Dental caries


Related to focal degradation of the tooth structure.

Dental caries is the most common chronic disease in the world. 

Most common cause of tooth loss before the age of 35 years.

In most industrialized countries, tooth decay affects 60–90% of schoolchildren and the vast majority of adults.

In the U.S., minorities and the poor both have higher rates of decayed and missing teeth, and their children have less dental care.

Dental caries is the most common chronic disease of children in US and disproportionately affects the vulnerable and underserved.


The  problem appears to be less in Africa’s developing countries, but is expected to increase in several countries there because of changing diet and inadequate fluoride exposure.

Modern oral microbiota are significantly less diverse than historic populations.


Only a limited set of microbes cause tooth decay, with most of the bacteria in the human mouth being harmless. 


Tooth decay is an infectious disease:  increased within dental plaque of bacteria such as Streptococcus mutans and Lactobacillus. 

These organisms produce organic acids when carbohydrates, especially sugar, are eaten.


When enough acid is produced to lower the pH below 5.5,  the acid dissolves carbonated hydroxyapatite, the main component of tooth enamel, in a process known as demineralization.


Cavities result when the rate of demineralization exceeds the rate of remineralization, typically in a process that requires many months or years.


Caries are caused by bacteria that erode the enamel outside shell of the tooth and the dentin underneath. 

Bacteria builds up on the surface of teeth as plaque which consists of both bacteria as well as food and saliva. 

As the starches in the mouth turn into acid, it dissolves the enamel and forms a pit that gradually grows in size.

Carbonated hydroxyapatite enamel crystal is demineralized by acid in plaque and becomes partly dissolved crystal. 


Demineralized enamel crystal is remineralized by fluoride in plaque to become fluorapatite-like coating on remineralized crystal

The oral microbiome in essential in dental health, as commensal microflora can switch to an opportunistic pathogenic flora.


Early childhood caries, defined as the decay in the primary dentition of children six years of age or younger, and may be present in up to 50% of children.

Caries, have become a major endemic disease, affecting 60-90% of schoolchildren in industrialized countries.


When tooth decay is small, patients may be asymptomatic, but as the decay grows the tooth may become sensitive.

Caries can be prevented by brushing and flossing daily as well as using antibacterial mouthwash in order to reduce the amount of bacteria in the mouth. 


Once a cavity occurs, the tooth will require repeated restorations, with estimates for the median life of an amalgam tooth filling ranging from 9 to 14 years.


Over 80% of cavities occur inside fissures in teeth where brushing cannot reach food left trapped after eating and saliva and fluoride have no access to neutralize acid and remineralize demineralized teeth, unlike easy-to-clean parts of the tooth, where fewer cavities occur.


In these fissures saliva and fluoride have no access to neutralize acid and remineralize demineralized teeth, unlike easy-to-clean parts of the tooth, where fewer cavities occur.


A cavity starts in a tooth’s outer enamel and spreads to the dentin and pulp inside.


Affected teeth generally are tender to percussion and temperature.


Teeth cleaning is the removal of dental plaque and tartar from teeth to prevent cavities, gingivitis, gum disease, and tooth decay. 

Between cleanings by a dental hygienist, good oral hygiene is essential for preventing tartar build-up which causes problems, and it is done through  frequent brushing with a toothbrush, combined with the use of dental floss or interdental brushes to prevent accumulation of plaque on the teeth.


Powered toothbrushes reduce dental plaque and gingivitis more than manual toothbrushing in both short and long term.

Early childhood caries is more prevalent in lower socioeconomic groups.

Tooth decay is one of the most prevalent chronic diseases worldwide.


Although it is rarely life-threatening, tooth decay can cause pain and impair eating, speaking, facial appearance, and acceptance into society,and it greatly affects the quality of life of children, particularly those of low socioeconomic status.

Children with severe early childhood carries have lower hemoglobin and ferritin levels than children without such problems.

Are the result of dissolution of mineral tooth structure by acid metabolic end products of oral bacteria capable of fermenting sugar.

Sugar is the most important dietary factor in the development of dental caries: the incidence of caries is lower when sugar intake is less than 10% of total energy consumed.

Rate is highest in industrialized countries where processed foods with high carbohydrate content is readily available.

Rate has dropped secondary to improved oral hygiene and the use of fluoridation in drinking water.

Fluoride enters the crystalline structure of enamel with the formation of fluoroapatite, which resists bacterial acid degradation.


The decline in caries in certain segments of the world is due to the addition of fluoride to public drinking water. 

Dental sealants, cover and protect fissures and grooves in the chewing surfaces of back teeth, preventing food from becoming trapped and thereby halt the decay process. 


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