Dental caries

Dental caries

Copyright © 2005 by Elsevier Inc. All rights reserved.

“The mouth is the gateway to the rest of the body, a mirror of our overall well-being.”

Harold C. Slavkin, D.D.S.

•Dental caries is defined as a progressive

irreversible multifactorial in nature

affecting the calcified tissues of teeth,

characterized by demineralization of the

inorganic portion and destruction of the

organic portion of the tooth- soben peter

The Caries Process•For caries to develop, three factors

must occur at the same time:

▫A susceptible tooth

▫Diet rich in fermentable carbohydrates

▫Specific bacteria (regardless of other

factors, caries cannot occur without

bacteria)

Diet and dental caries


Dental Caries: A Bacterial Infection

• There are two specific groups of bacteria found in the mouth that are responsible for dental caries:

▫Mutans streptococci (Streptococcus mutans)

▫Lactobacilli

• They are found in relatively large numbers in the dental plaque.

• The presence of lactobacilli in the mouth indicates a high sugar intake.

s. mutans

lactobacillus


Dental Plaque•Dental plaque is a colorless, soft, sticky

coating that adheres to the teeth.

•Plaque remains attached to the tooth despite

movements of the tongue, water rinsing,

water spray, or less than thorough brushing.

•Formation of plaque on a tooth concentrates

millions of microorganisms on that tooth.


Fig. 13-1 Dental plaque made visible with disclosing agent

Copyright © 2005 by Elsevier Inc. All rights reserved.The Role of Saliva

• Physical protection provides a cleansing effect. Thick, or viscous, saliva is less effective than a more watery saliva in clearing carbohydrates.

• Chemical protection contains calcium, phosphate, and fluoride. It keeps calcium there ready to be used during remineralization. It includes buffers, bicarbonate, phosphate, and small proteins that neutralize the acids after we ingest fermentable carbohydrates.

• Antibacterial substances in saliva work against the bacteria.

• If salivary function is reduced for any reason, such as from illness or medications or due to radiation therapy, the teeth are at increased risk for decay.


Fig. 13-2 Dental caries

Pit and fissure caries

Proximal caries

Progression of caries

Clinical cases

Copyright © 2005 by Elsevier Inc. All rights reserved.Fig. 13-4 A, The earliest sign of decay is

decalcification (Courtesy Dr. John Featherstone, University of California, San Francisco, School of Dentistry.)


Fig. 13-5 Severely decayed molar on a child


Fig. 13-7 Root caries –senile caries(Courtesy Dr. John Featherstone, University of California, San Francisco, School of Dentistry.)

Role of vitamins

Brushing techniques

Take home points• 1. eat a balanced diet- whole grains, fruits and

vegetables and practice good oral hygiene• 2. use fluoridated tooth paste• 3. eat a combination of foods to reduce risk of

caries and erosion-dairy products with fermentable carbohydrates instead of sugars

• 4.Consume these foods with instead of between meals

• 5.Raw vegetables increase salivary flow• 6. drink sweetened and acidic beverages with

meals• 7. rinse mouth with water and chew sugarless

chewing gum- remineralization

• 8. chew sugarless gum between meals and snacks to increase salivary flow

• 9. drink rarther sip, sweetened and acidic beverages

• 10. moderate eating frequency• 11. avoifd putting infant or child to bed with

bottle of milk, juice or sugar containing beverage

Dental caries

Health & Medicine

dental caries

risk of caries

caries process

dental plaque dental

fluoridated tooth

formation of plaque

susceptible tooth diet

tooth soben peter