dental caries
TRANSCRIPT
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)
Copyright © 2005 by Elsevier Inc. All rights reserved.
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.
Copyright © 2005 by Elsevier Inc. All rights reserved.
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.
Copyright © 2005 by Elsevier Inc. All rights reserved.
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.
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.)
Copyright © 2005 by Elsevier Inc. All rights reserved.
Fig. 13-7 Root caries –senile caries(Courtesy Dr. John Featherstone, University of California, San Francisco, School of Dentistry.)
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