Personal hygiene care consists of proper brushing and flossing daily. The objective of oral cleanliness is to minimize any etiologic agent associated with disease inside the mouth. The main focus of brushing and flossing is to remove and prevent the formation of plaque. Plaque consists of bacteria. As the quantity of bacterial plaque increases, the tooth is more vulnerable to dental caries when carbohydrate in the food is left on teeth after every meal or snack. A toothbrush enables you to remove plaque on accessible areas, but not between teeth or inside of pits and fissures on chewing surfaces. When used properly, dental floss removes plaque from locations which might otherwise develop proximal caries. Additional adjunct hygiene aids include interdental brushes, water picks, and also mouthwashes.
  2. Nibbling Dietary fibres like celery after eating forces saliva inside the trapped food to dilute any kind of carbohydrates such as sugar-neutralise acid and re mineralise demineralize tooth( the teeth which are at higher risk are 1st & 2nd molars). Rinsing the mouth with water after eating anything greatly reduces the risk of caries.
  3. Professional hygiene care includes- regular dental examination and cleanings (oral prophylaxis). Occasionally, complete plaque removal becomes tough, and a dentist may be needed. Together with maintenance of oral hygiene sometimes radio graphs may be needed, for identification of dental caries at risk site

Dietary modification
Frequency of sugar consumption is much more significant than the actual amount of sugar eaten. In the presence of sugar and other carbohydrates, bacteria in the mouth generate acids which can demineralize teeth enamel, dentin, as well as cementum. The more frequently teeth are exposed to this particular environment, the much more likely dental caries are to occur. Therefore, reducing snacking is recommended, since snacking creates a continuous supply of nutrition for acid-creating bacteria within the mouth. Furthermore, chewy as well as sticky foods (such as dried fruit or candies, cookies, chocolates)tend to adhere  to teeth longer, and there fore, best eaten as part of a meal or simply prior to meals. Brushing the teeth after meals is actually suggested. For children limiting the frequency of consumption  of drinks with sugar, and not giving baby bottles to infants during sleep is advised. Mothers are also recommended to avoid sharing utensils as well as cups with their babies to prevent transferring germs from the mother's mouth.
It has been discovered that milk and certain kinds of cheese such as Cheddar can help counter tooth decay if consumed soon after the consumption of meals potentially harmful to teeth. chewing gum containing xylitol (a sugar alcohol) is widely used to protect teeth. Xylitol's effect on decreasing plaque is probably because of bacteria's inability to utilize it like other sugars.Chewing and stimulation of flavour receptors on the tongue are also known to increase the production and release of saliva, which contains natural buffers to prevent the lowering of pH in the mouth to the point exactly where enamel may become demineralised.
Other Preventive measures
Dental caries
  1. The use of dental sealants is a means of prevention of dental caries . A sealant is a thin plastic-like coating applied to the chewing surfaces of the molars. This coating prevents food being trapped inside pits and fissures in grooves.Sealants are usually applied on the teeth of children, shortly after the molars erupt.
  2. Calcium found in food such as milk and green vegetables, are often recommended to protect against dental caries. It has been demonstrated that calcium and fluoride supplements decrease the incidence of dental caries. Fluoride helps prevent decay of a tooth by binding to the hydroxyapatite crystals in enamel. The incorporated calcium makes enamel more resistant to demineralization and, thus, resistant to decay.
  3. Application of Topical fluoride is also recommended to protect the surface of the teeth. This may include a fluoride toothpaste or mouthwash. Many dentists include application of topical fluoride solutions as part of routine visits.
  4. Furthermore, recent research shows that low intensity laser radiation of argon ion lasers may prevent the susceptibility for enamel caries and white spot lesions.
  5. There is currently research to find a vaccine for dental caries.


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